Medicaid Application Process
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State Medicaid Programs List
Published:Thu, 23 Feb 2012 17:45:37 -0800
It's a tricky math problem to get to the $2.7 billion that Gov. Pat Quinn wants cut out of Illinois's projected Medicaid spending, and four lawmakers designated to take a ......
Published:Wed, 22 Feb 2012 22:09:53 -0800
Centene, the nation's fourth-largest Medicaid contractor, employs about 5,300 workers nationwide.......
Published:Thu, 23 Feb 2012 08:16:40 -0800
Kansas officials announced Wednesday that five companies have submitted bids for three contracts to manage Medicaid, but skeptics of Gov. Sam Brownback's plan to overhaul the ......
Published:Wed, 22 Feb 2012 10:31:01 -0800
SPRINGFIELD, Illinois (Reuters) - Illinois Governor Pat Quinn will call for cuts to escalating pension and Medicaid costs in his budget address on Wednesday to stop the two progra......
Published:Wed, 22 Feb 2012 15:11:09 -0800
California patients and doctors had sued to block the state's decision to cut Medicaid payment rates. But instead of ruling on the matter, the U.S. Supreme Court sent the case......
The Florida Medicaid Program
The Florida Medicaid program is a federal and state medical assistance program that provides low-income Florida residents and families with health care coverage. Florida Medicaid also can help disabled and older individuals with medical expenses and the costs of nursing home care. Eligibility for Florida Medicaid is typically based on the individual or family's income and assets.
Both the State of Florida and the United States Government share the expenses of the Florida Medicaid program.
In Florida, the Agency for Health Care Administration (AHCA) manages the Medicaid program. Although the Health Care Administration oversees Medicaid, your eligibility for Florida Medicaid is decided by either the Department of Children and Families (DCF), Florida Healthy Kids Corporation determines eligibility for MediKids, or if you receive Supplemental Security Income (SSI) through the Social Security Administration.
Medicaid currently provides service to about 3 million people in Florida. More than half of these are children and adolescents under the age of 21. Estimated Medicaid expenses this year in Florida are around $22.3 billion.
In Florida, most Medicaid beneficiaries must enroll in a Medicaid managed health care plan. Each of the managed plans must include all of the basic Florida Medicaid benefits. These managed plans may include MediPass, health maintenance organizations (HMOs), provider service networks, and local provider organizations. The managed plans provide a network of doctors, clinics, hospitals, and drug stores you can use. Also, you have a choice of doctors to select for your Primary Care Provider (PCP).
Florida Medicaid Eligibility
In Florida, there are 3 general groups of people that may qualify for Medicaid coverage:
1. Supplemental Security Income (SSI) recipients residing in Florida are automatically eligible for Forida Medicaid and are entitled to full Medicaid benefits. In order to qualify for SSI, you must be 65 years of age or older, disabled, or blind, and meet the SSI income and asset limits.
2. Children and families, including women may qualify for full Medicaid benefits or limited Medicaid benefits.
Florida Medicaid programs with FULL Medicaid benefits for children and families include:
* Florida Breast and Cervical Cancer Early Detection Program - This is for women who have been screened and diagnosed with cervical or breast cancer throught the Florida Breast and Cervical Cancer Early Detection Program which is managed by the Department of Health. Women enrolled in this program must have income that is at or below 200% of the federal poverty level, and are not yet 65 years of age.
* Foster Care, Adoption, and Emergency Shelter - This includes dependent children that are in the care and control of the state, and children that have special medical needs and whose adoption was supported by a private or state adoption agency.
* Low Income Families - This group includes single-parent families and families that have an unemployed or disabled parent. This group is typically known as the Temporary Assistance for Needy Families (TANF - group).
* Medicaid Expansion Designated by Sixth Omnibus Budget Reconciliation Act (MEDS) - This covers children 18 years of age or younger and pregnant women.
* Public Medical Assistance - Children that are living with intact families and children born after September 30, 1983, that are not living with relatives.
* The Refugee Program - This covers people that are not U.S. citizens but who are eligible under a special general assistance program.
Florida Medicaid programs with LIMITED Medicaid benefits for children and families include:
* Emergency Medicaid for Aliens - People that do not meet U.S. citizenship or permanent residency requirements are eligible for emergency medical services only.
* Family Planning Waiver - This Florida Medicaid waiver provides limited Medicaid coverage for family planning and related services to women that are ages 14 through 55, whose family income is at or below 185% of the federal poverty level, and who are not otherwise eligible for Medicaid, health insurance coverage that provides family planning services, or the Children's Health Insurance Program (CHIP). Your eligibility is limited to two years after losing Medicaid coverage and is determined annually. The limited Medicaid benefits can include family planning services, related pharmacy and lab services, antibiotics and medication to treat sexually transmitted infections, colposcopy, and sterilization.
* Medically Needy - This category provides a way for individuals with high medical costs to recieve Florida Medicaid coverage. To be eligible, you must provide copies of your medical bills to the Department of Children and Families (DCF) each month. The DCF will then track your medical bills and notify you when you become eligible for coverage. Your Medically Needy coverage starts on the day of the month in which your share of cost is met and ends on the last day of that month. You must met the share of cost each month. Medically Needy coverage does not provide coverage for long-term care facilities like state mental hospitals, nursing homes, or assistive care services. Medically Needy recipients are not eligible for the payment of Medicare premiums unless you are also eligible for Qualified Medicare Beneficiaries (QMB), Qualifying Individuals 1 (QI1), or Specified Low-Income Medicare Beneficiaries (SLMB) coverage.
* Presumptively Eligible Pregnant Women (PEPW) - This temporary presumptive eligibility is determined by regional perinatal intensive care centers, county health departments, and other qualified medical facilities for pregnant women that are low-income. This presumptive eligibility provides women with access to prenatal care while the Department of Children and Families determines eligibility. PEPW only covers prenatal office and outpatient services. It does not include labor and child delivery costs.
3. Aged, blind, and disabled individuals includes people that need institutional care (often called SSI-related Medicaid) may qualify for either full or limited Medicaid benefits.
Florida Medicaid programs with FULL Medicaid benefits for the aged, blind, or disabled who are not otherwise eligible for Supplemental Security Income (SSI) include:
* Home and Community-Based Services (HCBS) Waiver Program - These Florida Medicaid provides HCBS to people that would require institutional care without these services. To qualify for HCBS, you must meet the level of care and eligibility requirements for each program. HCBS is not available to Medicaid recipients that live in a hospital, or nursing facility. All individuals 21 years of age and older that apply for home and community based services waivers must receive a Comprehensive Assessment and Review for Long-term Care Services (CARES) Program.
* Hospice - Provides services for the patients that are terminally ill and their families.
* Insitutional Care Program (ICP) - This Florida Medicaid program covers people that require long-term institutional care in nursing homes, hospice, or intermediate care facilities for the the developmentally disabled. If an individual transferred assets and is not eligible for the ICP may be eligible for other Medicaid services. Anyone that is 21 years of age and older applying for nursing home services needs to get an assessment from the Comprehensive Assessment and Review for Long-term Care Services (CARES) Program.
* Medicaid for the Aged and Disabled (MEDS-AD) - As of January 2006, the 1115 demonstration waiver covers individuals that are:
a. 65 years of age or older or are permanently and totally disabled.
b. Have assets with prescribed asset limits.
c. Have income below 88 percent of the federal poverty level.
d. Are not eligible for Medicare unless you are receiving home and community-based waiver services, hospice, nursing facility services, or assisitve care services.
Florida Medicaid programs with LIMITED Medicaid benefits for the aged, blind, or disabled who are not otherwise eligible for Supplemental Security Income (SSI) include:
* Emergency Medicaid for Aliens - If you are not a U.S. citizen or have permanent residency status you are only eligible for emergency services.
* Medically Needy - This Medicaid program provides you the ability to receive Medicaid coverage if you have high medical costs. This Medicaid coverage does not include long-term care, institutional care facilities, or assistive care services. The Medicaid coverage is available if you meet Medicaid eligibility requirements but have too much income.
Florida Medicaid Card
If you meet Florida Medicaid requirements, you will be issued a permanent gold Medicaid card. You should present your Medicaid card to your medical providers when you are requesting medical assistance.
What if you don't qualify for Medicaid but need medical assistance?
If you are not eligible to receive Mediciad because your income or assets are above the Florida Medicaid program limits, you might be eligible for the Medically Needy program. You need to be enrolled in the Medical Needy program and have a specific amount of monthly medical bills before Medicaid can share the cost of your health care.
If you are not eligible for Medicaid you might be able to get assistance paying for your prescription drugs through the Florida Discount Drug Card Program.
If you are 19 to 64 years of age, and have not had any health insurance for the previous six months, you might be eligible for affordable health insurance through the Cover Florida Health Care Program.
The recent federal stimulus package included about $19 billion in Medicaid and Medicare incentives for developing better health information technology. All of the states are currently working on some version of electronic health records.
Florida Medicaid Reform
Florida is recognized a one of the leading states when it comes to Medicaid reform. The Florida Medicaid program offers true flexibility to Medicaid participants so health plans can target your needs.
Florida Medicaid wants people to make healthy choices and participate in activities that will help keep you from getting sick. The Florida Medicaid reform program wants to reward you for your healthy behavior.
Florida Medicaid Claims Data Online
Florida recently announced that they are the first state to offer Medicaid claims data online. Physicians in Florida are the now able to access statewide data on Medicaid patient claims through a Web portal.
The Florida Agency for Health Care Administration launched the service known as the Florida Medicaid Health Information Network (FHIN) which provides up to 18 months of patient records for selected clinical information. Before physicians and other health professionals can view a patients records, they must obtain the patients' consent, except for medical emergencies.
The Florida Medicaid agency also introduced personal electronic health records for Medicaid enrollees. Medicaid patients can submit information like emergency contact information and family medical history. The system is called My Florida Health eBook, and the system will also include Medicaid claims information.
It is difficult to predict how many of Florida's 2.8 million Medicaid enrollees would fill out their personal records. Having access to patient's prescription histories should be useful because many Medicaid enrollees are on multiple medications.
Florida Medicaid Application
If you are a resident of Florida and interested in applying for Florida Medicaid, you can create an Access Florida account and submit your Florida application for Medicaid online at http://www.myflorida.com/accessflorida/
To make finding Florida Medicaid help easy for you:
Florida Medicaid Regions by County and Phone NumbersArea 1: Escambia, Okaloosa, Santa Rosa and Walton1-800-303-2422Area 2A: Bay, Franklin, Gulf, Holmes, Jackson and Washington1-800-226-7690Area 2B: Calhoun, Gadsden, Jefferson, Leon, Liberty, Madison, Taylor and Wakulla.1-800-248-2243Area 3A: Alachua, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, levy, Putnam, Suwannee and Union1-800-803-3245Area 3B: Citrus, Hernando, Lake, Marion and Sumter1-877-724-2358Area 4: Baker, Clay, Duval, Flagler, Nassau, St. Johns and Volusia1-800-273-5880Area 5: Pasco and Pinellas1-800-299-4844Area 6: Hardee, Highlands, Hillsborough, Manatee and Polk1-800-226-2316Area 7: Brevard, Orange, Osceola andSeminole1-877-254-1055Area 8: Charlotte, Collier, Desoto, Glades, Hendry, Lee and Sarasota1-800-226-675Area 9: Indian River, Martin, Okeechobee, Palm Beach and St. Lucie1-800-226-5082Area 10: Broward1-866-875-9131Area 11: Miami-Dade and Monroe1-800-953-0555
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The official U.S. Government Medicare Web site is cms.gov.