Children’s Medical Services (CMS) Health Plan Transition to Molina FAQs
Molina is proud the Agency for Health Care Administration (AHCA) chose us to provide services to members and families for the Children’s Medical Services (CMS) Health Plan.
When will the transition occur?
The CMS Plan operated by Sunshine Health will transition to the CMS Plan operated by Molina Healthcare on October 1, 2026. The Agency for Health Care Administration, Molina Healthcare, and Sunshine Health Plan are working together to ensure you have all the details you need.
How Does this Affect Me/My Child?
- Our goal is to make sure CMS Health Plan members, their parents, and families have a smooth transition and to have continuity of your / your child’s care.
- You / your child will continue to get the services and support you need. You / your child will still:
- Have a Case Manager
- Have providers to meet your needs. We will also work with your providers during the continuity of care period.
- Get all your Medicaid services and drugs, plus new programs and expanded benefits.
What benefits are going to be different after the transition?
You/your child will continue to get the same medically necessary covered services as you do today through CMS Plan. In addition, Molina Healthcare has many expanded benefits to support your/your child’s health. Any changes will be explained by your Case Manager who will help you get the benefits you need.
Who will I work with for my/my child’s care coordination?
You/your child will be assigned a CMS Plan Case Manager from Molina Healthcare. Your/your child’s Case Manager will work with you to coordinate your/your care. This includes coordination with your/your child’s health care providers and other community supports.
When will I meet my new Case Manager?
You will meet them in person at your first face-to-face visit. Prior to that visit, your Case Manager will contact you to introduce themselves, review your child's needs, and answer questions.
Will I have to switch providers?
Your/your child’s providers may not change. Molina’s goal is to ensure you continue with your current providers, beyond the Continuity of Care period of up to 8 months, where possible.
What will happen to my/my child’s currently authorized services/hours (e.g., PDN)?
Your/your child’s current authorized services and hours at the time of transition will continue during the Continuity of Care period for up to 8 months or until the plan of care is updated.
Where do I go to access my/my child’s benefits and health plan resources?
Beginning October 1, 2026, your/your child’s Molina CMS Case Manager will walk you through how to access care, providers, transportation, and other supports. Before October 1, you can visit us at our CMS Plan website where we will have information about CMS Plan and services offered by Molina Healthcare.
Who will I reach out to with questions?
CMS Plan will transition to Molina Healthcare on October 1, 2026. Sunshine Health Plan and Molina Healthcare, along with the Agency, are here to help you and your family through the process.
Questions for Sunshine: sunshinehealth.com/members/cms.html
If you have questions about your current or past CMS Plan services, please contact your CMS Plan Case Manager.
Questions for Molina:
Your/your child’s Case Manager will be assigned closer to October 1. Your Case Manager will assist you with any questions.
Want to learn more:
Reach out via SMMC Choice Counseling at (877) 711-3662, (TDD: (866) 467-4970) M-F, 8am-7pm or monitor the AHCA webpage for updates.