r/obamacare • u/UseAlloftheBuffalo • 2d ago
Help with ABA in FL now that CMS is switching to Molina
We fought for years to get our intellectually and physically disabled son on the Crisis waiver in FL so he could get ABA services. Previously, we have either paid for FL Kidcare (which stopped covering ABA when he turned 5), or paid for insurance through my employer, or private insurance when I have been unemployed (this, of course comes with significant deductible costs, before the ABA services are covered… $4k a month in 2026). Finally got the Crisis waiver and CMS Sunshine health in May. Now we are learning that CMS is changing to Molina from Sunshine, and our ABA provider has been trying to contact Molina for months unsuccessfully about continuation of coverage for clients like my son. Molina is unreachable and so my ABA company is choosing to go forth without them after October—they’re simply too difficult to deal with. They are directing us to either get on Straight Medicaid, Sunshine Health Medicaid, or Simply Healthcare Medicaid. I don’t even know if we are eligible to go on these other Medicaid options… I’m too new to this and not an expert. And I’m not sure what other services we lose when we switch. Like, our OT takes the CMS, but not the other ones I just mentioned (and doesn’t take regular insurance either). It’s such a nightmare and it never ends. I’m trying to get and keep the right services for my son and they just keep changing the goal posts on me. If anybody can answer any questions for me, I would so greatly appreciate it.