Important Dental Plan News from the Agency for Health Care Administration (AHCA)

All iBudget Florida customers will be required to use a dental plan as part of the
Statewide Medicaid Managed Care (SMMC) program. Nearly all iBudget recipients will no longer receive dental services through iBudget and must enroll through the State Plan program in an SMMC dental plan.

Please note that iBudget customers do not need to enroll in a medical plan because they are receiving those services through iBudget. iBudget is a fee-for-service program and recipients are not required to enroll in AHCA’s managed care health plans.

The Agency for Health Care Administration has re-procured health plans for the SMMC program. These plans will provide medical, behavioral health, and long-term care services. AHCA also competitively selected dental managed care plans to provide dental services for adults and children. Most Medicaid recipients will receive all their Medicaid services through the SMMC program. Recipients will enroll in one plan for their medical, behavioral, and long-term care services and a second plan for their dental services.

The new contracts contain major program improvements that will greatly benefit recipients and providers. Some of the most noteworthy benefits include:

Recipients

Double the primary care providers in each network
Guaranteed access to afterhours care and, where available, telemedicine
Higher standards and accountability for transportation services
More than 55 expanded benefits offered by health plans and extensive adult dental benefits offered by dental plans
Smoother process for complaints, grievances, and appeals

Providers

More pediatric physicians participating in the Medicaid Physician Incentive Program, which pays providers at the Medicare rate
Plans will complete credentialing of providers seeking to join a plan’s network in 60 days
Prompt authorization of services
Smoother process for complaints, grievances, and appeals

AHCA will transition to the new contracts through a regional phased rollout. During this transition, enrollees and new recipients will receive letters with specific enrollment information and needed action approximately 45 days prior to each phase going live. Below is when AHCA will transition to the new contracts and when letters will begin mailing for each Medicaid region.

Phase	Transition Date	Recipient Letter Date	Region	Counties
1	12/01/18	Mid-October	9	Indian River, Martin, Okeechobee, Palm Beach, St. Lucie
			10	Broward
			11	Miami-Dade, Monroe
2	01/01/19	Mid-November	5	Pasco, Pinellas
			6	Hardee, Highlands, Hillsborough, Manatee, Polk
			7	Brevard, Orange, Osceola, Seminole
			8	Charlotte, Collier, DeSoto, Glades, Hendry, Lee, Sarasota
3	02/01/19	Mid-December	1	Escambia, Okaloosa, Santa Rosa, Walton
			2	Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, Washington
			3	Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, Union
			4	Baker, Clay, Duval, Flagler, Nassau, St. Johns, Volusia

Below are links to resources about changes to the SMMC program that may be useful:

For more information, call 1-877-711-3662 (TTY 1-866-467-4970) or visit FLMedicaidManagedCare.com.