Main AHCA Website

AHCA’s main website for information on Medicaid, Health Quality Assurance and the Florida Center for Health Information and Policy Analysis.

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Florida Health Information Network

This website provides information and resources relating to AHCA’s initiatives for Health Information Technology and Health Information Exchange.

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FloridaHealthFinder.gov

Provides health education and information to compare and locate health care providers in Florida to make well-informed health care decisions.

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AHCA Network of Websites

Resources

GENERAL INFORMATION

Brochure

General information on the Florida Medicaid Program can be found in our brochure, “ Florida Medicaid – A Reference Guide”.

Application

Applications for Medicaid are made through the Florida Department of Children and Families (DCF). To learn more call the DCF toll-free number (866) 762-2237 or view the DCF website by clicking www.dcf.state.fl.us.

A person who moves here from another state, who had Medicaid in the prior state, has to apply again for Medicaid in Florida. Medicaid cannot be transferred between states. However, if they receive Supplemental Security Income (SSI) and had Medicaid in another state, they can contact the Social Security office to report their new address and begin the Florida application process. Call the Social Security office’s toll-free number (800) 772-1213 or TTY (800) 325-0778, or to view their website click www.ssa.gov.

Families who only want to apply for Medicaid for their children may submit a Florida KidCare application. Applications may be obtained by calling (888) 540-5437 or apply online at www.floridakidcare.org.

Area Medicaid Offices

Our Area Medicaid Offices have a list of doctors, dentists, and specialists who serve Medicaid patients. They can also answer questions about Medicaid services and providers. To find your office click http://ahca.myflorida.com/Medicaid/index.shtml#10 then click your County.

Each Area Office’s page includes phone numbers and a “Contact Our Office” link where you can send an e-mail. Scroll down the page to find links to a list of primary care doctors, dentists, and hearing and vision providers, as well as other Medicaid information. (The Area Offices also provide information for Medicaid providers, including training, handbooks, fee schedules, and more.)

However, if you are in a Medicaid health plan (HMO or PSN) you need to contact the health plan for a list of Medicaid providers. Call the health plan phone number listed on paperwork the health plan gave to you. If you do not have a number or are uncertain what type of Medicaid coverage you have, contact the Area Medicaid Office that serves your County (see the paragraphs above) and they can check what kind of coverage you have.

Please be aware, doctors and other health care providers are not required to accept Medicaid patients or they may not be accepting new patients. When you call a provider, ask if they are accepting Medicaid patients. If you call the providers listed on the Area Medicaid Office website and still are unable to find a provider, contact the Area Medicaid Office and they will try to find a provider for you.

Eligibility

The following people may qualify for the Florida Medicaid Program if they meet specific income and asset requirements:

  • Low-income families with children
  • Pregnant women
  • Infants and children under the age of 21
  • Recipients of Supplemental Security Income (SSI)
  • People who are aged 65 or older
  • People who are blind or expected to be disabled for at least a year
  • People who need nursing home care or home and community-based care
  • People who are on Medicare
  • Aliens and refugees under a special assistance program (Emergency Medicaid)
  • Individuals who are medically needy

To find out if a person is eligible he or she must submit an application to the Florida Department of Children and Families. Read the “Application” section on this Web page or follow this link for additional information:

http://www.dcf.state.fl.us/programs/access/index.shtml

Medicaid Card

The Florida Department of Children and Families (DCF) is the state agency that provides Medicaid cards. If a person needs a replacement card, call the DCF toll-free number (866) 762-2237.

If you were just approved for Medicaid it can take two to three weeks to receive the card.  If you need proof of Medicaid eligibility right away, you can print a temporary card at www.MyFlorida.com/accessflorida (click “My Access Account” on the right hand side of the page).

Medicaid Providers

Sign Up for Medicaid Health Care Alerts– The Florida Medicaid program has an e-mail alert system to supplement the present method of receiving Provider Alerts information and to notify registered providers or interested parties of "late-breaking" health care information.

Additional Medicaid provider information can be found on our Agency’s website http://ahca.myflorida.com/Medicaid.

Medicaid Services

Florida Medicaid covers a variety of medical services. The type and amount of services depends on the age of the beneficiary, the type of Medicaid program in which the beneficiary is enrolled, and the type of services determined medically necessary by the beneficiary’s primary doctor. Medicaid services may include: doctor, hospital, family planning (birth control, pregnancy and birth care), home health care, nursing home, hospice, transportation, dental and visual, prescription drugs, community behavioral health, and services through the Child Health Check-Up program, and other types of services.

For more information about services covered by Florida Medicaid click Medicaid Services. On the website there is a link to the publication “Summary of Services”.

Find Medicaid Doctors, Dentists & Specialists

Our Area Medicaid Offices have a list of doctors, dentists, and specialists who serve Medicaid patients. They can also answer questions about Medicaid services and providers. To find your office click http://ahca.myflorida.com/Medicaid/index.shtml#10 then click your County.

Each Area Office’s page includes phone numbers and a “Contact Our Office” link where you can send an e-mail. Scroll down the page to find links to a list of primary care doctors, dentists, and hearing and vision providers, as well as other Medicaid information. (The Area Offices also provide information for Medicaid providers, including training, handbooks, fee schedules, and more.)

However, if you are in a Medicaid health plan (HMO or PSN) you need to contact the health plan for a list of Medicaid providers. Call the health plan phone number listed on paperwork the health plan gave to you. If you do not have a number or are uncertain what type of Medicaid coverage you have, contact the Area Medicaid Office that serves your County (see the paragraphs above) and they can check what kind of coverage you have.

Please be aware, doctors and other health care providers are not required to accept Medicaid patients or they may not be accepting new patients. When you call a provider, ask if they are accepting Medicaid patients. If you call the providers listed on the Area Medicaid Office website and still are unable to find a provider, contact the Area Medicaid Office and they will try to find a provider for you.

Choosing a Medicaid Managed Care Plan

Many Medicaid beneficiaries in Florida are required to enroll in some form of managed care, which may include MediPass, health maintenance organizations (HMOs), provider service networks, and local provider organizations. A person chooses among the managed care options available in his or her area of the state and sees health care providers who are a part of the managed care plan. To choose a managed care plan, or to learn more about Medicaid managed care options:

If a person lives in Broward, Baker, Clay, Duval or Nassau County call the toll-free number (866) 454-3959 or TDD (866) 467-4970 or view the website www.FLMedicaidReform.com.

If a person lives in other areas of the State call the toll-free number (888) 367-6554 or TDD (800) 653-9803 or view the website www.MedicaidOptions.net.

Beneficiaries who are not required to enroll in a managed care plan may continue to receive services from any Medicaid-enrolled provider.

Discontinue Medicaid Enrollment

To stop Medicaid coverage you need to contact the Florida Department of Children and Families (DCF). Within Florida you can call the toll-free number (866) 762-2237. If you are outside of Florida you can write to a DCF district office. To find a list of district offices click www.dcf.state.fl.us/programs/access/servicecenters.shtml#svcctrs.

Medicaid and Medicare

Medicaid and Medicare are two separate programs. Medicaid is a program for people who meet certain eligibility requirements and programs can vary from state-to-state. Medicare is a federal health insurance program for people who are age 65 or older, disabled persons, or those with end-stage kidney disease. Medicare eligibility is not based on income and basic coverage is the same in each state.

If you have questions about Medicare, call the toll-free number (800) 633-4227 or TTY (877) 486-2048 or view the website www.Medicare.gov.

If a person is covered by both Medicare and Medicaid, the Florida Medicaid program may cover:

  • Medicare deductible (portion a person pays before Medicare starts to pay for covered services);
  • A portion of Medicare co-payment and co-insurance (portion of cost a person shares with Medicare for some covered services);
  • Premiums paid for Medicare coverage; and/or
  • Some services or items Medicare does not cover (up to the amount Medicaid will cover).

If a person does have Medicare and qualifies for Medicaid, they will receive these Medicaid benefits through the following programs: Qualified Medicare Beneficiaries (QMB), Qualifying Individuals 1 (formerly Part B Medicare Only), and Special Low-Income Medicare Beneficiaries (SLMB). To apply for one of these programs or for more information, contact the Department of Children and Families’ toll-free number (866) 762-2237 or view their website by clicking www.dcf.state.fl.us.

Refugee Assistance Program and Emergency Medicaid for Aliens

Refugee Assistance Program: Refugees might qualify for this program, which includes Medicaid for 8 months after arrival, along with education, social and employment services, and other possible services. This program is federally-funded through the U.S. Department of Health and Human Services, Office of Refugee Resettlement. The Florida Department of Children & Families (DCF) is the State Refugee Coordinator for Refugee Services. To learn more and for contact information, click www.dcf.state.fl.us/programs/refugee.

Emergency Medicaid for Aliens: Noncitizens who meet all Medicaid eligibility requirements except for citizenship may be eligible for Medicaid to cover medical emergencies, including birth of a child, stroke, heart attack, traumatic amputation, severe burns, etc. It covers only the medical emergency. The program covers legal aliens who haven’t yet been here for 5 years and illegal aliens. Noncitizens who are tourists or are here for business are not eligible. Applications are taken at the Florida Dept. of Children and Families (DCF). To learn more go to the DCF website or call the toll-free number (866) 762-2237.

Termination, Denial or Reduction Appeal

You have the right to appeal any decision made about your Medicaid application or any reduction or termination of your benefits. You can request a hearing by contacting your local office at the Florida Dept. of Children and Families (DCF). To find your local DCF office, click www.dcf.state.fl.us/programs/access/servicecenters.shtml#svcctrs.

Transportation

To arrange transportation services under Florida Medicaid, contact the local office of the Florida Commission for the Transportation Disadvantaged.  You can find the office that serves your County by clicking this link www.dot.state.fl.us/ctd/contacts/ctcsbycounty.htm.  Some Counties will have two listings for providers.  If there are two, contact the provider listed as Medicaid.  If there is only one provider, contact that one as they provide transportation under the Medicaid Program.