Effective 10-1-21 WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida, Inc. (Staywell) Members will Transfer to Sunshine State Health Plan, Inc. (Sunshine). The WellCare of Florida, Inc. d/b/a Staywell Health Plan of Florida, Inc. (Staywell) legal entity will be merging with Sunshine State Health Plan, Inc. (Sunshine Health). The Agency for Health Care Administration will move Staywell’s Medicaid membership, including Serious Mental Illness (SMI) Specialty Plan membership, to the Sunshine Health plan effective October 1, 2021. In addition, Children’s Medical Services (CMS) Health Plan, which has been operated by WellCare through a contract with the Florida Department of Health, will be operated by Sunshine Health effective October 1, 2021. Sunshine Health will be issuing new Medicaid ID cards. All billing and claims reimbursement will be provided by Sunshine Health for dates of service beginning October 1, 2021. All Staywell claims for service dates prior to October 1, 2021, must continue to be submitted through Staywell and related questions may be directed to Staywell at 1-866-334-7927 (TTY 711) Monday-Friday, 8 a.m. to 7 p.m.
Providers that are out of network as of October 1, 2021, will be eligible for a 120-day continuity of care period where claims will be payable to allow time for members to transition to a new provider, if necessary. The continuity of care period ends on January 31, 2022.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.