The Medicaid opt-out program is a component of Florida's Medicaid Reform initiative administered by the Agency for Health Care Administration. The program allows eligible beneficiaries to participate in their employer-sponsored health insurance plan as an alternative to enrolling in a Medicaid Reform plan. Beneficiaries choosing this alternative use their Medicaid premiums to purchase individual or family health insurance.
To date, the opt-out program has not been widely used. As of the end of March 2008, only 19 beneficiaries were enrolled in the opt-out program while a total of 30 beneficiaries had enrolled since September 2006. Eleven beneficiaries had disenrolled because they were no longer eligible for Medicaid or lost access to employer-sponsored insurance.

Medicaid Reform: Legislature Should Delay Expansion Until More Information Is Available to Evaluate Success
Report 09-29 June 2009
Medicaid Reform: Reform Provider Network Requirements Same as Traditional Medicaid; Improvements Needed to Ensure Beneficiaries Have Access to Specialty Providers
Report 08-64 November 2008
Medicaid Reform: Oversight to Ensure Beneficiaries Receive Needed Prescription Drugs Can Be Improved; Information Difficult for Beneficiaries to Locate and Compare
Report 08-55 September 2008
Medicaid Reform: Risk-Adjusted Rates Used to Pay Medicaid Reform Health Plans Could Be Used to Pay All Medicaid Capitated Plans
Report 08-54 September 2008

Copies of this report in print or alternate accessible format may be obtained by email OPPAGA@oppaga.fl.gov, telephone (850) 488-0021, or mail 111 W. Madison St., Room 312 Tallahassee, FL 32399-1475.