Physical, occupational and speech therapy. Did you know you can see your doctor from home? Access to specialists may be coordinated by your primary care physician. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs. Dixie, The Florida Medicaid MMA plan specialists can answer questions and help you enroll. Staywell’s. PDF (Portable Document Format) files can be viewed with Adobe® Reader®. 24 hours a day, 7 days a week. Polk, Search for doctors, hospitals and specialists. We can arrange for a medical interpreter to be at your appointments. Call Member Services at 1-800-477-6931 or TTY at 711 2 “If you do not speak English, call us at 1-800-477-6931 (TTY : 711). They will: Your case manager will stay with you or your child throughout the medical journey. Clay, endstream endobj 3464 0 obj <>stream and Chapter 59G, Florida Administrative Code (F.A.C. We are required by law to let you know that the Notice is available, and how you can get a copy of it. Obtaining the Handbook Update When a handbook is updated, the Medicaid provider will be notified. This link is being made available so that you may obtain information from a third-party website. You will need the Medicaid ID number of each member and the account PIN number. General Handbook General information for providers regarding the Florida Medicaid Program, recipient eligibility, provider enrollment, fraud and abuse policy, and important resources are included in the Florida Medicaid Provider General Handbook. Medicaid. Chances are, we have someone who speaks your language. Our plan will cover you up to $25 each month for medically necessary over-the-counter medicine or medical supplies you purchase. Florida Medicaid Provider Manual Effective November 20. Members needing help obtaining pediatric services, or providers experiencing issues, can contact our plan coordinator Adrianna Genaro at, Private Duty Nursing (PDN) Approval Letter -, UnitedHealthcare Connected™ for MyCare Ohio (Medicare-Medicaid Plan), UnitedHealthcare Connected™ (Medicare-Medicaid Plan), UnitedHealthcare Connected Benefit Disclaimer, UnitedHealthcare Senior Care Options (HMO SNP) Plan, Medicare dual eligible special needs plans, UnitedHealthcare is Closely Watching the Coronavirus (COVID-19), Agency for Health Care Administration’s website, Non-Discrimination Language Assistance Notices. This Florida Medicaid Plan offers a range of benefits. These types of lifestyle changes can help with many chronic conditions. You can download a copy of our Notice of Privacy Practices below. We have a program to help you with this. UnitedHealthcare Connected (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees. © 2021 UnitedHealthcare Services, Inc. All rights reserved. FLORIDA MEDICAID HEALTH PLAN MEMBER HANDBOOK. Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life. Our diabetes program also includes self-care training and classes focused on: Your health and safety at home are important. Florida Relay 711 or TTY 1-800-955-8771. Provider manual. 1-855-355-9800 (TTY 1-855-358-5856). Florida Medicaid Provider Handbook FLHJR7VEN 10 The Florida Medicaid program is implementing a new system through which Medicaid enrollees will receive services. Florida Medicaid Provider Manual Effective August 31, 2020 Page 5 of 136 secure provider portal: https://provider.wellcare.com 2020 Florida Medicaid Provider Manual Table of Revisions Date Section Comments Page Change 8/31/2020 Section 5: Claims 275 Claim Attachment Transactions via EDI 70 Added new section And we want to make getting your medicine easy. ATENCIÓN: Si habla [ingrese el idioma], hay servicios de asistencia lingüística disponibles para usted y que no tienen cargo. Call Member Services at 1-844-243-5187 (TTY: 711) Updated July 2020 2 If you do not speak English, call us at 1-844-243-5187 (TTY: 711). The notification instructs the provider to obtain the updated handbook from the Medicaid fiscal agent’s Web site at www.mymedicaid-florida.com This way you will be familiar with it. Chances are, we have someone who speaks your language. However, their mother may choose another plan for the baby within 90 days of enrollment. Benefits and/or copayments may change on January 1 of each year. Talk to your UnitedHealthcare network doctor about getting the flu shot. We have access to interpreter services and … Questions? Medicaid. Call the Helpline to speak to a Choice Counselor toll free at. We are here for you and your family. Already a member? hބ��n�0Ee��i���!���tA������%ǎ���cEjDWWc{���@� �e�O�����y�A�3A2�)�8��0z0{� ���]�XD�"4�C��l��X�F��>ڻ�v��¢������S�[��I���6{s+�bw�_@��wn� c�Qq"=c�E�+�k��J:���vA��G��&fe.���s�.��%�a�E#����T�a���5J��韅8��IE��\��>�Ç�0A�Z�'T|ZS�Ӯ�h���K�S�{�n��` ��� We can diagnose, treat, and prescribe medicine if needed for: Call 1-888-716-8787 for more information. Text4baby can help new and expecting mothers keep themselves and their babies healthy. Our program will help you take the right steps to keep you and your baby healthy. Help your child grow by protecting them against vaccine-preventable diseases. 3 If you do not speak English, call us at . General Handbook General information for providers regarding the Florida Medicaid Program, recipient eligibility, provider enrollment, fraud and abuse policy, and important resources is included in the Florida Medicaid Provider General Handbook. Medicaid. We use Health Homes to coordinate services for our members. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare® Connected™ de MyCare Ohio (plan Medicare-Medicaid), comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al 1-844-445-8328 (TTY 711) de lunes a viernes de 7 a.m. a 8 p.m. (correo de voz disponible las 24 horas del día, los 7 días de la semana). For example, your care provider might recommend: Sometimes you might need a little extra help using your health plan. This plan is available in the following counties: UnitedHealthcare continues to partner with state and local public health departments, following guidance and protocols appropriate to our members that are provided by the U.S. Centers for Disease Control and Prevention (CDC), and state and local public health departments that are appropriate for our members. Medicaid Provider Handbooks This handbook must be used in conjunction with the Florida Medicaid Provider Reimbursement Handbook, CMS-1500 which contains information about specific procedures for submitting claims for payment, and the Florida Medicaid Provider General Handbook, which describes the Florida Medicaid program. Explain what to expect at each stage of your pregnancy. Your doctor and you need to understand each other. Services that deliver right to your door. With us, you have someone you can call. and Volusia. Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which contains information about specific procedures for submitting claims for payment, and the Florida Medicaid Provider General Handbook, which describes the Florida Medicaid program. Routine shots help protect you from illness. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Florida Healthy Kids at 1-844-528-5815 (Monday through Friday 7:30 a.m. to 7:30 p.m. Eastern) Member Handbooks Florida Healthy Kids 2021 Handbook - English | Spanish Knowing what's wrong and finding it early can make all the difference. Looking for the federal government’s Medicaid website? This information is not a complete description of benefits. Use the Doctor Lookup tool to see if your doctor is in our network. Humana Medical Plan Inc. is a Managed Care Plan with a Florida Medicaid Contract. We also have people at our customer service who speak more than one language. Flagler, All of these programs are available at no cost to you. Budgeting Medicaid Waiver ser vices to individuals enrolled in that waiver. We are doctors and nurses working to help you. Lighthouse Health Plan is your Medicaid plan. The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. Newborns will be automatically enrolled in their mother’s plan at the time of birth. MMA: 1-844-446-2151 LTC: 1-844-445-7229 TTY: 711. The following are links to the Florida Medicaid Program Policy Manual. Medicare evaluates plans based on a 5-Star rating system. Effective 10/01/20. That's why our plan benefits include: If you have asthma, diabetes or another long-term condition, you can depend on us. See a doctor without leaving your house. We do not make any representations regarding the quality of products or services offered, or the content or accuracy of the materials on such websites. Talk to a doctor 24/7 by phone or video—day or night from wherever you are. Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Medicaid is the medical assistance program authorized by Title XIX of the Social Security Act, 42U.S.C. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program. You have access to our member-only website. These visits can catch health problems early, so they can be treated. You will receive notice when necessary. Print ID cards, chat with a nurse online, and more. We do not guarantee that each provider is still accepting new members. The notification instructs the provider to obtain the updated handbook … %PDF-1.6 %���� You can receive information in your preferred language. Plans that provide special coverage for those who have both Medicaid and Medicare. Provide the care team with medical records. That includes: We want to help you to get the most from your health plan. endstream endobj 3465 0 obj <>stream Influenza, commonly called the flu, is a serious illness that can spread easily. You know you need to quit. Call 1-800-905-8671 TTY 711 for more information. To address the recent Hepatitis A public health crisis, UnitedHealthcare Community & State of Florida will begin covering the Hepatitis A vaccine as an expanded benefit for our adult members. information in the online or paper directories. If you have noticed changes in your mood, habits or the way you feel, you may need to talk to someone about these feelings. You'll get medicine, supplies and education to help you reach and stay your best. That includes rides to: You’ll get the care, eyeglasses and treatment that let you see life more clearly. We are here Monday through Friday from 8:00 a.m. to 7:00 p.m. ATTENTION: If you speak [insert language], language assistance services, free of charge, are available to you. Levy, hޜ��nB1E���8v �t�b@� ui�B��}��u:V�%��s|m'�b�@�"3�"�� Do you or your child have a serious health problem? Sumter, Text ENROLL to FLSMMC (357662). Lighthouse Health Plan is your Medicaid plan. Llame al 1-800-905-8671 TTY 711. Eligible recipients who must enroll will have 30 days to choose a managed care plan from the plans available in their region. For more information contact the plan or read the Member Handbook. You may have a $3 copayment per day for a nonemergency dental visit in a federally qualified health center. Are you elgible for Florida Medicaid… It must be used together with the Florida Medicaid Provider General Handbook, which contains information about the Medicaid program, and the Florida Medicaid Provider Reimbursement Handbook, CMS-1500, which contains procedures for submitting claims for payment. Required care is 100% covered. We have access FLORIDA MEDICAID MEMBER HANDBOOK 2020-2021 Effective 10/01/20 . A nurse who specializes in breathing issues can really help. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services. Advise you about getting care at a doctor visit or an urgent care center. Gilchrist, To Learn More About UnitedHealthcare Community Plan. Lake, Therapy can help you recover from a serious injury or illness, or simply reach your full potential. It can lead to missed days at school or work, and even hospital stays. If you don't already have this viewer on your computer, download it free from the Adobe website. Our plan covers medical equipment ordered by your doctor or case manager. Do you smoke? Get the care you need to stay healthy, or to get better if you are injured or sick. Enrollment in the plan depends on the plan’s contract renewal with Medicare. Call 1-800-905-8671 TTY 711. If you have not completed a pregnancy health risk assessment, please call 1-888-716-8787 to talk with a representative from 8-5 pm M-F. FL1WMCMHB66598E_1120 Member Handbook . Florida Medicaid enrolled hospital providers may elect to make presumptive eligibility determinations in accordance with federal law and state policy. We have access to interpreter services and can help answer your questions in … General Handbook General information for providers regarding the Florida Medicaid Program, recipient eligibility, provider enrollment, fraud and abuse policy, and important resources are included in the Florida Medicaid Provider General Handbook. The benefit information provided is a brief summary, not a complete description of benefits. The Handbook is for long-term care providers, physicians, ancillary providers, health service providers, hospitals, and, other ... Florida Medicaid is the state and federal partnership that provides health coverage for Questions? Miami-Dade, Members receive needed: Our plan provides unlimited round trips to and from health care locations. Medicaid. UnitedHealthcare Community Plan wants to help you and your family stay connected to your doctor during these uncertain times. Please review the UnitedHealthcare Coronavirus (COVID-19) Information. Parents, remember that well-child visits are very important during the COVID-19 pandemic. If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to: Your health care costs may include non-prescription medicines and supplies like aspirin, cough medicine or bandages. Manatee, E Florida Medicaid Health Plan Member Handbook SunshineHealth.com SH_2370 1-866-796-0530 TTY 1-800-955-8770 November 2020 §1396 et seq., and regulations thereunder, as administered in the State of Florida by the Agency for Alachua, Bradford, Citrus, Columbia, Dixie, Gilchrist, Hamilton, Hernando, Lafayette, Lake, Levy, Marion, Putnam, Sumter, Suwannee, and Union Counties, Baker, Clay, Duval, Flagler, Nassau, St. Johns, and Volusia Counties, Hardee, Highlands, Hillsborough, Manatee and Polk Counties, UnitedHealthcare Community Plan Medicaid (MMA). 3462 0 obj <>stream Not speaking English well makes this difficult. Suwannee, Section 409.906, Florida Statutes (F.S.) We have a smoking cessation program that is available at no cost. You can get up to 10 meals delivered each year after being discharged by the hospital. You can apply for Medicaid through the Florida Department of Children and Families You can also visit the SMMC website at https://www.myflfamilies.com/service-programs/access/medicaid.shtml. Out-of-network/non- contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Preventive services include: There are no copayments for preventive care. Schedule visits and exams and arrange rides to your visits. This is not a complete list. Coverage includes: This benefit is offered by Vision Service Plan. And be more relaxed when you have your baby. Introduction The update log provides a history of the handbook updates. If needed, our plan covers short stays in a rehabilitation center where you can heal. Your health information is kept confidential in accordance with the law. The portion that pertains directly to Nursing Home Medicaid are the sections denoted by MSSI (Medicaid … If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you. A pregnancy is a journey you’ll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN. If you have any questions, or need help making appointments, just call us at 1-866-796-0530. St. Johns, Click here for more information from the CDC. MMA Member Handbook (End Date September 30, 2020) MMA Member Handbook (Updated Version Effective October 1, 2020) Need your Member Handbook in your language or format? with no copay. Plus you can earn $10 just for signing up. The benefit information is a brief summary, not a complete description of benefits. Putnam, Then our case managers are in your corner. Provide medical care for you or your child. It was designed for you. Benefits include: Get the medical care and equipment you need to live safely at home. This program is called the Statewide Medicaid Managed Care Managed Medical Assistance program. Eligible Medicaid recipients will receive a letter with enrollment information, including information on how to enroll. Avoid the waiting room, taking time off work and the drive or bus ride. Benefits include: Make sure your sight and hearing are at their best. You qualify based on your family’s income. MMA: 1-844-446-2151 Miami Children’s Health Plan Member Handbook Questions? This can include supplies like: Trouble hearing can affect your everyday life in many ways. In 2014, the Florida Medicaid program implemented a new system through To report incorrect information, email provider_directory_invalid_issues@uhc.com. Some network providers may have been added or removed from our network after this directory was updated. There may be providers or certain specialties that are not included in this application that are part of our network. Humana Healthy Horizons™ in Florida Medicaid Member Handbook. Medicaid also assists the elderly and people with disabilities with the costs of nursing facility care and other medical and long-term care expenses. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Florida Medicaid Non-emergency Transportation Beneficiary handbook Regions 1,2,9,10 and 11 Version: July 2015 . FLORIDA MEDICAID DENTAL PROGRAM ENROLLEE HANDBOOK OCTOBER 2020. Where you have your baby is an important choice. Limitations, copays and restrictions may apply. The benefit information provided is a brief summary, not a complete description of benefits. After a serious illness, surgery or injury, you may need extra nursing and therapy. If you would like to join any of these programs, please call us at 1-844-446-2151. Each text contains health and safety tips for topics like: So you and your baby can make a healthy start. UnitedHealthcare Connected has a Model of Care approved by the National Committee for Quality Assurance (NCQA) to operate as a Special Needs Plan (SNP) until 2017 based on a review of UnitedHealthcare Connected’s Model of Care. Simply Healthcare Plans, Inc.’s Florida Medicaid Member Handbook Managed Medical Assist ance • 844-406-2396 (TTY 711) Long-T. erm Care • 877-440-3738 (TTY 711) ACCESS Central Mail Center Florida Medicaid Member Handbook Updated 10/01/2019 . Call Member Services at 1-844-243-5176 (TTY: 711) Updated July 2020 2 . The only thing you won't get from us is a lecture. h�d�AK�@࿲�&���n�&R Lighthouse Health Plan Member Handbook Questions? Limitations, co-payments, and restrictions may apply. General Handbook General information for providers regarding the Florida Medicaid Program, recipient eligibility, provider enrollment, fraud and abuse policy, and important resources are included in the Florida Medicaid Provider General Handbook. Specific statutory authority for the promulgation of the Florida Medicaid Developmental Disabilities Waiver Services Handbook into rule is found in the following provisions of Call Member Services at 1-855-355-9800 or TTY 1-855-358-5856. 2020 Page 3 of 136. secure provider portal: https://provider.wellcare.com . Newborns will be automatically enrolled in their mother’s plan at the time of birth. Language help If you do not speak English, call MMA Member Services at 1-888-716-8787, TTY 711; and LTC Member Services at 1-800-791-9233, TTY 711. Information to clarify health plan choices for people with Medicaid and Medicare. Referrals to specialists for certain conditions. income families and individuals. The Managed Medical Assistance (MMA) program is comprised of several types of Call Member Services at 1-844-243-5131 (TTY: 711) Effective 10/1/2020 7 Welcome to Vivida Health’s Statewide Medicaid Managed Care Plan Vivida Health has a contract with the Florida Agency for Health Care Administration (Agency) to provide health care services to people with Medicaid. E Florida Medicaid Health Plan Member Handbook SunshineHealth.com SH_2370 1-866-796-0530 TTY 1-800-955-8770 November 2020 If you have any problem reading or understanding this or any other UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) information, please contact our Member Services at 1-844-445-8328 (TTY 711) from 7 a.m. to 8 p.m. Monday through Friday (voice mail available 24 hours a day/7 days a week) for help at no cost to you. Duval, Lafayette, In 2014, the Florida Medicaid program implemented a new system through which Medicaid enrollees receive services. This general handbook is distributed to all enrolled Medicaid providers and is Eligible Medicaid recipients will receive a letter with enrollment information, including information on how to enroll. That's why we have coverage for both. UnitedHealthcare Connected for MyCare Ohio (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. Call Member Services at 1-844-243-5176 or TTY at 711 2. This plan pays for all expenses related to a hospital stay, so you can rest and heal.