Families in Florida with children enrolled in the Children's Medical Services (CMS) Plan have a new company managing their medical coverage since October 1, 2026: Molina Healthcare has replaced Sunshine Health. This change affects a program aimed at children with special medical needs and raises particularly important questions for those who rely on ongoing treatments, specialists, and prescribed medications.
The Agency for Health Care Administration of Florida (AHCA) confirmed that beneficiaries who were already enrolled have been automatically transferred to Molina and do not need to submit a new application for this transition. The program retains the name CMS Plan and the coverage of existing services includes protections to prevent disruptions during the change of administrator.
The transition applies statewide, including Miami-Dade. This does not mean that all Medicaid or Medicare beneficiaries need to change insurers: it specifically affects the CMS Children's Plan previously administered by Sunshine.
Are appointments with doctors and specialists being canceled?
They must not be automatically canceled. Both the AHCA notice and the information published by Sunshine Health indicate that already scheduled appointments and prior authorizations must be honored during the period of continued care. Professionals attending to enrolled minors should not suspend existing consultations simply due to a change in company.
However, just because an existing appointment is protected does not mean that all specialists will remain part of the Molina network indefinitely. Sunshine explains that provider contracts do not transfer automatically: doctors and centers must join the Molina network to continue providing services after the continuity protection ends.
For a family with appointments in neurology, cardiology, rehabilitation, therapies, or home care, it is advisable to confirm with the office and the Molina care manager that the service is identified and authorized. It is not advisable to cancel an appointment or discontinue treatment without first checking the covered alternatives.
How long can they continue with the same doctor or treatment?
The Sunshine notice regarding the change establishes a continuity of care period of up to 240 days for transferred members, or until Molina completes the new individual care plan and authorizes the ongoing services, whichever comes first.
In its frequently asked questions in Spanish, Molina states that May 29, 2027 is the maximum date for the transition period for former members. For new enrollees, it reports a continuity period of up to 180 days from enrollment. These dates are general references for the program: the family must confirm the situation and specific authorizations for their child, as coverage may end sooner when the corresponding care plan is completed and authorized.
What happens with prescription medications and the pharmacy?
Molina assures that during the transition, the medications that minors currently receive and which are listed in the program's preferred medication list will continue to be covered. Families can initially use their regular pharmacy, even if it is not yet part of the Molina network. After the continuity period, they will need to visit a participating pharmacy in the network, according to the applicable conditions.
If a rejection occurs when trying to fill a prescription, it is advisable to ask the pharmacy to verify the details of the new administrator and to contact the care manager or Molina Member Services before assuming that the medication is no longer covered. The AHCA also published a specific alert regarding continuity in the dispensing of medications on September 15.
Is there a new CMS Plan card?
Yes. Molina indicates that a welcome package was sent, which includes a new identification card for each minor, an enrollment letter, and a guide to the services. If the material has not arrived, the family should request assistance by calling the official CMS Molina Plan phone number: 1-800-262-0750 (TTY: 711).
Some cards include the instruction in English “Continue to see your current PCP”, which means “Continue visiting your current primary care physician”. Molina explains that this note may appear while they are incorporating doctors into their network. If the doctor is not yet listed as a participant, families should not automatically interpret that phrase as a requirement to seek another doctor; they can request that their case be verified. Molina has indicated that new cards will be sent out when appropriate.
If the card shows a different office address from the usual one, it's also possible to request an update of the information without assuming that a change of location for care is necessary.
What services are still covered?
The official summary of benefits from Molina for CMS includes medical consultations, behavioral health services, hospitalization and outpatient care, home health care, pharmacy, and other services covered by Medicaid. The company also provides information on additional benefits and transportation to covered medical services, subject to program rules.
Each minor has a care or case manager, responsible for helping to coordinate services and providers. Families can request support to resolve continuity issues, locate a specialist, review authorizations, or request a change of manager, as per the care management information published by Molina.
In the case of authorized representative forms, guardianship documents, or powers of attorney, Molina warns that he received copies of some Sunshine files and that those transferred documents remain valid until December 31, 2026. He recommends contacting the case manager to verify and update records when necessary.
Molina's phone and what families should do now
For inquiries regarding the CMS Plan, the official Member Services line is 1-800-262-0750 (TTY: 711), Monday through Friday, from 8:00 a.m. to 7:00 p.m. Eastern Time. Molina states that it provides free language assistance for those who do not speak English and accessible formats for individuals with disabilities.
Before calling, it is advisable to have the new card ready, if it has arrived, as well as the details of any pending inquiries, prescriptions, and authorizations. It is helpful to specifically ask if the doctor is still covered during the transition, which authorizations are registered, when the applicable coverage ends, and which pharmacy should be used afterward. Sunshine has also warned about possible fraudulent calls posing as program representatives: it is better to verify any communication through the numbers published on official pages.
Is it the same as the open enrollment for Medicaid?
No. The change of administrator for the CMS Plan is automatic for its existing members and does not require reapplying for the program. Separately, Florida has opened the annual period for certain Medicaid managed care beneficiaries to review and, where appropriate, voluntarily change their plan. CiberCuba explained how this open enrollment works and its deadlines.
This transition of the CMS Plan should not be confused with federal eligibility modifications for certain immigrants covered by Medicaid, which is a separate issue and depends on the individual program rules.
The conclusion for parents is clear: the children's plan still exists and there is no need to re-enroll due to the change from Sunshine to Molina, but it is advisable to review the cards, authorizations, and the continuity of each treatment before the protection period ends. For individual and updated information, the reference is the official Molina CMS Plan website.
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