GENERAL INFORMATION

Brochure

General information on the Florida Medicaid Program can be found in our brochure, “Florida Medicaid – A Reference Guide.” To request a brochure, call the toll-free number (888) 419-3456 or view it by clicking Florida Medicaid.

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.myflorida.com/cf_web.

Click here to access the application.

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.

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.myflorida.com/accessflorida/

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.

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” plus a list of Area Offices. Find the office that serves your County or scroll to the bottom of the page and click “Area Office Addresses,” to find an Area Office e-mail link as well as the street address and phone number.

Find Medicaid Doctors, Dentists & Specialists

There are two ways to locate Medicaid doctors, specialists and dentists, depending on the type of Medicaid coverage a person has.

1. If a person is covered by Medicaid, but not enrolled in a managed care option or MediPass: Our Agency’s Area Medicaid Offices have information on Medicaid doctors, dentists, and specialists. They can also answer questions about Medicaid services and providers.
2. If a person is enrolled in MediPass and needs specialist care, they can call their primary care doctor for a referral. If the doctor’s office needs help finding a specialist, they can contact the Area Medicaid Office.
   
   A person can find the office that serves their county by clicking Medicaid Area Offices then click on your County’s name or the area of the map where you live. It will include a phone number and an e-mail link for contacting the office that serves your county.
3. If a person is enrolled in a Medicaid managed care plan, they need to contact their managed care plan for information on doctors and services. The phone number should be on the person’s Medicaid card. If a person is not sure if they are covered by a Medicaid managed care plan, they can call our Area Medicaid Office (see the instructions in the paragraph above) for help.

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.

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.myflorida.com/cf_web.