Aetna Better Health of Florida and Simply Healthcare Plans provide full-pay coverage statewide and Community Care Plan provides full-pay coverage in the following eight Southeastern Florida counties: Broward, Indian River, Martin, Miami-Dade, Monroe, Okeechobee, Palm Beach, and St. Lucie.
The Florida Healthy Kids full-pay plan provides health and dental insurance for Florida children who do not qualify for subsidized coverage because of their household size and income.
Florida Healthy Kids remains committed to continuing the full-pay plan and works hard to offer high quality and competitively priced health insurance that is child-centered, including comprehensive medical, dental and the services children need at each stage of growth and development.
Semi-private room, Pre-authorized, includes 15 day rehabilitation stay for non-acute confinement
$0
Offices visits for minor illness, accident care
$5 copay/visit
$0
$0
i.e. Laboratory, X-rays, etc
$0
Must be referred by your PCP
$5 copay/visit
Up to 3 days maximum – limited to vaginal delivery
$0
Physical, Occupational, Respiratory and Speech Therapies. Limited to 24 treatment sessions within a 60-day period per episode or injury)
$5 copay/ visit
Shall be provided in the same manner as in the Florida Medicaid program – 24 visits/year
$5 copay/visit
Limited to 1 visit per day, totaling 2 visits per month for specific foot disorders.
$5 copay/visit
Copayment is waived if authorized by Primary Care or patient is admitted
$10 copay/visit
$10 copay
$0 copay/visit
$0
$0 copay/visit
$0
$5 copay/visit
After failing vision screening by PCP – 1 pair every 2 years or when head size or prescription changes warrant. Coverage is limited to Medicaid frames with plastic or SYL non-tinted lenses.
$10 copay/visit
$0
Includes pre-transplant, transplant and post–transplant services and treatment when authorized by insurer at approved facility.
$0
Coverage includes all drugs available under the Florida Medicaid program. Generic or brand name when generic is not available.
$5 copay
Pre-authorized medically necessary equipment
$0
Must meet Skilled Care criteria - Limited to 100 days per contract year
$0
Must meet Skilled Care criteria
$5 copay/visit
Must meet Skilled Care criteria
$5 copay/visit
