Carelon

Health Insurance Coverage in Florida

Health Plan Overview

Insurance CompanyCarelon
StateFlorida
Websitecarelon.com
Number of Hospitals in Network13
Number of Plans Offered9

Network Hospital Locations

Hospitals in Network (13)
Holmes Regional Medical CenterJackson Memorial HospitalCleveland Clinic Martin North HospitalCleveland Clinic Indian River HospitalCape Canaveral HospitalCleveland Clinic HospitalViera HospitalPalm Bay HospitalCenterstone Bradenton-Hospital and Addiction CenterWekiva Springs CenterPark Royal HospitalNorth Tampa Behavioral Health HospitalUniversity Behavioral Center

Available Plans

Employer Sponsored Plan

1 plan

Government Program

1 plan

Health Insurance Marketplace Plan

1 plan

Health Plan

4 plans

Health Service

1 plan

Pharmacy Benefit Manager

1 plan

Plan Details
Plan NamePlan Type
NAHealth Plan
NAHealth Plan
NAHealth Plan
NAHealth Plan
NAEmployer Sponsored Plan
NAPharmacy Benefit Manager
NAHealth Insurance Marketplace Plan
NAGovernment Program
NAHealth Service

Recent News

Undated (referencing upcoming effective date and submission dates in Dec 2024)
Provider news announced new Carelon Medical Benefits Management programs effective January 1, 2025, for Wellpoint members in Florida, including pre-service review requirements for post-acute inpatient management services.
Undated (referencing effective date 1/1/2025)
Carelon will begin managing in-patient post-acute care services for most commercial Wellpoint members in Florida effective January 1, 2025. This was announced on Wellpoint's provider resources page, referencing Carelon.
2025-04-01
An update dated April 1, 2025, for Simply Healthcare Plans in Florida announced the adoption of updates to several Carelon Medical Benefits Management Clinical Appropriateness Guidelines effective July 26, 2025.
2024-09-30
A provider orientation and training document for Humana Healthy Horizons in Florida, dated September 30, 2024, references Carelon Behavioral Health and discusses various aspects of the Medicaid program in the state.
2024-07-01
A provider news update for Simply Healthcare Plans, Inc. and Clear Health Alliance in Florida announced the adoption of Carelon Medical Benefits Management Clinical Appropriateness Guidelines effective September 1, 2024.
2024-05-22
Carelon Medical Benefits Management announced that Simply Healthcare Plans, Inc. in Florida will transition to their Clinical Appropriateness Guidelines for medical necessity reviews effective September 1, 2024. This update was communicated in provider news.
2024-04-16
An article from April 16, 2024, discussed Elevance's Carelon vertical integration with CD&R, forming a joint venture that includes Millennium Physician Group, which operates throughout Florida.

State Leadership

P. B.

President

Based in Florida

Glenn MacFarlane

President and Chief Executive Officer of Carelon Behavioral Health

Involved in Florida initiatives and leads Carelon Behavioral Health