Insurance Insurance

How to Disenroll in a Medicaid HMO in Florida

    • 1). Understand the rules. After you choose a Medicaid HMO, there is a 90-day period known as open enrollment during which you can change your plan freely. The period after the open enrollment expires is known as the "lock in" time. When you are in the lock in period of your plan, the state must approve your plan change. Approval is granted if you have a good cause to need a different plan. Many reasons meet the good cause criteria, including if your doctor leaves the HMO network, you are receiving substandard care, your doctor doesn't supply translation services that you need, or you need care not covered by your current HMO.

    • 2). Contact the Florida Medicaid Enrollment/Disenrollment hotline at 888-367-6554. You will need your Medicaid ID or Gold Card number, the last four digits of your Social Security number and your birth date handy so the caseworker can access your account information.

    • 3). Seek disenrollment. If you are leaving Medicaid or are in your open enrollment period, disenrollment is straightforward. If you are in your lock in period, the caseworker will help you determine if you have a good cause reason to disenroll in your current plan to move to a different plan. Note that you may be required to submit evidence to support your claims.

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