Medicaid is a program designed to help certain low-income populations with quality health care. Florida's Medicaid program offers comprehensive coverage, but benefits may be different depending on why a person is qualified for Medicaid. Any benefit-related questions should be directed to the Florida Department of Children & Families.
Hospital Services
Any care received in a hospital supervised by a licensed health care provider, such as a physician or a dentist, is covered by Florida Medicaid. This includes any supplies necessary for treatment, nursing care, therapies and drugs. Children under 21 have unlimited hospital services, while other populations are limited to $1,500 in hospital services annually.
Medical Services
Provider services are covered by Florida Medicaid. Enrollees may go see one physician a day, in addition to one long-term facility stay per month, one physical per year, and ten prenatal visits. Florida Medicaid will also cover other necessary laboratory and X-ray work.
Dental Services
Florida Medicaid covers some dental care. For children under 21, it includes regular exams, X-rays, preventive services (such as sealants), restorative work, periodontal work, dentures, oral surgery and orthodontic treatment. Adults have access to problem-focused dental work (no preventive care), meaning it covers the work necessary to relieve pain (extractions and the draining of abscesses).
Preventive Services
Florida Medicaid offers some preventive services. The Early and Periodic Screening Diagnosis and Treatment Program is designed to give comprehensive preventive services for children under 21. Medicaid also offers family planning services.
Prescription Drugs
Medicaid recipients must go to a Medicaid-participating pharmacy. Some drugs require prior authorization. Florida Medicaid will pay for most drugs, though brand-name drugs are limited to four per month (except in the case of insulin, diabetic supplies, contraceptives, mental health and HIV antiviral drugs).
Transportation
When commuting to or from a Medicaid-covered service, Medicaid enrollees may have their transportation costs covered. This is limited to those who do not have another family or community member who can drive them.
Case Management
Florida Medicare will pay for up to 86 hours of a mental health case management per month for those who qualify and require these services.
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