Recently, significant changes to Medicaid programs have affected families enrolled in the iBudget Waiver and other Medicaid services. If you or a loved one relies on Medicaid for health services, these changes may have come as a surprise and left you feeling uncertain about how to proceed. Here’s what you need to know about the new Statewide Managed Medical Care (SMMC) program and how to opt out if it doesn’t align with your needs.
What is SMMC?
SMMC is the program where most Medicaid recipients receive their Medicaid services. There are three different programs that makeup the Statewide Medicaid Managed Care:
- Managed Medical Assistance (MMA),
- Program, Long-term Care (LTC) Program,
- Dental Program
What Has Changed?
In September 2024, the Agency for Health Care Administration (ACHA) sent out letters informing Medicaid recipients that they could be enrolled in the SMMC program. While these communications were intended to provide families with information about their options, many individuals were initially unaware of the substantial change.
In October, ACHA made a critical ruling: iBudget Waiver recipients would be automatically enrolled in the SMMC program unless they specifically opted out by February 1, 2025. Unfortunately, not everyone was informed about this automatic transition, and the tight deadline left many families struggling to reach the call center, often encountering lengthy hold times.
For some families, this change was entirely unexpected, and by the time they realized what had transpired, the deadline had elapsed, resulting in their enrollment in the SMMC program. Consequently, they faced challenges in accessing their existing healthcare providers and services.
Good Grief! Took my adult son to Dr after work as he is not feeling well… only to find out his Mediciad waiver is no longer active. What is going on? Why? The letter I received said if you didn’t want to make changes nothing needed to be done.
-Anonymous
It has recently come to my attention that an individual with severe dental needs had their case reported to both their WSC and SE APD. He is in extreme pain, to the point of beating on his head due to the distress. The issue? He no longer has Medicaid dental coverage because he is enrolled in a Medicare HMO.
-Anonymous
What Can You Do Now?
If you were affected by this change and would like to remain in your original program, there’s some good news: you still have time to opt out.
You were given a 120-day window from the date of the switch (February 1, 2025) to revert to your original program. If you miss this window, you’ll have to wait until the next annual re-enrollment period, which runs from October 15 through December 7, 2025, to make any changes.
How Do I Opt Out of SMMC?
To opt out of SMMC and revert to your original iBudget Waiver program, contact the Medicaid Customer Service Center at 1-877-711-3662. However, be prepared for extended hold times. When you make the call, the recipient of Medicaid must either make the call themselves or be available to grant permission for you to revert to the iBudget Waiver, unless you are the guardian of the Medicaid recipient.
You might also have some success opting out of SMMC online at flsmmc.com.
Additional Resources
To help you make an informed decision for your family, we highly recommend watching this video presentation by Dawson Sullivan, a Community Partner with the Department of Children and Families (DCF). In this detailed video, he addresses many of the concerns families have about the recent policy shift and explains the changes in great detail.
Story by Deborah Beaucaire
