Miami-Dade & Florida Medicaid Information

Florida Medicaid

Please visit the AHCA website where all of this information comes from @

We are using the Medicaid information from the state of Florida even though it might be obvious to you or me as to what is there for many Floridians don’t even realize how important it is for people to try to get this basic coverage nor it is not as difficult as to get this as everyone thinks.  Certainly it is true that the state of Florida was forced to cut the budget of this program this year due to the economic circumstances that in this bloggers eye’s are only going to get worse which is indeed a scary proposition.  In any case, please contact social security if  you are currently unemployed, minimum wage with a family, or even underemployed (that’s fancy boy talk) with a family as even if you don’t qualify for basic Medicaid there are so many other great programs available.  Ok, perhaps not great but certainly better then what you have now.  Additionally, please make sure to read this blog as we update this daily and have other sections with more information about the local county health plans in Miami.

Medicaid is the state and federal partnership that provides health coverage for selected categories of people with low incomes. Its purpose is to improve the health of people who might otherwise go without medical care for themselves and their children. Medicaid is different in every state.

Florida implemented the Medicaid program on January 1, 1970, to provide medical services to indigent people. Over the years, the Florida Legislature has authorized Medicaid reimbursement for additional services. A major expansion occurred in 1989, when the United States Congress mandated that states provide all Medicaid services allowable under the Social Security Act to children under the age of 21.

Below is the Broward and Miami Dade Mediciad phone numbers.  We have also attached the Medicaid Summary PDF complete book!

Eligibility for Medicaid Services

Recipient eligibility for Medicaid is determined by the:

For more information call the toll-free telephone number:
1-866-76ACCESS (1-866-762-2237)

Each program has its own income and asset requirements.

Information about Medicaid eligibility criteria for children and family programs can be obtained from the Department of Children and Families web site or the local Children and Families service centers. Information about how to apply for Medicaid is available from local Children and Families service centers.

The SSI-Related Programs Fact Sheet contains information about Medicaid eligibility criteria for the aged, blind and disabled, including Medicare cost-sharing coverage for Qualified Medicare Beneficiaries (QMBs), Specified Low-Income Beneficiaries (SLMBs), and coverage for Qualified Individuals.

Florida’s average monthly eligibles is currently approximately 2.4 million Medicaid recipients. The reports below are broken into five categories that display Medicaid eligibles as of the last day of each month.

June 30, 2009
Age by Assistance Category [3.2 MB PDF]
Age by County [1.9 MB PDF]
Age by Program – Group by Sex [3.7 MB PDF]
MediKids Eligible by County [974 KB PDF]
Program – By County [2.2 MB PDF]

May 31, 2009
Age by Assistance Category [3.8 MB PDF]
Age by County [1.7 MB PDF]
Age by Program – Group by Sex [3.5 MB PDF]
MediKids Eligible by County [952 KB PDF]
Program – By County [2.1 MB PDF]

Medicaid Child Health Services
CHS Logo

Certified School Match

The purpose of the Medicaid Certified School Match program is to provide reimbursement for medically necessary services provided by or arranged by a school district for Medicaid-eligible students from birth through age 20.

Child Health Check-Up

The Child Health Check-Up program is a preventive and comprehensive service for eligible children birth through 20 years of age and for children in the MediKids program.

County Health Department (CHD)
Certified Match Program

The purpose of the Medicaid County Health Department (CHD) Certified Match Program is to provide reimbursement to CHDs for medically necessary nursing, medication, administration, and social work services provided in a school setting to Medicaid-enrolled students from birth through age 20.

Early Intervention

Medicaid may reimburse for services under the early intervention program for Florida’s infants and toddlers from birth to 36 months. These services include: screenings; initial or follow-up evaluations; and individual, group or home visit sessions. These services are for children who have developmental delay or a condition that places them at risk for developmental delay and are medically necessary.

Medical Foster Care (MFC)

The Medical Foster Care (MFC) program enables Medicaid eligible children from birth through age 20 with medically-complex conditions whose parents cannot care for them in their own homes, to live and receive care in foster homes rather than in hospitals or other institutional settings. Children’s Medical Services (CMS) enrolls MFC parents and provides training for them to care for the medically necessary needs of these children.

Prescribed Pediatric Extended Care (PPEC)

Prescribed Pediatric Extended Care (PPEC) centers allow Medicaid eligible children from birth through age 20 with medically-complex conditions to receive continual medical care in a non-residential setting. When approved, children can attend a PPEC up to a maximum of 12 hours per day while receiving nursing services, personal care, developmental therapies, and caregiver training. PPECs provide a less restrictive alternative to institutionalization, and reduce the isolation that homebound children may experience.

Targeted Case Management

Medicaid reimburses for services under the targeted case management program for recipients from birth through age 20 who are receiving services through the Department of Health Children’s Medical Services Early Intervention (also termed “Early Steps”) program or primary care contractors. These services assist Medicaid recipients in gaining access to needed medical, social, educational, and other support services in their community.

Therapy Services

The purpose of the therapy services program is to provide medically necessary physical therapy (PT), occupational therapy (OT), respiratory therapy (RT) and speech-language pathology (SLP) services to Medicaid recipients from birth through age 20. Regardless of age, the therapy services program provides services to all Medicaid recipients for SLP services for the provision of augmentative and alternative communication systems and PT and OT services for wheelchair evaluations and fittings.

Need more information about the Child Health Services Programs?

The programs above are the primary services available to Medicaid eligible children. For more information regarding coverage for Medicaid eligible children, you may visit the Medicaid fiscal agent’s Provider Web Portal. Once inside the site, look to the left of the screen and choose “Provider Support”, then ”Provider Handbooks”. Scroll until you locate the handbook you need. For example, if you need further information about the Therapy Services Program, choose “Therapy Services Coverage and Limitations Handbook.”

Area 10 Broward County
(954) 202-3200, Ext. 277
Toll Free 1-866-875-9131
Area 11 Miami-Dade County
(305) 499-2100
Miami-Dade and Monroe Counties