Florida delivers most Medicaid coverage through Statewide Medicaid Managed Care (SMMC), reorganized as SMMC 3.0 into 9 lettered regions (A through I) effective February 1, 2025. Per CMS's most recent managed care enrollment data, report year 2024, Florida's comprehensive Medicaid managed care plans covered approximately 3.05 million members, predating the SMMC 3.0 regional realignment. Eight managed care organizations currently hold SMMC contracts, four of which also hold comprehensive long-term-care contracts across all 9 regions.
Florida delivers most Medicaid coverage through Statewide Medicaid Managed Care (SMMC), reorganized as SMMC 3.0 effective February 1, 2025 into 9 lettered regions (A through I), with contracts running through 2030. Eight managed care organizations currently hold SMMC contracts: Florida Community Care, Humana, Simply Healthcare Plans (Elevance), Community Care Plan, Sunshine State Health Plan (Centene), Aetna Better Health of Florida (CVS), Molina Healthcare of Florida, and UnitedHealthcare of Florida. Four of these plans (Humana, Sunshine State Health Plan, Simply Healthcare, and Florida Community Care) hold comprehensive long-term-care contracts across all 9 regions. Per CMS's most recent managed care enrollment data, report year 2024 (predating the SMMC 3.0 regional realignment), Florida's comprehensive Medicaid managed care plans covered 2,702,638 members in the 7 MMA+LTSS plans plus another 348,162 in specialty MMA-only plans, for a combined 3,050,800.
Long-term services and supports are integrated directly into the comprehensive managed care contracts ("MMA+LTSS") rather than carved out to a separate LTSS-only plan or vendor. LTSS enrollment is reported as part of the same comprehensive plans as physical and behavioral health, not as a separate program line.
Integrated into managed care
Behavioral health is included within each Managed Medical Assistance (MMA) plan's comprehensive capitated benefit alongside medical, hospital, and specialty services, not carved out to a separate statewide vendor. Behavior Analysis (BA) services specifically were the one exception until SMMC 3.0: effective February 1, 2025, BA services for children under 21 moved from a fee-for-service-only delivery model into the MMA plans for the first time, ending the prior carve-out and requiring recipients to use an in-network BA provider with prior authorization routed through their plan rather than through the state's separate FFS utilization management vendor.
Carved in
Dental coverage is delivered through three statewide dental-only prepaid ambulatory health plans (PAHPs) on a choice basis, separate from the comprehensive MMA plans. All three operate statewide with a combined 2024 enrollment (3,091,795) larger than the comprehensive MMA+LTSS population, since dental PAHP enrollment covers both MMA and LTSS members plus additional populations. Effective October 1, 2025, SMMC dental coverage was expanded to include non-emergency dental services delivered in ambulatory surgical center and outpatient hospital settings.
Pharmacy is carved into each MCO's own capitated benefit rather than administered by a single statewide pharmacy benefit manager. Each of the 8 comprehensive plans manages its own pharmacy network and formulary. Florida maintains a uniform Preferred Drug List (PDL) for at least some drug classes, applied consistently across both fee-for-service and managed care to avoid formulary fragmentation between delivery systems.
Non-emergency medical transportation (NEMT) is delivered through two regional capitated brokers under SMMC's 9-region structure. Medical Transportation Management, Inc. covers Regions B, C, D, E, and F (91,965 enrollees per CMS's most recent data), and Modivcare Solutions, LLC covers Regions A, G, H, and I (73,612 enrollees).
Gainwell Technologies operates as Florida Medicaid's fiscal agent, handling provider enrollment, claims processing, payments, and provider call center support under the Florida Medicaid Management Information System (FLMMIS). A modernized provider enrollment system, AHCA Enterprise, operates under the same Gainwell fiscal-agent contract.
Last updated: Sep 22, 2026
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