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Local Medicaid Resource Center

The important distinction is that Florida Medicaid is a statewide program, but the experience of receiving Medicaid can differ substantially from county to county.

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The biggest differences are usually not the basic eligibility rules. Those are largely statewide. The county-level differences are primarily about managed care plans, available providers, healthcare networks, transportation, local resources, enrollment populations, and access to services.

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Florida's SMMC 3.0 program, implemented February 1, 2025, divides the state into nine Medicaid managed-care regions.

Florida Medicaid is a statewide program, and many fundamental rules are statewide.

The 10 biggest county-level Medicaid differences are:

1. Medicaid managed-care plans

This is probably the most important difference.

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The health plans available to a Medicaid recipient depend on the county/region where the recipient lives. Florida's current SMMC 3.0 regions group the 67 counties into nine regions.

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For example:

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Region         Counties

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A                   Bay, Calhoun, Escambia, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Okaloosa, Santa                             Rosa, Taylor, Wakulla, Walton, Washington

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B                   Alachua, Baker, Bradford, Citrus, Clay, Columbia, Dixie, Duval, Flagler, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy,                       Marion, Nassau, Putnam, St. Johns, Sumter, Suwannee, Union, Volusia

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C                   Pasco, Pinellas

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D                   Hardee, Highlands, Hillsborough, Manatee, Polk

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E                   Brevard, Orange, Osceola, Seminole

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F                   Charlotte, Collier, DeSoto, Glades, Hendry, Lee, Sarasota

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G                   Indian River, Martin, Okeechobee, Palm Beach, St. Lucie

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H                   Broward

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I                    Miami-Dade, Monroe

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That means a Medicaid recipient in Duval County may have different plan choices than someone in Hillsborough County, Broward County, or Miami-Dade County

2. The Medicaid doctors available

A major practical difference between counties is the provider network. Two people with the same Medicaid eligibility category can have very different choices of:

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  • Primary-care doctors

  • Specialists

  • Pediatricians

  • OB/GYNs

  • Behavioral-health providers

  • Hospitals

  • Pharmacies

  • Home-health providers

  • DME suppliers

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Your managed-care plan matters, but where you live also matters because plan availability and local provider networks vary by region.

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For example:

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"Medicaid doctors in Duval County" is much more useful to a Jacksonville Medicaid recipient than a generic statewide list.

3. Medicaid dentists

Dental access can also vary locally. Florida Medicaid has a separate dental component within SMMC.

4. Hospitals

The hospitals available to a Medicaid recipient can be dramatically different depending on the county.

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For example, someone in:

  • Miami-Dade

  • Broward

  • Hillsborough

  • Orange

  • Duval

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has access to a very different healthcare infrastructure than someone in a small rural county.

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The important question isn't simply:

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"What hospitals are in this county?" It's:

"Which hospitals in this county accept the Medicaid recipient's specific managed-care plan?"

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That distinction is extremely important.

5. Transportation

Medicaid transportation is another area where local availability and logistics matter.

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For rural counties, transportation can be considerably more important because healthcare providers may be much farther away.

6. Medicaid enrollment and local assistance

The eligibility rules are statewide, but where someone goes for assistance can be locally relevant.

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Florida Medicaid eligibility and enrollment are administered through the state's systems, while AHCA administers Medicaid. The Medicaid Help Line is statewide at 1-877-254-1055.

7. Medicaid enrollment population

The number and characteristics of Medicaid recipients differ enormously by county.

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AHCA publishes monthly Medicaid data broken down by county, region, program and eligibility category.

Recipients can identify differences such as:

  • Children

  • Pregnant women

  • Adults

  • SSI recipients

  • Seniors

  • Long-term-care recipients

  • MediKids

  • Other Medicaid categories

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A county with a large senior population will have very different Medicaid needs from a county with a large population of families with young children.

8. Long-term care

Long-term-care Medicaid is especially important at the local level.

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A county may have different availability of:

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Florida's Medicaid managed-care system includes a dedicated Long-Term Care program.

9. Waiver and specialty services

The availability and practical accessibility of specialty services can vary significantly by location.

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This matters for people seeking services involving:

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Florida also has specialty Medicaid managed-care arrangements for certain populations.

10. Actual access to healthcare

This may ultimately be the biggest difference of all.

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A county can have Medicaid coverage but still have challenges involving:

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Provider availability → appointment wait times → transportation → specialist availability → hospital access → distance to care.

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Florida actually requires managed-care plans to report appointment wait-time information, which demonstrates how important network access is to the managed-care program.

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So "Does Medicaid cover it?" and "Can I actually get the service locally?" are two different questions.

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