Florida’s Medicaid regions are nine geographic zones, labeled A through I, that the Agency for Health Care Administration (AHCA) uses to run the Statewide Medicaid Managed Care (SMMC) program. Your county decides your region, and your region decides which managed care plans you can choose from.1Florida Senate. Florida Code 409.966 – Statewide Managed Care Program
The Nine Regions and Their Counties
Find your county in the list below to identify your region.1Florida Senate. Florida Code 409.966 – Statewide Managed Care Program
- Region A — Panhandle and Big Bend: Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa Rosa, Taylor, Wakulla, Walton, and Washington.
- Region B — North Central and First Coast: Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Nassau, Putnam, St. Johns, Sumter, Suwannee, Union, and Volusia.
- Region C — Tampa Bay West: Pasco and Pinellas.
- Region D — Tampa Bay East and Heartland: Hardee, Highlands, Hillsborough, Manatee, and Polk.
- Region E — Central Florida: Brevard, Orange, Osceola, and Seminole.
- Region F — Southwest Florida: Charlotte, Collier, DeSoto, Glades, Hendry, Lee, and Sarasota.
- Region G — Treasure Coast and Palm Beach: Indian River, Martin, Okeechobee, Palm Beach, and St. Lucie.
- Region H — Broward: Broward.
- Region I — South Florida: Miami-Dade and Monroe.
Older AHCA materials sometimes still list 11 regions numbered 1 through 11. The current statutory map uses the nine lettered regions above; some of the former regions were consolidated when the system was redrawn, though the underlying county assignments are largely the same.
Why Your Region Matters
Nearly all Florida Medicaid recipients must enroll in a managed care plan rather than get services through traditional fee-for-service Medicaid.2Medicaid.gov. Managed Care in Florida AHCA contracts a limited number of plans to serve each region, so only plans operating in your region appear as options when you enroll. A plan available in Region E (Central Florida) will not show up for someone living in Region A (Panhandle). More populated regions typically have more plans competing for enrollees.
The SMMC program has three components, and plan availability is set region by region for each one.3Florida Statewide Medicaid Managed Care. Health Plans and Program
- Managed Medical Assistance (MMA): doctor visits, hospital care, prescriptions, mental health, and transportation to medical appointments. Most enrollees are in an MMA plan.
- Long-Term Care (LTC): nursing facility care, assisted living, and home-based long-term services. Enrollees must be at least 18 and meet a nursing-home level of care.
- Dental: a prepaid dental plan, required for both children and adults.
Each contracted plan must build a provider network within its region that meets AHCA’s access standards, including enough primary care, specialty, and behavioral health providers to serve enrollees.4Online Sunshine. Florida Code 409.967 – Managed Care Plan Accountability That is why your region shapes not just your list of plans but which doctors and hospitals you can see in-network.
Specialty Plans That Cross Regions
A few plans serve specific populations statewide and are not limited by region. The Children’s Medical Services Network (CMSN) plan, run by the Department of Health, is available to children under 21 with chronic conditions or special healthcare needs anywhere in Florida.5Agency for Health Care Administration. Children’s Medical Services Network Plan A separate Child Welfare Specialty plan serves children in the care of the Department of Children and Families. If you qualify for a specialty plan based on a diagnosis or circumstance, the state may assign you to it automatically regardless of your region.
Picking a Plan in Your Region
New Medicaid recipients have 30 days after receiving their enrollment packet to pick a plan from the ones available in their region.6Online Sunshine. Florida Code 409.969 – Enrollment and Disenrollment After enrolling, you get another 90 days to switch to a different plan in your region without needing a reason. Once that window closes, you are locked into your plan for the rest of a 12-month enrollment period. At the end of 12 months, you can choose again.
If you let the 30 days pass without selecting, AHCA auto-assigns you. The algorithm looks at whether the plan’s network includes providers you already see, how close those providers are, and whether the plan has capacity for new enrollees.7Agency for Health Care Administration. Florida Medicaid Managed Care Auto-Assignment Methodology Plans that fall below AHCA’s performance standards are excluded from auto-assignment. Auto-assignment is not a bad outcome, but the algorithm cannot know which doctors you prefer or whether a given plan’s formulary covers your medications. Choosing yourself during the 30-day window keeps that control.
Moving to a New County or Region
Update your address with AHCA as soon as you move. If your move crosses a region boundary, the plan you are currently enrolled in may not operate in your new area, and you will have to pick from the plans available in your new region. Even a move within the same region can change which in-network providers are reasonably close to you, so review your plan’s network after any relocation.
Getting Help Finding Your Region
The SMMC website at flmedicaidmanagedcare.com lets you look up available plans by county or zip code and shows every MMA, LTC, and dental plan contracted for your area. For one-on-one help, Florida’s Medicaid Choice Counselors can be reached at 1-877-711-3662 (TDD: 1-866-467-4970).8Florida Statewide Medicaid Managed Care. Statewide Medicaid Managed Care Long-Term Care Services Brochure They can walk you through your options, explain coverage differences, and complete your enrollment, and you can also arrange to meet with one in person. Under federal rules, these counselors must be independent and cannot steer you toward any particular plan.9eCFR. 42 CFR 438.71 – Beneficiary Support System