Florida: Start Here
Beginner guide for Florida—HealthCare.gov, HMO grievances, federal external review, and what to open next.
Read guideState playbook
Florida
State insurers, legislation, and appeal resources for patients and advocates in Florida.
4 guides
Florida Prior Authorization Law
Standardized PA forms (§ 627.42392), electronic PA, federal UR timelines, and HMO grievance rules.
Read guideFlorida Health Insurance Appeals and Grievances
ACA internal timelines, HMO 30-day panel review, 72-hour urgent grievances, path to federal external review.
Read guideFlorida External Review
HHS-administered IRO review—60-day filing, standard and expedited timelines, fully insured FL plans.
Read guidePrior auth & internal appeals
Match the plan on the member ID card. Use the denial letter for where to file appeals.
- Florida Blue
- Oscar Health
- Molina Healthcare
- Ambetter / Centene
- Florida Medicaid
External appeals
After internal appeal, for eligible Florida fully insured plans only.
- HHS Federal External Review (Florida)
- Florida DFS Consumer Services