CMS case workers.
Trained nurses skilled to assist with children with special needs.
Trained nurses staffed to help AHS employees with their complex medical needs.
Trained nurses staffed to assist recipients with complex medical needs.
When Medicaid is approved. The effective date can be any day of the month.
When Medicaid is approved. The effective date is always on the first of the month.
As soon as the applicant applies for Medicaid, even if the status is "Processing".
The following month. The recipient will have FFS for the first month.
Be at least 18 years old, File for financial eligibility and Meet the required Level of Care.
Be 65 or older, need someone to care for you and already be approved for Medicare.
Have filed for a disability check, food and medical assistance through SSA.
Need someone to take care of you while your family goes to work.
AHCA and The Florida Legislature
DCF & SSA
LTC & MMA
LTC & CARES
Adult Day Healthcare
Home Delivered Meals
DCF and SSA
Elder Affairs and CARES
HMO's and PSN's
AHCA and DOEA
Prescriptions, Check Ups, Laboratory, X Rays
Over the Counter Items, Circumcision, Adult Dental, Pet Therapy
Surgery, Birthing Center Services, Hospice Services
Emergency Services, Transportation, Podiatric Services
Receive services from doctors that accept straight Medicaid.
See a primary care provider that will coordinate their overall care and will be referred to a specialist if needed.
Call the AHCA Medicaid Helpline concerning their benefits and questions.
See any primary care provider and specialists under any plan in their current region.
Continuity of Care
Comprehensive Care Plan
Coordination of Dual Eligibles
Have to start the enrollment process to be eligible for the LTC program all over.
Be responsible for paying the plan for services received during the temporary loss.
Continue receiving services from the LTC plan for up to 60 days and cannot change plans.
Have the option to change to a different LTC plan if they choose to.
A company that has been approved to work for the LTC plan to provide long-term care services to enrollees.
A company that has been approved to provide medical services to enrollees.
A company that provides services to children with special medical needs.
A company that has been approved to provide services for individuals that are 65 years old or older.
DCF case worker who will meet with enrollees to perform an assessment, develop a plan of care, and assist the enrollee in obtaining appropriate care.
Care coordinator/case manager who will meet with enrollees to perform an assessment, develop a plan of care, and assist the enrollee in obtaining appropriate care.
Care coordinator/case manager who will provide long-term care services that are needed.
DCF case worker who will provide information to enrollees or thier families to help them choose a direct service provider.
Establish Medicaid eligibility and verification of assets.
Recommend the least restrictive, safe, and most appropriate placement, identify the Level of Care, and long-term care needs.
Determine if the recipient will qualify for disability with the SSA or for workers compensation.
Identify if the recipient qualifies for services under the Agency for Persons with Disabilities.
Become the Power of Attorney and make changes to the recipients case.
Develop a plan of care, assign direct services providers, and perform an assessment.
Determine if the recipient would qualify for food stamps and cash assistance.
Perform a CARES assessment to determine the level of care.
MMA will provide medical services; LTC will provide long-term care services.
There is no difference.
MMA is secondary to any LTC services.
LTC will cover all services MMA doesn't cover.
Is the Thursday before the 2nd to the last Saturday of the month before 11:59pm.
Is the second to the last day of the month before 11:59pm.
Is the last day of the month before 11:59pm.
Agent states: "Yes, this long-term care plan will best meet all of your needs."
Agent states: "My grandmother has that plan, you'd probably like it too."
Agent states: " You'd get more services and better doctors with this plan."
Agent states: "All MMA plans offer dental services. Contact the plan to find out more information about dental services."
Enroll Susie into an LTC plan
Refer Susie to the SSA
Refer Susie to DOEA to get screened for LTC
Refer Susie to her Primary Care Doctor
Tell Susie its her choice and you cannot provide any information.
Tell Susie she is eligible for a comprehensive plan, she is eligible to enroll into the same plan for both programs.
Tell Susie she can go on the website to review her plan enrollment options.
Tell Susie she can go to the senior center and someone will help her choose a plan.
"Since this is free medical care, once you enroll you cannot change it."
"Don't worry, you have 60 days for open enrollment to change the plan for any reason, call us back if you want to change the plan."
"Once you enroll, you will be in a no change period, and you will not be able to change the plan."
"Don't worry, you have 120 days to change the plan for any reason. Call us back if you want to change the plan."