Medicaid Provider Phone Number Florida

Date:

How Do I Find My Florida Medicaid Number

Compliance Tips for Florida Medicaid Providers

Your Florida Medicaid identification number is not listed on your gold card. Your Florida Medicaid number is kept in your Florida Medicaid file.

Any Medicaid provider can use your gold card or health plans membership card to check the Florida Medicaid file to find out if you are eligible for Florida Medicaid services.

Provider Eligibility And Compliance

Responsible for ensuring the continued eligibility of enrolled providers through research and validation of providers who are excluded from participation in Medicare, Medicaid, or other federally-funded programs documenting justifications for exclusions from Florida Medicaid coordinating with Medicaid Program Integrity and the OGC regarding referrals for legal sanctions monitor provider background screening processes taking appropriate actions when providers have disqualifying offenses participate on the Clearinghouse Advisory Board coordinate with Medicare related to mismatches in provider data between PECOS and the MMIS coordinate requests for onsite reviews with the RPA Onsite Review Desk perform change of ownership reviews, including determining if there is any pending enforcement action by MPI or MFCU, verify accuracy of ownership disclosures, and identify any money owed by the seller or the buyer and participate in an interagency workgroup on provider license compliance.

Why Is It Important For Me To Go To The Dentist

Preventive dental services are covered benefits. MCNA encourages you to schedule an appointment with your dentist. Regular preventive dental checkups are very important. They can prevent serious dental conditions from happening. If you would like help scheduling an appointment, please call our Member Hotline at 1-855-699-6262. It is open Monday through Friday, from 8 a.m. to 8 p.m.

Read Also: How Much Can You Make To Apply For Medicaid

No Aca Medicaid Eligibility Expansion In Florida

Florida is one of 12 states that has not expanded Medicaid eligibility as allowed under Affordable Care Act . The ACA doesnt provide subsidies for people with income below the poverty level, because the law called for them to have Medicaid instead. But in states that have refused Medicaid expansion people who arent eligible for Medicaid and whose income is too low for exchange subsidies are in whats called the coverage gap.

Federal

Floridas eligibility standards are:

  • Children up to 1 year old: 206% of the federal poverty level
  • Children ages 1-5: 140% of FPL
  • Children ages 6-18: 133% of FPL
  • Pregnant women: 191% of FPL
  • Adults with dependent children: 27% of FPL

People who qualify for Supplemental Security Income automatically qualify for Medicaid in Florida. See more information in the SSI-Related Programs Financial Eligibility Standards.

Can A Single Person Get Medicaid In Florida

Molina Medicaid Phone Number Florida

Unfortunately, no. That is because Florida is one of 12 states that, as of August 2020, has not expanded Medicaid eligibility as allowed under the Affordable Care Act .

This means that adults without dependents who have low income cannot qualify for Medicaid, like residents in the 38 states that have expanded Medicaid.

In Florida, if Medicaid had been expanded under the ACA, some 391,000 people who do not currently have coverage would gain coverage.

Republicans control Floridas House and Senate as well as the governors office.

Democrats in the Florida legislature have been pushing for Medicaid expansion for years, but have consistently been blocked by Republicans.

You May Like: Does Medicaid Cover Paragard Iud

Who Is Eligible For Medicaid In Florida

The following people may qualify for Florida Medicaid if they meet certain financialrequirements:

  • Infants and children under the age of 21
  • Recipients of Supplemental Security Income
  • Seniors 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
  • Medicare Beneficiaries whose income is low
  • Aliens and refugees under a special assistance program
  • Individuals who are medically needy

Plan And Provider Enrollment And Outreach

Responsible for assisting plans and providers with the provider enrollment process, both initial and renewal submitting provider maintenance to the Medicaid fiscal agent receiving, tracking, and monitoring escalated issues, legislative requests, and public records requests performing onsite reviews coordinating and delivering plan and provider trainings related to provider enrollment providing support for new plan enrollments under SMMC procurement, and coordinating with external agencies, including APO and DOH, regarding provider enrollment.

Also Check: How Do I Add Someone To My Medicaid

Do You Have Questions

We are happy to help you. Call Staywell toll-free at 1-866-334-7927 , MondayFriday, 8 a.m.7p.m.

You can visit us too! We have Welcome Rooms throughout the state of Florida. Representatives are there to answer your questions. They can help with things like:

  • Updating your address
  • Changing your Primary Care Provider
  • Ordering over-the-counter items and more

Florida Medicaid Phone Number

Video: Central Florida medical provider accused of defrauding thousands from Medicaid

Heres how to contact the Florida Medicaid Agency:

To reach Florida KidCare, call 1-800-821-5437.

For Medicaid Applicant & Member Services, call 1-877-711-3662, TDD 1-866-467-4970.

Customer Service is available Monday through Thursday from 8 a.m. to 8 p.m. Friday from 8 a.m. to 7 p.m.

If you are not enrolled in a health plan, call the Medicaid Helpline at 1-877-254-1055.

Also, if you need help finding contact information for your Medicaid plan, call ourMedicaid Helpline at 1-877-254-1055. You can get help with:

  • Locating a doctor
  • The services your plan covers
  • Transportation to access covered services
  • Other general questions you may have

Don’t Miss: Free Breast Pump Through Medicaid Texas

Florida Has Not Accepted Federal Medicaid Expansion

  • 4,956,941 Number of Floridians covered by Medicaid/CHIP as of September 2021
  • 1,378,000 Number of additional Florida residents who would be covered if the state accepted expansion
  • 415,000 Number of people who have NO realistic access to health insurance without Medicaid expansion
  • $6.6 billion Federal money Florida is leaving on the table in 2022 by not expanding Medicaid

History Of Floridas Medicaid Program

Florida was one of the later states to implement a Medicaid, not adopting the program until January of 1970 .

Florida Medicaid spending grew 13.5% on average every year between 1980 and 2004. In an effort to slow that trend, Florida applied for and received approval for an 1115 waiver for its Medicaid Reform pilot. The pilot implemented managed care in two counties in 2006 and added three more counties in 2007 the waiver was extended several times.

In 2013, the federal government approved an amendment for statewide expansion of managed care the amendment also renamed Medicaid Reform as Managed Medical Assistance . Ninety percent of all Florida Medicaid beneficiaries are now enrolled in managed care plans, like health maintenance organizations . The state hopes to improve quality through better coordination of care and save money through smaller networks of providers.

Part of the reason Medicaid enrollment has grown is the extensive outreach on the part of ACA navigators some residents were already eligible for Medicaid or CHIP prior to 2014 , but werent aware of their eligibility until enrollment outreach efforts under the ACA. But since Florida hasnt expanded Medicaid, the newly insured population is covered according to the normal state/federal split.

Floridas decision not to expand Medicaid leaves nearly 400,000 people in the state in the coverage gap ineligible for Medicaid and also ineligible for tax subsidies to help them afford private health insurance .

Read Also: I Am On Disability Can I Get Medicaid

What Is The Eligibility For Pregnancy Medicaid In Florida

A pregnant woman may qualify for Medicaid if her familys countable income does not exceed income limits.

For pregnant women who do not meet the citizenship requirements for Medicaid, there is Emergency Medical Assistance for Non-Citizens.

Furthermore, you can get Presumptively Eligible Pregnant Women , which is temporary coverage for prenatal care only.

During the temporary coverage period, while you are on PEPW, you will have to submit an application to determine if you can continue to receive Medicaid benefits during your pregnancy.

Additionally, women with family income over the limit for Medicaid may qualify for the Medically Needy Program.

Staywell Opens Doors To Valuable Coverage

Pregnancy Medicaid Florida Phone Number

Staywell Health Plan provides health care and long-term care services to people who qualify for Florida Medicaid. Floridas Medicaid program is called the Statewide Medicaid Managed Care Program.

Staywell offers the following types of plans in the SMMC program:

  • Managed Medical Assistance : Provides health care services like doctor visits and emergency care and covers prescription drugs
  • Long-Term Care : Provides long-term care services, such as nursing facility services and home and community-based services. Contact the Department of Elder Affairs Aging and Disability Resource Centers to complete the screening. Learn more about Staywell’s Long Term Care Plan.
  • Specialty: Similar to MMA, but with specialized care for members with serious mental illness . Learn more about Staywells Specialty Health Plan.

Some members have both MMA and LTC plans. This means that Staywell covers both health care and long-term care services for these members.

Staywell also offers valuable programs and support. This includes extra benefits.

If you are Staywell member, please review the member handbook. The handbook will help you understand how the plan works. It will also let you know what services are covered.

You May Like: Does Nc Medicaid Cover Chiropractic

How Do I Enroll In Medicaid In Florida

Review Floridas eligibility criteria, and if you believe you are eligible to enroll in Medicaid you have several options:

  • Enroll at Healthcare.gov .
  • Apply online at ACCESS Florida, or fill out a paper form. Use this application for low-income children, pregnant women, families, and aged or disabled individuals who are not currently receiving Supplemental Security Income .
  • Use this application to apply for food or cash assistance in addition to Medicaid. You should also use this form if you currently receive SSI or if you are applying for home-based and community services, hospice care, or nursing home care.
  • Submit a paper application submitted by mail, fax or in person to a local service center.

For help with the application process, call 1-866-762-2237.

Whats The Eligibility Requirement For Long

An applicant is not eligible for Florida Long Term Care Medicaid unless he or she meets certain asset and income limitations.

To be approved for Long Term Care Medicaid in Florida, you must be:

  • At least 65 years of age or disabled
  • A United States citizen or a qualified alien
  • A Florida resident
  • Gross monthly income must not exceed $2,382/month and
  • Countable assets for a single person must not exceed $2,000.Assets for a married couple allow the Community Spouse to have $130,380 in countable assets.

You May Like: How To Become A Medicaid Consultant

Who Determines Eligibility For Medicaid In Florida

Eligibility for Medicaid in Florida is determined by the following agencies:

The Social Security Administration determines eligibility for Supplemental Security Income . Recipients of SSI are automatically eligible for Medicaid.

The Florida Department of Children and Families determines eligibility for low-income children and families, aged persons, persons with disabilities, and persons seeking institutional care.

Florida Healthy Kids Corporation determines eligibility for MediKids.

How Does Medicaid Provide Financial Help To Medicare Beneficiaries In Florida

Medicaid Provider Compliance Program and Provider Self Audits, Fraud Prevention and Compliance Unit

Many Medicare beneficiaries receive Medicaid financial assistance that can help them with Medicare premiums, lower prescription drug costs, and pay for expenses not covered by Medicare including long-term care.

Our guide to financial assistance for Medicare enrollees in Florida includes overviews of these programs, including Medicaid nursing home benefits, Extra Help, and eligibility guidelines for assistance.

Read Also: How Do You Know If You Still Have Medicaid

Before You Call The Florida Medicaid Phone Number

As we mentioned above, the Florida Medicaid phone lines are flooded with phone calls as a result of the fact that their offices have been closed during the pandemic.

Therefore, hold times are long when you call the phone number.

We have answered the top questions people call the Florida Medicaid Phone Number for.

Scroll down below to see if your question has been answered below.

Find A Dentist Near You

MCNA has a large network of general and specialty dentists throughout Florida. You can choose a dentist from MCNAs online Provider Directory. The directory is always current.

Please call our Member Hotline at 1-855-699-6262 if you need help to find a dentist. We can also help you schedule an appointment for dental care. to download a Provider Directory for your region.

Don’t Miss: Neurologist In Alexandria La That Accept Medicaid

Enjoy A Gift Card From Us

MCNA rewards our members who take care of their oral health!

Parents or guardians of our Florida Medicaid Dental Health Program members can earn a $10 Amazon.com Gift Card* per child! To earn this reward, the child must see the dentist for an initial dental exam and preventive service when they join our plan. They must then go back for a follow-up dental checkup within 6 months. Adult members aged 18 and older can also earn this reward when they complete the steps listed above.

To learn more, call MCNA toll-free at 1-855-699-6262.

Florida Medicaid Phone Number Summary

Medicaid Phone Number Florida

We hope this post on Florida Medicaid Phone Number was helpful to you.

If you have any questions about Medicaid in the state of Florida, you can ask us in the comments section below.

Help us spread the word! If you found this post on Florida Medicaid Phone Number helpful, help us spread the word by sharing it using the Share this button below.

Be sure to check out our other articles about Medicaid.

Don’t Miss: How To Get Medicaid For Seniors

What Is Medicaid In Florida

Medicaid is a federal and state health insurance program for people with a low income.

It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.

The Childrens Health Insurance Program offers health coverage to children in families with incomes too high to qualify for Medicaid, but who cant afford private coverage.

The Medicaid program is different in every state. The federal government sets the general guidelines and each state decides how to run the program.

Florida implemented the Medicaid program on January 1, 1970, to provide medical services to low-income people.

The Florida State Legislature determines who qualifies for Medicaid, what services will be covered, and how much to pay for the services.

The state agency that administers Florida Medicaid is the Agency for Health Care Administration .

Apply For Medicaid In Florida

Online at ACCESS Florida, or submit a paper application by mail, fax or in person to a local service center. For help with the application process, call 866-762-2237.

Eligibility: Children up to 1 year old with family income up to 206% of FPL children 1-5 with family income up to 140% of FPL children 6-18 with family income up to 133% of FPL pregnant women with family income up to 191% of FPL young adults 19-20 with family income up to 30% of FPL adults with dependents with family income up to 30% of FPL.People who qualify for Supplemental Security Income automatically qualify for Medicaid. For information: SSI-Related Programs Financial Eligibility Standards

You May Like: Iowa Dhs Medicaid Income Guidelines

How Do I Contact My Local Florida Medicaid Office

You can contact your local Florida Department of Children and Families office for help with your Medicaid application or benefits.

to locate an ACCESS Service Center Locations. You can search by county.

In addition, local community partner agencies help the Department of Children and Families provide access to public assistance services.

To find a partner agency in your area, to search by county or zip code.

How Much Do I Have To Pay For Dental Services

Overview of the Florida Medicaid Assistive Care Services and Assisted Living

The Florida Medicaid Dental Health Program covers many of the costs of routine dental care. You qualify based on your familys income. Families with children or adults who receive Medicaid services have no co-payments. You may have a $3 copayment per day for a nonemergency dental visit in a federally qualified health center.

If your dentist orders a prescription drug for you, we can help you get that drug through Medicaid or your Medicaid health plan. You can avoid extra costs by checking that your drugs are on the Agency for Health Care Administrations Preferred Drug List.

Also Check: Does Medicaid Cover Assisted Living In Michigan

A Specialty Medicaid Health Plan For Members In Florida

Magellan Complete Care of Florida is a specialty health plan for people living with serious mental illness. We provide members with access to both mental and physical healthcare.

This information is available for free in other languages and formats. Please contact Member Services number at between 8 a.m. and 7 p.m. Eastern time, Monday-Friday.

To set up your new Molina member portal, please visit www.molinahealthcare.com/members.

A Health Care Plan That Is Easy To Use And Understand

AmeriHealth Caritas Florida operates as a Medicaid managed care plan through Florida’s Statewide Medicaid Managed Care program. AmeriHealth Caritas Florida is part of the AmeriHealth Caritas Family of Companies. AmeriHealth Caritas Florida has earned the Commendable Health Plan Accreditation status from the National Committee for Quality Assurance for 2019 2020.

Don’t Miss: How To Apply For Medicaid In Buffalo Ny

Enroll As A Member Of Mcna Dental

If you live in Florida, you or your children may qualify for Medicaid dental care! The State of Florida will let you know that you have been assigned to one of three insurance companies to manage your dental needs.

If you are assigned to MCNA Dental, you are in luck! You will automatically have access to great dental care and and services. You will also be eligible to get an Amazon.com Gift Card after two preventive dental visits.

Do you need help choosing or changing dental plans? Medicaid has specially trained people to answer your questions and to help you enroll in the plan that best fits your needs. These people are called choice counselors and they provide services free of charge. To speak with a choice counselor, call the Statewide Medicaid Managed Care Help Line toll free at 1-877-711-3662 or visit www.flmedicaidmanagedcare.com.

Please call our Florida Member Hotline at 1-855-699-6262 if you have any questions.

Share post:

Popular

More like this
Related

List Of Texas Medicaid Managed Care Plans

Prior Authorization...

Eye Places That Take Medicaid

What Is...