FLORIDA MANAGED MEDICAL ASSISTANCE (MMA) – BENEFITS AND CONTACT INFORMATION PLANS
FLORIDA MANAGED MEDICAL ASSISTANCE (MMA) – BENEFITS AND CONTACT INFORMATION Region 11 – Miami-Dade & Monroe MMA Expanded Benefits Primary Care Visits (Non-pregnant Adults) Home Health Care (Non-pregnant Adults) Physician Home Visits Prenatal/Perinatal Visits Outpatient Services OTC Medication/Supplies PLANS Amerigroup Florida Phone Number: 1-800-600-4441 TDD: 1-800-855-2880 Visit: www.myamerigroup.com/fl Coventry Health Care of Florida Phone number: 1-800-441-5501 TDD: 711 Visit: www.coventryflmcd.com Humana Medical Plan Phone number: 1-800-611-1467 TDD: 711 Florida Relay Visit: www.Humana.com Molina HealthCare of Florida Phone Number: 1-866-472-4585 TDD: 1-800-955-8771 Visit: www.molinahealthcare.com Preferred Medical Plan Phone number: 1-800-767-1725 TDD: 1-800-955-8771 Visit: www.pmphmo.com Unlimited visits Unlimited visits Unlimited visits Unlimited visits 1 extra visit a day Unlimited visits Unlimited visits Unlimited visits 1 extra visit a day Unlimited visits 1 extra visit a month 4 extra visits a month for each specialty For adults, 21+ years old; Unlimited services Unlimited services Mammograms and obstetric ultrasounds do not count towards Medicaid service limit Unlimited visits Unlimited visits $25.00 for each household a month $25.00 for each household a month Adult Dental Services All adult members: 2 basic exams a year; 2 cleanings a year; SSI, non-dual eligible members: 1 x-ray a year; Unlimited fillings; 2 fluoride treatments a year; No co-pay Waived Copayments 2 basic exams a year; 1 partial x-ray a year; 2 2 basic exams a year; 2 full exams a year; 2 cleanings a year; 2 fluoride treatments a year; 1 1 basic exam a year; 1 full x-ray a year; or cleanings a year; 2 full x-rays a year; 4 partial silver filling every 3 years; or 1 white filling every 3 2 cleanings a year; 7 fillings a year; 2 fluoride x-rays a year; No copay years; or 1 crown every 5 years; 1 periodontal treatments a year; No co-pay treatment every 3 years No co-pay No co-pay Vision Services Hearing Services Newborn Circumcisions Pneumonia Vaccine Influenza Vaccine Shingles Vaccine Post-Discharge Meals Nutritional Counseling Pet Therapy Art Therapy Equine Therapy Medically Related Lodging & Food No co-pay 1 a year For adults, 60+ years old: 1 per lifetime For adults, 21+ years old: 14 meals 4 visits a year Unlimited visits No co-pay Unlimited visits Unlimited services $25.00 for each household a month 2 basic exams a year; 2 full exams a year; 1 full x-ray every 3 years; 1 partial x-ray a year; 2 cleanings a year; 4 simple extractions a year; 2 surgical extractions a year; Unlimited simple fillings; 4 complex fillings a year; 1 fluoride treatment a year; No co-pay No co-pay For adults, 21+ years old: 1 extra sets of glasses a year For adults, 21+ years old: Unlimited hearing aid repairs, maintenance and cleaning; 40 hearing aid For adults, 21+ years old: $500 every 3 years for batteries a year; Limit 1 factory repair every 3 inner-ear hearing aid years Up to 12 weeks old During initial hospital stay 1 hearing exam a year; 1 hearing aid exam a year; 1 hearing aid fitting/adjustment/check a year; $500 a year to buy and maintain hearing aid 1 every 5 years As medically advised 1 per lifetime As medically advised 2 a year As medically advised 1 a year As medically advised 10 meals a year 21 meals 7 meals 1 year supply of hearing aid batteries 1 per lifetime without plan approval; 1 every 5 years with plan approval $25.00 for each household a month Children, -21 years old: Unlimited glasses; Adults, 21+ years old: 1 extra set of glasses every 2 years; For adults, 21+ years old: Unlimited sets of 1 extra set of frames a year; Member must pay glasses; $100 extra for lenses or frames a year any costs over $50 for specialty contact lenses; Member will get a 20% discount on the extra costs For adults, 21+ years old: $100 extra a year for contact lenses and contact lens services Up to 28 days old $25.00 for each household a month 12-16 extra prenatal visits Up to 12 weeks old For adults, 60+ years old: 1 per lifetime As medically advised 6 visits a year Unlimited visits Unlimited visits 1 per lifetime Unlimited visits Unlimited therapy visits, training and/or supplies $150 a day; For members and 1 traveling partner; Max 5 days a year; Only if traveling more than 200 $125-165 a day miles from member's home www.flmedicaidmanagedcare.com Unlimited visits FLORIDA MANAGED MEDICAL ASSISTANCE (MMA) – BENEFITS AND CONTACT INFORMATION Region 11 – Miami-Dade & Monroe MMA Expanded Benefits Primary Care Visits (Non-pregnant Adults) Home Health Care (Non-pregnant Adults) Physician Home Visits Prenatal/Perinatal Visits Outpatient Services OTC Medication/Supplies Adult Dental Services Waived Copayments Prestige Health Choice Phone number: 1-855-355-9800 TDD: 1-855-236-9281 Visit: www.prestigehealthchoice.com Simply HealthCare Phone number: 1-800-887-6888 TDD: 711 Visit: www.simplyhealthcareplans.com Staywell Phone number: 1-866-334-7927 TDD: 1-877-247-6272 Visit: http://florida.wellcare.com Sunshine Health Phone number: 1-866-796-0530 TDD: 1-800-955-8770 Visit: www.sunshinehealth.com UnitedHealthcare of Florida Phone number: 1-888-716-8787 TDD: 711 Visit: www.uhccommunityplan.com Unlimited visits 1 extra visit a day Unlimited visits Unlimited visits Unlimited visits 2 extra visits a day 3 extra visits after hospitalization 1 extra visit a day 1 extra visit a day 1 extra visit a day Unlimited visits 2 extra primary care visits a month Unlimited visits 2 extra visits a month for each specialty Unlimited visits 4 extra prenatal visits; 1 extra postnatal visit Unlimited visits Unlimited visits 4 extra visits a month; limited to certain groups For adults, 21+ years old: Speech Therapy; 1 evaluation + 3 visits a week for 3 weeks An extra $1000 a year for services $25.00 for each household a month $25.00 for each household a month 1 facility-based Physical Therapy and Speech Therapy evaluation a year; 12 therapy visits a year. 1 home Physical Therapy evaluation a year; 4 Physical Therapy home visits a year $50 per household per year 2 full exams a year; 1 full x-ray every 2 years; 2 cleanings a year; 4 simple extractions a year; 2 surgical extractions a year; 3 fillings a year; No co-pay No co-pay Vision Services 1 extra set of glasses a year Hearing Services 1 hearing aid every 2 years Newborn Circumcisions Pneumonia Vaccine Influenza Vaccine Shingles Vaccine Post-Discharge Meals Nutritional Counseling Pet Therapy 2 basic exams a year; 1 full exam every 3 years; 1 full x-ray every 3 years; 2 partial x-rays a year; 2 exams a year; 1 x-ray a year; 2 cleanings a 2 cleanings a year; 2 simple extractions a year; year; No co-pay No co-pay No copay except: Denture services For adults, 21+ years old: 1 extra set of glasses every 2 years For adults, 21+ years old: 1 exam a year During initial hospital stay Up to 12 weeks old Restricted to as medically advised 1 a year Restricted to as medically advised Restricted to as medically advised Unlimited visits 2 per lifetime For adults, 50+ years old: 1 per lifetime 10 meals For adults, 21+ years old: 15 visits a year Art Therapy Equine Therapy Medically Related Lodging & Food PLANS No co-pay except: Non-emergency ER visits; and Chiropractic services $100 extra for frames, lenses and contact lenses a year 1 hearing exam every 2 years; 1 hearing aid every 2 years Up to 3 months old 1 per lifetime 1 a year 1 every 6 years 10 meals; limited to certain groups Unlimited visits Unlimited visits; limited to certain groups $1000 a year $70 a day Unlimited services $25.00 for each household a month $25.00 for each household a month 2 basic exams a year; or 1 full exam a year; 1 full x-ray every 2 years; 1 partial x-ray every 2 years; 2 cleanings a year; $10 co-pay 2 basic exams a year; 2 x-rays a year; 2 cleanings a year; 9 silver fillings every 3 years; 9 white fillings every 3 years; No copay No co-pay No co-pay $100 extra for lenses or frames a year 1 extra set of glasses a year; 1 eye exam (refraction) During initial hospital stay Up to 12 weeks old 1 hearing exam a year; $500 to buy a hearing aid every 2 years 1 extra hearing aid fitting every 3 years; 1 hearing aid every 3 years Restricted to as medically advised Restricted to as medically advised Restricted to as medically advised Restricted to as medically advised 1 a year 10 meals 3 visits a year Unlimited visits; limited to certain groups Unlimited visits Unlimited $100 a day 10 sessions per year; limited to certain groups Unlimited visits www.flmedicaidmanagedcare.com Restricted to as medically advised 10 meals; limited to certain groups
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