What Is Covered Under Florida Medicaid?

Most medical services are covered by Medicaid in Florida.

Medicaid is a government-sponsored program that provides health care coverage, much like health care insurance, to low income families, pregnant women and people over the age of 65. Each state has a unique Medicaid program for state residents. In Florida, Medicaid is administered by the Agency for Health Care Administration (AHCA).

Coverage

In Florida, some individuals may have different coverage than others based on their unique needs. For example, a pregnant woman's coverage may be limited to pregnancy and birth-related services and costs and may not extend to other areas of health that are not related to her pregnancy.

Services

Medical services typically covered by Florida's Medicaid include regular doctor office check-up visits, physical therapy services, chiropractor services, hospital services both inpatient and outpatient, x-rays, and laboratory tests and services. However, for the service to be covered, it must be done by an approved Medicaid provider. Services completed by non-providers will not be reimbursed or paid for by Medicaid under Florida law.

Costs and Fees

Florida Medicaid typically covers the cost of medical equipment, medical supplies and prescription medications in whole or part. Likewise, individuals who qualify for Medicaid still bear some of the costs for their medical treatments. Medicaid subscribers pay a flat fee for all services and procedures they undergo or pay a co-pay or deductible, depending on their plan and coverage.

AHCA

Florida's Agency for Health Care Administrations (AHCA) regulates Florida's 41,000 healthcare facilities and functions as the licensor for healthcare professionals in the state. AHCA was created by Florida law and serves more than 2.7 million Floridians on Medicaid.

Misconceptions

Not all medical providers in Florida accept Medicaid. Doctors, hospitals, clinics and other medical providers are not required by law to accept Medicaid. As a result, individual covered by Medicaid may have to travel outside of their area to find a provider and may need to switch doctors once they go on Medicaid.

References

• Florida Medicaid
• Sean w. Scott, Elder Law Attorney: Medicaid Planning
• AHCA: Summary of Services (PDF)
• Florida Dept. of Children & Families: Medicaid
• Florida Medicaid Covered Services

Resources

• State of Florida: Medicaid & Medicare
• AHCA: Florida Medicaid