Florida Medicaid has changed the way it will deliver long-term care services
to most of its participants. This is a statewide change that is being
introduced around the state region by region. Pinellas County is part
of Region 5 which means that any current long-term care Medicaid participants
impacted by this change will start to receive letters introducing them
to the new managed care program in October. The new program will then
become effective on February 1, 2014.
The new program is called the Statewide Medicaid Managed Care (SMMC) Long-Term
Care Program. Under this program, each recipient of long-term care services
will have to choose an insurance plan to manage their care. In Pinellas
County there are four plans from which to choose. They are American Elder
Care, Molina, Sunshine and United.
If the current Medicaid long-term care participant is currently living
in an assisted living community, then they are probably already receiving
Medicaid benefits through a managed care insurance plan. However, if the
current Medicaid long-term care participant is currently living in a skilled
nursing facility, then they will probably be entering into a managed care
plan for the first time.
Every participant should exercise their option to enroll in a managed care
insurance plan of their choice. This is because if they do not make a
choice, they will be assigned to a managed care insurance plan. Statewide
enrollment brokers will be available to assist participants in the enrollment process.
If you have a family member impacted by the new SMMC Long-Term Care Program,
it will be important to familiarize yourself with the resources available
to explain 1) the choices available under the plan, 2) what care your
family member is entitled to receive under the plan and 3) what to do
if you feel that the care is not living up to the required standards.
As with any new program, there will be some glitches as it rolls out,
however, if you are armed with this information, you will be in a better
position to recognize and quickly act to correct any glitches that impact
your family member.