Asthma and COPD Support

Do you or your child have trouble managing COPD or asthma symptoms? A nurse who specializes in breathing issues can really help. You'll get a customized treatment plan and medicine to:

• Manage flare-ups.
• Reduce symptoms.
• Let you or your child stay active.

Care Management

A serious health problem requires extra care and support. We use Health Homes to coordinate services for our members.

Do you or your child have a serious health problem? Then our case managers are in your corner. They will:

• Explain medical terms in plain language.
• Coordinate doctor appointments.
• Provide the care team with medical records.

Your case manager will stay with you or your child throughout the medical journey. He or she will:

• Think beyond immediate medical needs.
• Make sure there is support at home.

Choice of Doctor

You get a primary care physician (PCP), who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you. 

Your PCP is your main doctor for:

• Preventive care.
• Treatment if you are sick or injured.
• Referrals to specialists for certain conditions.

Choice of Birth Center

Where you have your baby is an important choice. That's why you can pick from nearly 80 hospitals across Florida.

We also encourage you to tour the hospital’s birthing center. This way you will be familiar with it. And be more relaxed when you have your baby.

Diabetic Support

If you have diabetes, we'll make life a little easier for you. You'll get medicine, supplies and education to help you reach and stay your best.

Our diabetes program also includes self-care training and classes focused on:

• Planning healthy meals.
• Managing stress.
• Living a healthy lifestyle.

Equipment and Supplies

Your health and safety at home are important.

Our plan covers medical equipment ordered by your doctor or case manager. This can include supplies like:

• Hospital beds.
• Oxygen tanks.
• Wheelchairs or walkers.

Hearing Care

Trouble hearing can affect your everyday life in many ways. Our plan includes services and support to help protect your hearing.

We cover:

• Exams, therapy and tests.
• Hearing aids every three years.

Healthy Behavior Programs

Do you smoke? If so, do you want to try and quit? We have a smoking cessation program that is available at no cost.

Do you want to work on weight loss or healthier eating habits? These types of lifestyle changes can help with many chronic conditions. We have a program to help you with this.

If you have noticed changes in your mood, habits or the way you feel, you may need to talk to someone about these feelings.

Behavioral health services are available as part of your benefits. We also offer a reward program if you would like help with a drug abuse problem.

All of these programs are available at no cost to you. If you would like to join any of these programs, please call us at 1-844-446-2151. We are here Monday through Friday from 8:00 a.m. to 7:00 p.m. If you are hard of hearing, please dial 711.

Healthy First Steps®

Build a healthy future for you and your baby and earn great rewards with Healthy First Steps. Our program will help you take the right steps to keep you and your baby healthy. Plus you can earn $10 just for signing up. 

We will help you:

• Choose a pregnancy provider and a pediatrician (child’s doctor).
• Schedule visits and exams and arrange rides to your visits.
• Earn rewards for going to visits throughout your pregnancy and baby’s first 15 months of life.
• Get supplies, including breast pumps for nursing moms.
• Connect with community resources such as Women, Infants and Children (WIC) services.

Home Meal Delivery

Taking care of the basics, like cooking, can be difficult after an illness or sickness. That’s why we’ll bring nutritious meals to you to help you through tough times. You can get up to 10 meals delivered each year after being discharged by the hospital.

Hospitalization

This plan pays for all expenses related to a hospital stay, so you can rest and heal.

Our plan covers:

• Nursing care.
• Room and board.
• Supplies and equipment.
• Treatment and therapies.
• Diagnostic tests and exams.

And after you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.

Interpreters

Your doctor and you need to understand each other. Not speaking English well makes this difficult. We can arrange for a medical interpreter to be at your appointments.

We also have people in member services who speak more than one language. Chances are, we have someone who speaks your language.

Lab and X-rays

Knowing what's wrong and finding it early can make all the difference. Our plan covers:

• Labs and testing.
• X-rays, scans and other imaging.

We’ll help you get the information needed to improve your health or be at your best.

Language Help

You can receive information in your preferred language. Just ask. We also have people at our customer service who speak more than one language. Chances are, we have someone who speaks your language.

Medicines

Our plan includes prescription drugs and refills.

And we want to make getting your medicine easy. You can fill your prescriptions at:

• In Network Local pharmacies.
• Services that deliver right to your door.

Member Services

Sometimes you might need a little help understanding your health care options. With us, you have someone you can call. We’ll answer your questions simply and completely.

We can also help you find:

• Primary Care Physicians and Specialists.
• Dentists and vision providers.
• Local pharmacies.

Mental Health

Mental health is as important as physical health. That's why we have coverage for both.

Required care is 100% covered. with no copay. This includes:

• Behavioral therapy.
• Medications.

No Copays

You will not have a copayment for care and services covered by our plan.

NurseLine℠

Medical questions and situations sometimes happen at inconvenient times. When you have questions about your health or your child’s health, you can call a nurse 24 hours a day, 7 days a week.

Our NurseLine nurses will:

• Listen to the symptoms.
• Guide you on self-care.
• Advise you about getting care at a doctor visit or an urgent care center.
• Help you know when to go to the emergency room.

Nurse Visit

Sometimes you may need continued care after you leave the hospital or urgent care.

If your health is at risk after a serious illness, surgery or injury, a nurse will visit you at home to:

• Provide medical care for you or your child.
• Answer your questions and concerns.

Over-the-Counter Supplies

Your health care costs may include non-prescription medicines and supplies like aspirin, cough medicine or bandages. Our plan will cover you up to $25 each month for medically necessary over-the-counter medicine or medical supplies you purchase.

Pregnancy Care

A pregnancy is a journey you’ll want to make with the help of friends, family and a pregnancy doctor, or OB-GYN.

All of your recommended prenatal clinical visits and tests are covered.

At these visits, the clinic will:

• Make sure you and your baby are healthy.
• Explain what to expect at each stage of your pregnancy.
• Answer your questions.

Residential Care

After a serious illness, surgery or injury, you may need extra nursing and therapy.

If needed, our plan covers short stays in a rehabilitation center where you can heal. Included are:

• Nursing home services.
• 24-hour nursing care.
• Help with activities of daily living.
• Physical, occupational and speech therapy.

Quitting Tobacco

You know the bad health effects of smoking.

You know you need to quit. We support you while you quit with the help of coaches and supplies. The only thing you won't get from us is a lecture.

Shots and Vaccines

Routine shots help protect you from illness.

So, our plan covers:

• Pneumonia, influenza and shingles shots.
• Other recommended shots and vaccines.

Text4baby

Text4baby can help new and expecting mothers keep themselves and their babies healthy.

You’ll get three text messages each week throughout your pregnancy and your baby’s first year. Each text contains health and safety tips for topics like:

• Prenatal care.
• Labor and delivery.
• Breastfeeding.
• Safe sleep.
• Nutrition.
• Car seat safety.

So you and your baby can make a healthy start.

Therapy Services

Therapy can help you recover from a serious injury or illness, or simply reach your full potential. Members receive needed:

• Occupational therapy.
• Physical therapy.
• Respiratory therapy.
• Speech therapy.

Transportation

Our plan provides unlimited round trips to and from health care locations. That includes rides to:

• Doctor or therapy visits.
• Health departments.
• Vision clinics.
• Urgent care centers.

Vision Care

You’ll get the care, eyeglasses and treatment that let you see life more clearly. Coverage includes:

• Regular exams.
• Up to two pairs of frames each year.
• Prescription lenses.

This benefit is offered by Vision Service Plan.

Well Visits

Well visits with your doctor can help keep you healthy. These visits can catch health problems early, so they can be treated. Preventive services include:

• Checkups for adults and children.
• Routine shots and tests.
• Mammograms.

There are no copayments for preventive care.