The Sunshine Health Ambetter transition moves Florida marketplace members from Sunshine State Health Plan to another Ambetter company. Sunshine's marketplace plans end December 31, and Ambetter will place members who don't choose in a new plan.
The name on your card may look the same, but the plan behind it can change. Check it before December 15. For free help, call 888-730-6031.
- Sunshine State Health Plan's marketplace plans end December 31 in Florida.
- Members who do nothing will move to an Ambetter plan from a sister company.
- The new plan may use a different network and referral rules.
- Log in on November 1, review your new plan and update your income.
- Choose by December 15 so the right plan starts January 1.
What Is the Sunshine Health Ambetter Transition?
It is a change in which company insures some Florida Ambetter plans. Today, Ambetter Health in Florida is underwritten by two companies: Centene Venture Company Florida and Sunshine State Health Plan, Inc.
The Sunshine State Health Plan exit started with a notice to Florida regulators. That filing discontinues its marketplace products. As a result, those plans end when the current plan year ends, according to the healthinsurance.org Florida marketplace guide.
Both companies share the same parent, Centene. So, Ambetter will move members who don't pick a plan into one from Centene Venture Company. For a refresher on why fall is the time to act, see our guide to the yearly enrollment window.
| Item | Plan ending December 31 | Plan starting January 1 |
|---|---|---|
| Brand you see | Ambetter from Sunshine Health | Ambetter Health |
| Insurance company | Sunshine State Health Plan, Inc. | Centene Venture Company Florida |
| Network and referrals | Your current network | May be different, so check your doctors |
| Premium | Current price | May change for the new plan year |
| What you need to do | Keep paying through December | Review, update income and confirm by December 15 |
Sources: Ambetter Health Florida and the healthinsurance.org Florida guide. Your renewal notice shows your exact plan.
Will Your Doctors and Costs Change?
They might. Ambetter says a member moved into a new plan may face a different network and different referral rules. Premiums may also adjust for the new plan year.
That's why this Ambetter plan change deserves a careful look. A doctor you see today may not be in the new network. In addition, a specialist might now need a referral.
Before you accept the new plan, check three things:
- Doctors: look up each one in the new plan's network, using our doctor network search or Ambetter's tool.
- Prescriptions: confirm each drug is on the new plan's drug list.
- Total cost: compare the premium, deductible and out-of-pocket maximum.
Our guide to the Ambetter provider network explains how its networks work in Florida.
A licensed Vivna agent can check your doctors and compare Florida plans at no cost. Call 888-730-6031 or request a free quote.
How Much Are Florida Rates Changing?
Florida regulators approved an average increase of about 10.4% before subsidies, according to ACASignups' Florida rate tracker. The Centene Venture Company filing asked for 3.9%, the lowest request in the state.
Still, your price depends on your plan, county and subsidy. Last season, more than 95% of Florida enrollees got a premium tax credit. On average, subsidized members paid about $62 a month after that help.
Other Florida changes are happening too. Cigna and Molina are listed as leaving the Florida marketplace. Our Florida enrollment guide covers those exits and the key dates.
What to Do During the Sunshine Health Ambetter Transition
Sunshine Health moving to Ambetter is a good reason to review your coverage early. Don't let it renew without a check. These steps follow Ambetter's own renewal advice.
- Log in on November 1: review the plan Ambetter picked for you in your member account.
- Update your income: your tax credit depends on your estimate for the coming plan year.
- Check doctors and drugs: confirm your providers and prescriptions are covered.
- Compare other plans: another Ambetter plan or another insurer may fit better.
- Confirm by December 15: that way, the plan you want starts January 1.
If you like your current Ambetter benefits, you may find a close match. Our overview of Ambetter plan options explains the metal levels and plan types.
Sunshine Health Ambetter Transition FAQs
Do I have to do anything if I'm happy with Ambetter?
You aren't required to act, because Ambetter may move you into a new plan automatically. However, that plan can have a different network and price.
A short review before December 15 makes sure the plan still fits. You can also read our Ambetter FAQ library for common questions.
Will I lose coverage on January 1?
Not if you stay enrolled and pay your first premium. With Sunshine Health marketplace plans ending, Ambetter will move members who don't choose into a Centene Venture Company plan.
Coverage on any new plan starts only after you pay. Set up automatic payments if you can.
Can I switch to a different insurer instead?
Yes. Open enrollment lets you pick any marketplace plan in your county. Choose by December 15 for January 1 coverage, or by January 15 for February 1.
After that, you'll need a qualifying life event. Our Florida health insurance FAQs explain those events.
Next Steps for the Sunshine Health Ambetter Transition
The Sunshine Health Ambetter transition is simple to handle if you start early. First, log in on November 1 and find your new plan. Next, check your doctors and update your income before December 15.
Want a second set of eyes? Call a licensed Vivna agent at 888-730-6031, Monday through Friday, 9 a.m. to 6 p.m. Eastern. You can also visit our Ambetter health insurance page or our Florida health insurance guide.
Sources
- healthinsurance.org: Florida health insurance marketplace
- ACASignups: Florida rate filings
- Ambetter Health: Florida
- Ambetter Health: Florida renewal information
- healthinsurance.org: Health insurers are exiting the Marketplace again
- HealthCare.gov: Renew, change, update, or cancel your plan
Related Guides
- What is open enrollment?
- When your insurer leaves the marketplace
- Renewing your health insurance
- Ambetter coverage choices
About the author: Michael Sprague
Michael co-founded Vivna Insurance, a licensed independent agency in Deerfield Beach, Florida. He has worked in health insurance sales for more than a decade. Today, he helps Florida families and self-employed clients compare marketplace, short-term and supplemental plans. Licensed health insurance agent, Vivna Insurance (Agency NPN 19168641). Call 888-730-6031.
Reviewed by Heather Sprague, licensed health insurance agent.
Vivna Insurance is a licensed independent agency, not a government website. Our help is free; we are paid by the insurance companies we work with. Plan availability, rates and savings vary by county and income.
Find Local Health Insurance Help
Plans, prices and help programs change by state and even by county. These local guides show what is available near you.
More local help: the Florida health insurance guide, plus guides for Texas, Georgia, North Carolina and every state we serve.
Prefer to talk it through? Call 888-730-6031 Monday through Friday, 9 a.m. to 6 p.m. Eastern, for free help from a licensed agent.
