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Health Insurance Navigator Troubled by Florida's Medicaid Redetermination Process

Susan P., is a Marketplace Navigator with Covering Florida, an organization that provides free assistance to Floridians enrolling in health insurance coverage. Having seen many of her clients face an abrupt loss of Medicaid coverage in recent months, Susan is concerned about Florida’s handling of the Medicaid Redetermination process.

The Department of Children and Families is required to send advance notification to anyone being disenrolled from Medicaid prior to termination of coverage. However, many of Susan’s clients told her they received no prior notification, and others did not receive notice until after their coverage was terminated.

In the wake of Florida’s Medicaid Redetermination, many families have experienced unexplained changes in their insurance or loss of coverage altogether. Susan spoke to one family whose Share of Cost had unexpectedly doubled. When they reached out for clarification, they received multiple conflicting explanations for the increase in cost, leading Susan to believe that the call center representatives may not know the true reason.

Another family with 2 children on the Autism Spectrum were told that their SSI Income made them ineligible for Medicaid.

One woman contacted Susan because she thought she might be pregnant. Her coverage had been terminated and she was told she had to wait 30 days to see a doctor to confirm her pregnancy. She was offered no further assistance or resources.

Susan has seen clients repeatedly call DCF, AHCA, CMS, and Medicaid, waiting hours to speak to a representative. Some English-speakers have resorted to using the Spanish line, apologizing and explaining that they’ve exhausted all other options and are desperate to speak to someone about their case.

Some paths to regaining coverage require submitting applications with multiple state agencies. However, those agencies and their software systems do not communicate with each other, which only adds to the confusion and frustration of families who are simply trying to retain coverage.

Susan concludes, “Our Florida Medicaid portal needs a do-over. It’s so difficult to do applications and results are cryptic at best. Many are denied Medicaid who are legally deemed disabled due to the two-portal conflict.”

If you've lost coverage or need help selecting a health insurance plan that's right for you, Covering Florida Navigators are available to assist you in finding quality, affordable health coverage. To receive free, expert support from a qualified Navigator, visit


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