What Florida law says
Section 409.965, Florida Statutes, says "All Medicaid recipients shall receive covered services through the statewide managed care program." The only people left out entirely are those eligible only for family planning, only for breast and cervical cancer services, or only for emergency Medicaid for noncitizens.
Section 409.972 lists people who may choose whether to join the Managed Medical Assistance (MMA) program. The first group is people "who have other creditable health care coverage, excluding Medicare." So other insurance can make MMA voluntary, but Medicare doesn't.
SMMC has two parts that matter to people with Medicare
| SMMC program | Who is in it | What it covers |
|---|---|---|
| Managed Medical Assistance (MMA) | Most people with full Medicaid | Medicaid medical services, and Medicare cost sharing when Medicaid owes it |
| Long-Term Care (LTC) | People 65+ (or 18+ with a disability) who qualify for nursing-facility-level care | Nursing home care and home and community-based services; enrollment is required for those who qualify (s. 409.979) |
If you get only a Medicare Savings Program, your case is different. DCF's policy manual says QMB-only Medicaid is "limited to payment of the Medicare premiums, coinsurances and deductibles," and SLMB and QI pay the Part B premium. See Medicare Savings Programs in Florida.
How the plan works with your Medicare
- Medicare pays first. You keep Original Medicare or your Medicare Advantage plan and your Part D plan.
- Your Medicare doctor stays. AHCA's MMA contract (July 2026 update) bars plans from making a full-benefit dual eligible pick a new primary care provider.
- Your Medicaid card won't list a PCP. The contract leaves the PCP off dual eligibles' ID cards.
- A FIDE SNP can combine the two. In a FIDE SNP, one company handles your Medicare and your Medicaid, including long-term care.
What to do
- Read your welcome letter. AHCA's letter shows your assigned plan, the date it starts and the deadline to pick a different one.
- Get help choosing. Call Choice Counseling at 1-877-711-3662; in-person visits are available on request for people with special needs.
- Choose your Medicare coverage on its own terms. You can request a call from a licensed insurance agent to compare Medicare Advantage, D-SNP and Part D plans from the companies they work with.
More in Florida Medicaid and Medicare.
Related questions
Can I have Medicare and Medicaid at the same time in Florida?
How dual eligibility works.
What is a FIDE SNP in Florida?
One company for Medicare and Medicaid.
What is the SMMC Long-Term Care program?
Nursing home and in-home care.
What is MEDS-AD Medicaid in Florida?
Why it rarely covers people with Medicare.
Sources
- Florida Statutes 409.965 — Mandatory enrollment
- Florida Statutes 409.972 — Mandatory and voluntary enrollment
- Florida Statutes 409.979 — Long-term care eligibility
- AHCA — Exhibit II-A, Managed Medical Assistance (MMA) Program, update July 1, 2026
- AHCA — Pick a Long-Term Care Plan
- DCF — ESS Program Policy Manual, chapter 2000 (2040.0817 QMB)
More questions in this guide
- Can I have Medicare and Medicaid at the same time in Florida?
- Can permanent residents get Florida Medicaid?
- How do I renew my Florida Medicaid on ACCESS Florida?
- What is a dual eligible special needs plan (D-SNP) in Florida?
- What is a FIDE SNP in Florida?
- What is MEDS-AD Medicaid in Florida?
- What is the Florida Medicaid Long-Term Care program (SMMC LTC)?
Part of the guide: Florida Medicaid and Medicare together · All questions
Frequently asked questions
Can I keep my Medicare doctor if I'm in an SMMC plan?
Yes. AHCA's MMA plan contract says a plan may not require a full-benefit dual eligible to choose a new primary care provider and may not stop you from getting primary care from your existing Medicare doctor.
Does my Medicaid plan replace Medicare?
No. Medicare, or your Medicare Advantage or Part D plan, pays first. The SMMC plan covers Medicaid services and can pay Medicare copays, coinsurance and deductibles to Medicare providers enrolled with Florida Medicaid.
How do I choose or change my SMMC plan?
Call Florida's SMMC Choice Counseling line at 1-877-711-3662. After a short period following enrollment, you can generally change plans only at your yearly open enrollment or with a state-approved good cause reason.
Medicare in your Florida county
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