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Need Help Understanding Medicaid

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In order to be on the Florida Medicaid Waiver, you MUST have medicaid. There are certain safeguards a person must take in order to keep their medicaid eligibility. If a person loses their medicaid, providers don't get paid, and the person can not get the medications and treatment they need. The support coordinator must call l 800-239-7560 at the beginning of each month to verify eligibility.

Learn about Florida Medicaid, Learn how to fill out a Medicaid application, understand what Medicaid covers.

Please write to WaiverInfo@aol.com if you know of any other resources. We would love to know if they ever make the process for filling out the Florida Medicaid Application more user friendly.

 
** Some Clients Also Have Medicare.**
Lose Your Florida Medicaid?

Support Coordinators, it's bound to happen sooner or later.  Someone will lose their Florida medicaid, usually because they didn't return the paperwork medicaid requested in time.  Medicaid truly gives them an very short deadline, usually about days to find documentation such as birth certificate, photo id, proof of income, etc, and submit to their office for review.

When it happens, you have to help the person reapply as soon as possible.  Without Florida medicaid eligibility you don't get paid, the other providers don't get paid, and they don't get their medication. 

Luckily, There have been vast improvements to the online application process.

Filling Out The Online Florida Medicaid Application- Part 1- Find The Application

Florida Online Medicaid Application (there is now a direct link.)

1. Go to the online application. The application allows you to apply for Food Stamps, Temporary Cash Assistance, and/or Medicaid. You will choose "Apply for Benefits"

2. Read the directions and the warnings, and then click "continue". It will bring you to the start application page.

3. Once on the "Start Application" page, click "Apply for benefits". Then click "continue" Then click continue.

4. Select who you are applying for. Also,choose which benefits you would like to apply for.

5. Fill out the "Benefit Selection" Information. And press continue.

6. If applying for food stamps or cash assistance, this next step warns you that you might be drug tested. Click continue.

7. You will be given an "Access Number" on the next screen, make sure you write it down. You will also have to fill in the same password twice. It's very important that you write down your access number and your password. Keep these in a safe place.

 

Filling Out The Online Florida Medicaid Application- Part 2- Tips For Completing The Application.

Here are some tips.

1.  You can now apply online by providing just your name, address, and signing your application. It is best to fill out as much of the application as you can.

2.  Have the person that handles their affairs handy (bank accounts, school information, job information, etc). You want to try to fill out as much of the information as you can.

3.  Have a copy of their support plan handy (you will need their social security number, address, etc)

4.  The application now allows you to the next step even if you have not filled in every line they request.  The will ask for things you don't know, and maybe nobody knows.  If the application is not complete, you will be asked to provide the rest of the information at a later date.

5.  Don't forget to write down the access number of the application and the password.

6.  When you finish the Florida Medicaid application, return to the application to fill out the comments section.  You will want to write comments such as "Medicaid Waiver Client.  Forward to a Medicaid Waiver Specialist.  Support Coordinator is John Doe, phone number (999) 999-9999."

7.  You will need to send the medicaid specialist in their county a copy of the 2515 form and the Level of Care Form.

8. Each district has a different process for the 2515 forms. Contact your local APD office to find out their policy.

Does Florida Medicaid Cover That? (For Florida Medipass Users Only)

Florida Medicaid has 11 area offices.  For example "Area 5" supports people in Pasco and Pinellas Counties. Staff are available during regular business hours to answer many questions.  If you want to know if medicaid pays for glasses, call your area office.   If you want to know if Medicaid pays for physical therapy, call your area office.  They will be able to answer your questions in detail.  They can also provide you with a list of Florida medicaid providers, doctors, and dentists.  You can also call the Medicaid Resources help line at (800) 299-4844 extension 276 for help.

There Are Different Kinds Of Medicaid, Not Everyone Has MediPass.

Unfortunately, the Medicaid Area offices can not help everyone.  They can only assist people who have Medi-Pass.  Everyone on Medicaid in Florida has a choice of "Medicaid Managed Care Plans".  For example, they might have Medi-Pass, Amerigroup, Staywell, or United HealthCare (to name just a few). If they don't have Medi-Pass,  Medicaid Options will be able to give you the phone number to any of the Medicaid Managed Health Care plans.  You will then need to call the Medicaid Managed Health Care plan to get specific information about doctors and covered items. 

 If a person wants to choose a Medicaid Managed Care Plan or a doctor, they need to call Medicaid Options at (888) 367-6554.   You can not do this for them unless they are present with you and give the phone operator permission.

Florida Medicaid Covered Services
(From AHCA handout dated 07/06)

-  Hospital Services:  Check for dollar limits and day limits.

- Prescribed Drug Service:  Covers generic and brand name drugs on the Preferred Drug list.  If drugs on the Preferred Drug list have been tried, and do not work, you can request an approval to use Non-PDL medications.

- Chiropractic Services-  Maximum of 24 visits per year.

- Community Mental Health Services

- Dental Services-  Ages 0-20 includes: Diagnostic, preventive, therapeutic, and emergency dental services.  Ages 21 and over covers emergency services only such as extractions.

- Hearing Services- Evaluations, hearing aid devices, hearing aid repairs, cochlear implant devices and repairs.

- Home Health Services- Limitations apply to certain age groups.  Covers private duty nursing, therapy, and medical supplies.

- Podiatry Services

- Transportation Services- Transportation to receive a Florida Medicaid covered medical services (when no other means are available)

- Visual Services - Covered for any age.  Includes 1 exam and 1 pair of eyeglasses per year.  Exceptions can be made.

Medicaid Offices by County

County

Phone

County

Phone

 

Alachua

386-418-5350

Lake

352-732-1349

 

Bay

1-800-699-70687

Lee

1-800-226-6735

 

Baker

1-800-273-5880

Leon

1-800-248-2243

 

Bradford

386-418-5350

Levy

386-418-5350

 

Brevard

1-877-254-1055 (toll free)

Liberty

1-800-248-2243

 

Broward

954-202-3200

Madison

1-800-248-2243

 

Calhoun

1-800-248-2243

Manatee

1-800-226-2316

 

Charlotte

1-800-226-6735

Marion

352-732-1349

 

Citrus

352-732-1349

Martin

561-881-5080

 

Clay

1-800-273-5880

Monroe

305-499-2000

 

Collier

1-800-226-6735

Nassau

1-800-273-5880

 

Columbia

386-418-5350

Okaloosa

850-595-5700

 

Dade

305-499-2000

Okeechobee

561-881-5080

 

DeSoto

1-800-226-6735

Orange

1-877-254-1055 (toll free)

 

Dixie

386-418-5350

Osceola

1-877-254-1055 (toll free)

 

Duval

1-800-273-5880

Palm Beach

561-881-5080

 

Escambia

850-595-5700

Pasco

1-800-299-4844

 

Flagler

1-800-273-5880

Pinellas

1-800-299-4844

 

Franklin

1-800-699-70687

Polk

1-800-226-2316

 

Gadsden

1-800-248-2243

Putnam

386-418-5350

 

Gilchrist

386-418-5350

Santa Rosa

850-595-5700

 

Glades

1-800-226-6735

Sarasota

1-800-226-6735

 

Gulf

1-800-699-70687

Seminole

1-877-254-1055 (toll free)

 

Hamilton

386-418-5350

St. Johns

1-800-273-5880

 

Hardee

1-800-226-2316

St. Lucie

561-881-5080

 

Hendry

1-800-226-6735

Sumter

352-732-1349

 

Hernando

352-732-1349

Suwannee

386-418-5350

 

Highlands

1-800-226-2316

Taylor

1-800-248-2243

 

Hillsborough

1-800-226-2316

Union

386-418-5350

 

Holmes

1-800-699-70687

Volusia

1-800-273-5880

 

Indian River

561-881-5080

Wakulla

1-800-248-2243

 

Jackson

1-800-699-70687

Walton

850-595-5700

 

Jefferson

1-800-248-2243

Washington

1-800-699-70687

 

Lafayette

386-418-5350