Florida Healthy Kids

Medical and Prescription Benefits for Community Care Plan

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Value-Added Services

PCP Office Visit Copay Waiver

COVERAGE LIMITS: To ensure your child has all the needed care from his/her PCP, Community Care Plan
- Florida Healthy Kids has waived the copays for any visit provided by the enrollee’s PCP. There is no limit to this benefit.

COPAY: $0

Sports/School Physical Copay Waiver

COVERAGE LIMITS: Community Care Plan – Florida Healthy Kids enrollees are eligible for an annual school or sports physical provided by the enrollee’s PCP with no copay. Limited to one (1) physical per enrollee per year.

COPAY: $0

Health Risk Assessment (HRA) Incentive

COVERAGE LIMITS: The Health Risk Assessment (HRA) helps Community Care Plan – Florida Healthy Kids better understand your child’s health needs. To encourage completion of the HRA, Community Care Plan
– Florida Healthy Kids provides a onetime incentive of one (1) of the following:

  • A $25 gift card for completing the HRA within 30 calendar days of enrollment
  • A $20 gift card for completing the HRA within 60 calendar days of enrollment
  • A $15 gift card for completing the HRA within 90 calendar days of enrollment
COPAY: N/A

CVS ExtraCare Health Card

COVERAGE LIMITS: Community Care Plan – Florida Healthy Kids will provide one (1) CVS ExtraCare Health Card to each enrollee’s household by mail upon enrollment. The CVS ExtraCare Health Card provides a 20% discount on CVS brand over-the-counter health-related items available in CVS retail stores or online. One (1) CVS ExtraCare Health Card per household.

COPAY: N/A

Transportation for Medical and Dental Preventive Services

COVERAGE LIMITS: Must be approved by Community Care Plan – Florida Healthy Kids. Benefi t limited to $150 per episode of care. Reimbursement is only available when services are not available within the Community Care Plan – Florida Healthy Kids network. Enrollees must provide proof of relevant expenditures to receive reimbursement.

COPAY: $0

Hypoallergenic Bedding

COVERAGE LIMITS: Community Care Plan – Florida Healthy Kids provides up to $100 per year of hypoallergenic bedding for enrollees with an appropriate diagnosis of allergies or asthma for whom hypoallergenic bedding is medically necessary.

COPAY: $0

Provider House Calls

COVERAGE LIMITS: Community Care Plan – Florida Healthy Kids offers up to 20 visits per year for home visits by a licensed provider to enrollees who are homebound or who are not engaged with a PCP and need an emergency department follow-up visit. Must be approved by Community Care Plan – Florida Healthy Kids.

COPAY: $0

Healthy Behavior Coaching

COVERAGE LIMITS: Community Care Plan – Florida Healthy Kids offers individualized, in-person coaching programs for the following health behaviors:

  • Tobacco/nicotine cessation
  • Substance use disorder
  • Medically necessary supervised nutrition counseling for enrollees in need of weight management; program length is six (6) months

To support the enrollee and family, case management will be provided to track progress and remove barriers to success.

COPAY: $0

Obesity Program “Food, Fun, and Fit”

COVERAGE LIMITS: In partnership with other community organizations, Community Care Plan – Florida Healthy Kids offers a series of three (3) education workshops to address childhood obesity. You and your child will learn about healthy eating and adopting a healthier lifestyle. This program is tailored to each participating enrollee and will include a self-management assessment tool upon enrollment in the program, at three (3), six (6), and 12 months enrollment. As an incentive, each participating family receives a Bluetooth-enabled scale to help them and their PCP track the child’s progress.

  • All children ages 5-18 with a BMI at or above the 95th percentile for children and teens the same age and sex, as defined by the Centers for Disease Control and Prevention and the American Academy of Pediatrics, are eligible for this program
  • Onetime benefit
COPAY: $0

Water Safety Classes “Swim, Seconds, and Safety”

COVERAGE LIMITS: In collaboration with local agencies, Community Care Plan – Florida Healthy Kids provides water safety and drowning prevention classes to all enrollees. You can request this benefi t for your child. Limited to one (1) set of classes per enrollee per lifetime.

COPAY: $0