Florida program
A health plan for children with serious conditions (CMS Health Plan)
The Children’s Medical Services Health Plan adds a care coordinator to Medicaid or KidCare coverage.
What it is
The Children’s Medical Services Health Plan adds a care coordinator to Medicaid or KidCare coverage.
A serious condition can make care across several clinics hard to arrange. The CMS Health Plan adds a coordinator and a children’s-hospital network. The clinical screening and your child’s existing coverage decide whether it fits.
Eligibility rules
- The Medicaid route serves children under 21. The KidCare route serves children under 19.
- Children’s Medical Services reviews the clinical screening or physician attestation. AHCA handles enrollment.
What you get
- No extra charge for the specialty plan.
- A care coordinator to help connect treatment, home services and covered trips.
What the help covers
- The plan covers the underlying Medicaid or KidCare benefits. Travel extras depend on the plan and date.
If you decide to apply
- Ask the hospital social worker for the CMS Health Plan screening or your doctor’s signed statement.
- Ask the coordinator to check your oncology team, hospital and existing treatment approvals before a plan change.
CMS Health Plan: Sunshine 866-799-5321 through September 30, 2026; Molina 800-262-0750 from October 1 · Official page ↗
What happens next
- Members move automatically during the October 1, 2026 transition, and existing approvals carry over. The new member card identifies the contact details.
Good to know
The company running this plan changes from Sunshine to Molina on October 1, 2026.
Other details
- If the plan says no to something, you have 60 days to appeal and the plan has 30 days to answer, or 72 hours when waiting would be dangerous.
- To keep care going while you appeal, send the appeal within 10 days of the notice and ask in the same letter for the care to continue.
- If the plan turns the appeal down, you can ask the state for a hearing within 120 days; asking within 10 days keeps the care going in the meantime.
Official sources
- AHCA — CMS Plan Transition
- Sunshine Health — Children’s Medical Services Health Plan
- Molina Healthcare — Florida Contact Us
- Sunshine Health — CMS Health Plan Medicaid Benefits Overview
- AHCA — Florida KidCare: Title XXI CHIP
- AHCA CMS transition
- Official policy reviewed September 17, 2026 — www.sunshinehealth.com
- Official policy reviewed September 17, 2026 — www.sunshinehealth.com
- Official policy reviewed September 17, 2026 — www.flmedicaidmanagedcare.com
- Official policy reviewed September 17, 2026 — www.ecfr.gov
- Official policy reviewed September 17, 2026 — www.ecfr.gov
- Official policy reviewed September 17, 2026 — www.medicaid.gov
- Official policy reviewed September 17, 2026 — www.myflfamilies.com
“Would the CMS plan make our child’s care easier to arrange, and would any doctors or approvals change? If it fits, could you help with the screening?”
Why I’m asking: I want one person who can help connect our child’s treatment, home care and appointments.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask for the Children's Medical Services plan by name and answer the screening questions.
Your social worker
The social worker sends the screening or gets the doctor's attestation and confirms the hospital is in the plan.
The care team
The doctor signs the clinical attestation.
- Who decides
- Children's Medical Services at Florida's Department of Health screens the child; the state Medicaid agency (AHCA) enrolls.
- Ask your social worker
- “Can you start the Children's Medical Services plan screening for us, and check that this hospital and the oncology group are in that plan?”
How to apply
First step: Tell the social worker you want the Children's Medical Services Health Plan and ask them to start the clinical screening with the application.
- Ask the social worker to start the Children's Medical Services screening with the Medicaid or KidCare application.
- After October 1, 2026, confirm the new member-services number with the plan letter.
Official application / program page ↗
Where it starts: Ask for the CMS Health Plan screening when applying; current member services 866-799-5321 (Sunshine, through 2026-09-30); Molina 800-262-0750 from 2026-10-01
What to gather
- Medicaid or KidCare application number
- Diagnosis letter from the oncology team
How long: No published screening time. Members already in the plan on October 1, 2026 move to Molina automatically.
What a yes looks like
A plan card naming the Children's Medical Services Health Plan and a care coordinator's name and phone.
What a no looks like, and the next move
Ask whether the screening failed or was never sent. The doctor can send a signed statement (attestation) again.
Watch out
- The company running it changes on October 1, 2026 (Sunshine Health, then Molina). Members move automatically and approvals carry over, but confirm the phone number on your new card.
- The screening needs the doctor's paperwork. Ask the social worker to send it with the application, not after.
- The announced plan change is Sunshine through September 30, 2026 and Molina from October 1. Confirm the new card, oncology network and existing approvals before the handover.
Dates that change this
2026-10-01: The state Medicaid agency (AHCA) says Sunshine State Health Plan runs the Children's Medical Services plan through September 30, 2026 and Molina from October 1, 2026, with members moved automatically. Still to be confirmed on the AHCA page. (not yet confirmed against the final rule)
The numbers and the rules
The arcane layer, kept on purpose. Checked September 10, 2026.
What it is worth
The Medicaid or KidCare plan built for children with serious conditions. No extra cost. Care coordination and a children's-hospital network.
Covers: Medicaid or KidCare coverage through a specialty plan · Care coordination · Rides to appointments (through the plan's ride company) · Meals on treatment trips over 100 miles (plan extra, with prior approval)
What it costs the family: Nothing beyond the KidCare premium, if any. Medicaid members pay nothing.
The eligibility facts, as published
- Coverage
- Medicaid or KidCare
- Clinical
- Children's Medical Services screening or physician attestation
- Age
- under 19 for KidCare; under 21 for Medicaid
The trap: The company running it changes on October 1, 2026: Sunshine Health until September 30, then Molina. Members move automatically; appointments, prescriptions and approvals carry over. Check the phone number you are given.
Where I read this
- AHCA — CMS Plan Transition — Florida AHCA, read September 8, 2026
- Sunshine Health — Children’s Medical Services Health Plan — Sunshine Health, read September 8, 2026
- Molina Healthcare — Florida Contact Us — Molina Healthcare of Florida, read September 8, 2026
- Sunshine Health — CMS Health Plan Medicaid Benefits Overview — Sunshine Health, read September 8, 2026
- AHCA — Florida KidCare: Title XXI CHIP — Florida AHCA, read September 8, 2026
- AHCA CMS transition — ahca.myflorida.com, read September 10, 2026