CMS Health Plan
What it is. A Medicaid / KidCare specialty health plan for children under 21 with chronic, serious conditions. Every member gets a case manager who coordinates care across doctors, therapists, and community services, plus a 24-hour nurse line. Direct coverage plus care coordination.
As of October 1, 2026 the plan is run by Molina Healthcare of Florida. Older materials naming Sunshine Health or WellCare are out of date. Families who were on the plan were moved automatically and can keep their current providers for up to 240 days (AHCA letters say through May 30, 2027; Molina says May 31) or until a new care plan is in place. Medicaid members can switch to a standard plan until January 31, 2027 if a provider won't accept Molina.
Who it's for. Children who (1) have Medicaid or KidCare, and (2) pass a clinical eligibility screening for a chronic, serious physical, developmental, behavioral, or emotional condition that requires more care than children generally need.
First step.
- Get Medicaid or KidCare first (see the coverage card).
- Get the clinical screening, either way: call DOH's CMS Plan clinical eligibility line, 1-855-901-5390 (TTY 711), Mon–Fri 8 a.m.–5 p.m., and complete the parent survey; or ask your child's doctor to submit a physician attestation.
- Medicaid families then choose the CMS Plan through Choice Counseling, 1-877-711-3662. KidCare children are enrolled automatically and can opt out at any time.
Cost. No premium on Medicaid; $15 or $20 a month on KidCare. No full-pay option.
Contact. Molina CMS Plan Member Services 1-800-262-0750 (TTY 711), Mon–Fri 8 a.m.–7 p.m. · Nurse Advice Line 1-888-275-8750 · CMS Plan Ombudsman (DOH) 1-833-956-0322
Official sources. Molina CMS Plan (opens in a new tab) · AHCA transition notice (opens in a new tab) · DOH CMS Health Plan (opens in a new tab) · DOH eligibility flow chart (PDF) (opens in a new tab)
Not yet confirmed: whether the plan includes a defined respite-care benefit.
Read the application-preparation guide ↗