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Florida Medicaid’s Health Plan Resources

Florida Medicaid’s Health Plan Resources

As part of the Agency for Health Care Administration’s (Agency) quality initiatives, the Agency requested that each Medicaid health plan develop provider resource guides with direct service lines, escalation contacts, and after-hours instructions covering a wide range of service areas. The following service areas can be found in each plan’s resource guide:

  • Behavioral Health
  • Case Management
  • Community Resources
  • Perinatal Care
  • Pharmacy
  • Subcontracted Services
  • Transportation
  • Utilization Management

The Agency’s goals with this initiative are to improve communication and coordination between plans and providers generally, and more specifically: to reduce readmissions by improving communication among health plans and providers; to improve members’ access to timely and appropriate services post-discharge; and to streamline the coordination of behavioral health services for members, especially those with substance use disorder (SUD) and opioid use disorder (OUD).

Click on the health plan’s link below to find more information on resources for providers.

Aetna Resource Guide[ application/pdf ]
AmeriHealth Resource Guide[ application/pdf ]
Children's Medical Services Resource Guide
Clear Health Alliance Resource Guide
Community Care Plan Resource Guide
Florida Community Care Resource Guide[ application/pdf ]
Humana Resource Guide
Molina Resource Guide
Simply Healthcare Resource Guide
Sunshine Resource Guide
United Healthcare Resource Guide[ application/pdf ]

If you experience issues connecting with any of the plans' provider resources, please contact the Agency by using the Florida Medicaid Complaint Form or call our Medicaid Helpline at 1-877-254-1055.

Other Behavioral and Mental Health General Resources

Florida Medicaid covers a wide array of behavioral and mental health services, as do Florida Medicaid managed care plans.  This section provides links to various resources.

The Office of Substance Abuse and Mental Health within the Florida Department of Children and Families (DCF) is the Florida’s single legislatively designated mental health authority.  For information about the services offered, please visit https://www.myflfamilies.com/services/substance-abuse-and-mental-health

DCF offers a series of Marchman Act and Baker Act trainings. The Introduction to the Baker Act course examines Florida Baker Act law (chapter 394) and addresses those who qualify for Baker Act services, methods used to initiate services at a Baker Act facility and discharge procedures. Health Plan Care Coordinators are required to take a course on the topic annually by June 1st. Course Access Instructions can be found here: Course Access Instructions [ pdf 872.8 kB ]

In addition, DCF contracts for behavioral health services through regional systems of care called Managing Entities (MEs). These entities do not provide direct services; rather, they allow DCF’s funding to be tailored to the specific behavioral health needs in the various regions of the State. Click here for more information, including links to the MEs throughout Florida:  https://www.myflfamilies.com/services/samh/providers/managing-entities

For links to resources for supporting the mental and emotional health needs of children and families before, during, and after a disaster, please visit https://www.floridahealth.gov/programs-and-services/emergency-preparedness-and-response/prepare-yourself/behavioral-health/index.html.  These resources may be helpful to families, community planners and child care partners, or healthcare system partners.

The Agency for Persons with Disabilities supports persons with Developmental Disabilities in living, learning, and working in their communities. For mental health resources, please visit: https://apd.myflorida.com/covid19/mentalhealth.htm

The Florida Department of Juvenile Justice works to reduce juvenile delinquency through prevention, intervention and treatment services. The following link provides resources for youth receiving mental health and substance abuse services: https://www.djj.state.fl.us/faqs/health-services/mental-health-substance-abuse-services

Mental Health First Aid is a course that helps people identify, understand, and respond to signs of distress until a family member or professional can provide assistance. This was developed by a nurse and a mental health literacy professor in 2001 and is used worldwide. More information can be found here: https://www.samhsa.gov/resource/dbhis/mental-health-first-aid

This site provides an interactive map to show Mental Health First Aid trainers and instructors in the U.S.: https://www.mentalhealthfirstaid.org/algee-ometer/

Mental Health America provides resources for mental health screenings, public education programs and mental health fundraisers. They have a variety of webinars spanning all aspects of mental health linked here: https://www.mhanational.org/mha-webinars

Hope for Healing navigates the many ways Floridians can access help for mental health and substance abuse. Please visit the link to find mental health and substance abuse providers and local organizations in your area: https://www.hopeforhealingfl.com/

The Florida Department of Education has a program called The Facts. Your Future. This program directly engages youth in Florida to improve their understanding of the life-altering effects of drug abuse and empowers teens to reach their full potential. More information can be found here: The Facts Your Future (fldoe.org)

For more information on available services and to identify and understand current and best practices, click below:

Wraparound Brochure [ pdf 1.2 MB ]