Healthcare is an integral component in society.
Medicaid Options is the division of the State of Florida Medicaid program that offers enrollment services for the state's managed care programs. The program works directly with qualified beneficiaries who are approved through the Florida Department of Children and Families or the Social Security Administration. Medicaid is generally available to low-income families, children of low-income families, pregnant women, elderly individuals, people who are disabled and for noncitizens as emergency assistance. Depending on the area of residence, the recipient is advised to choose from either a health maintenance organization (HMO), MediPass or provider service network (PSN) plan.
Medicaid Reform HMO or PSN
Medicaid Reform offers an HMO or PSN to residents who reside in Broward, Duval, Baker, Clay and Nassau counties. The companies that offer services include Buena Vista Medicaid, Humana Family, Jackson Memorial Health Plan, Molina Healthcare, Personal Health Plan, Preferred Medical Plan and Sunshine State Health. Individuals are required to choose a primary care physician (PCP) under both plans, who will be the first doctor seen when medical attention is required on a nonemergency basis. The plans cover physician visits, hospital inpatient care, emergency care, transplant services, outpatient surgery, laboratory and radiologic services, home health care and prescription drugs. This list is not inclusive of all the benefits available under this plan; for further information, contact the health plan directly.
HMO Options
In all other counties not covered by the Medicaid Reform program, the HMO options available for medical coverage for the qualified beneficiary include Amerigroup, Citrus Health Care, Freedom Health, Healthease and Staywell Health Plan. The HMO program for these health plans offer all basic medical services, such as physician visits, emergency care, inpatient care, outpatient services and prescription drug coverage. The benefits will vary according to the health plan.
MediPass
Starting in 1991, the Medicaid Provider Access System (MediPass) was established as a primary case management program developed by Florida Medicaid as an option for Medicaid recipients. This program was established to monitor medical services to prevent inappropriate medical testing and procedures. As with the HMO and PSN programs, the MediPass program is similar in the benefits offered and the patient being established with a PCP. One of the differences with this program is that the individual is charged a $2 monthly case management fee, which is always subject to change. This program also offers a disease management program especially focused on high-risk patients who suffer with heart conditions, diabetes, asthma and various other chronic diseases. This program is focused on providing nurse care management and enhancing the patient's quality of life.
Tags: Medicaid Reform, This program, case management, emergency care, Florida Medicaid, Health Plan
