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MEDICAID
 What is Medicaid Medicaid is similar to an insurance program that pays for necessary health care. Those eligible for Medicaid receive a permanent gold Medicaid card that looks much like a credit card. Back to top How do I apply for Medicaid? Medicaid eligibility is determined by the Florida Department of Children and Families Program. The Social Security Administration determines eligibility for Supplemental Security Income Program. Full Medicaid benefits will be for children who are dependent in the care and control of the state and children with special medical needs who adoption was supported by the state or a private adoption agency. Medicaid coverage will be active until 1 month before you turn 21. You can apply for benefits online http://www.myflorida.com/accessflorida/. Back to top How do I use my Gold Medicaid Card? Keep your card in a safe place and have it available when you make a medical appointment and when you go to the doctor, pharmacy, or any healthcare provider. You card has an eight digit control number that the Medicaid provider needs in order to verify that you are Medicaid eligible. If you lose your Medicaid card you should call the Children and Families, Public Benefits staff, at the local service center. They will help you get a new card. Back to top What are the different types of Medicaid? Most Medicaid recipients are required to obtain services through managed care. Recipients who are not required to enroll in managed care obtain services through the Medicaid providers of their choice on a “fee-for-service” basis. Once approved, recipients received information on managed care plans in their area. In Miami-Dade, Medicaid Options mails newly eligible recipients informational material and assists recipients in choosing a managed care plan. If you have active Medicaid, you may be enrolled in MediPass, Minority Physician Network (MPN), Health Maintenance Organizations (HMOs), Prepaid dental health plans (PDHPs), Provider Service Networks (PSNs), or you may not be enrolled in any and have “Straight Medicaid” (also known as “Fee-forservice). Back to top What is a Medicaid HMO? A Medicaid HMO is a health maintenance organization that has a contract with the Florida Medicaid Program. The HMO has a network of doctors, specialists, dentists, and other providers that work for them to offer a wide range of health care services, including physical exams, and treatment services. If you are a mandatory enrollee in a Medicaid HMO, once you are enrolled in a health plan, you will have 90 days from the date of your first enrollment to try the plan. During the first 90 days you can change health plans for any reason. After the 90 days, if you are still eligible for Medicaid, you will be enrolled in the plan for the next nine months. This is called “lock-in.” Back to top How do I change HMO’s? Exemption from mandatory assignment: Children in foster care and in subsidized adoption arrangements cannot be mandatorily assigned into a plan. They remain free in the system until a voluntary plan choice is made. Exemption from open enrollment: Children in foster care and subsidized adoption arrangements can change plans at anytime for any reason. They may move from fee-for-service to managed care assignment as necessary at any point of time. However, any changes made to this Medicaid population follow the established cut-off dates. Exemption from managed care assignment: Foster care children whose Medicaid eligibility is through the emergency shelter Medicaid cannot be assigned to a Medicaid plan. They are exempt from managed care assignment and have to receive medical services on a fee-for-service basis. If you have fee-for-service or “Straight Medicaid,” you can enroll into any managed care plan (See Medicaid HMO’s/PSN’s list for Miami-Dade County) by calling: Medicaid Options Helpline: 1-888-367-6554. For More Information visit them online: http://www.medicaidoptions.net/ Back to top What if I am in Monroe county? In Monroe County, you may be assigned to MediPass or fee-for-service Medicaid. If you would like to enroll into MediPass or if you would like to change from one MediPass provider to another MediPass provider, contact your local Medicaid Office: 305-593-3000 Option 3 (Monday thru Friday 8 a.m.-5 p.m.) Back to top |
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