Eligible children in Florida can enroll in one of four Medicaid health insurance (Florida KidCare) programs. These programs are:

• Children’s Medical Services Managed Care Plan (CMS Plan) covers children with special needs from birth to 19 years of age
• Florida Healthy Kids covers children ages 5 to 19
• Medicaid covers children from birth to 19 years of age
• MediKids covers children ages 1 to 4

Your family’s income will determine if you qualify for one of these programs. Income requirements are based on the Federal Poverty Level and how many people live in your home. After you apply, you will find out which plan(s) your child might be able to get.

Keep in mind:

• It is not likely that your child will qualify for all of the programs
• Different agencies make decisions for each program
• Some programs have costs that you may have to pay, called premiums and copayments

Learn more about health insurance options for children in Florida

EPSDT

Keeping your kids healthy shouldn’t be hard. Yet it often is. We want to catch problems early and help kids stay healthy. Members under age 21 can get any health service that treats, prevents, or improves a health problem at no cost. This is a special set of benefits known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services.

Members who get EPSDT benefits:

• Can get EPSDT services through their health plan
• Do not have to pay copays for EPSDT services
• Can get help to schedule appointments
• Can get help arranging for free transportation to and from their appointments

Some EPSDT services may require approval. This approval is called prior authorization. To learn more about which services may need prior authorization please call Member Services 800-477-6931 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m., Eastern Time. EPSDT services include:

Health and immunization history

• Physical exams
• Health assessments and counseling
• Lab and screening tests
• Follow-up care
• Applied behavioral analysis (ABA) services
• And more!

If you have questions about EPSDT services, talk with your child’s primary care provider (PCP).

EPSDT FAQs from AHCA

Child health visits schedule

We recommend regular child health appointments on the following schedule:

• Infancy - Younger than 1 month, 2 Months, 4 months, 6 months, 9 months, 12 months
• Early Childhood – 15 months, 18months, 24 months, 30 months, 3 yrs, 4 yrs
• Middle Childhood and adolescence – once a year for ages 5-20
• Enrollees qualify through the end of their 21st birth month

Learn more about wellness visits

Medicaid Well-Child Visits

These visits help your child’s doctor detect, diagnose, and treat health problems as early as possible. Children older than 24 months through age 20 can have an in-person or virtual care (telehealth) visits, if the doctor offers this service.

Well-being visits can include:

• Dental screenings
• Growth measurements
• Immunizations and vaccines
• Physical exams
• Referrals for diagnosis and treatment if necessary
• Vision and hearing screenings
• Preventive and comprehensive services
• Other important tests and services

If your child has a virtual care (telehealth) visit, the doctor will set up a follow-up in-person visit for a physical exam, vaccines, and other important tests and services that cannot be done during a virtual care visit.

Learn more about virtual care visits

Remember to:

• Make and keep appointments with your child’s doctor when your child is well, not just when your child is sick.
• Talk to your child’s doctor about any concerns you have.

Go365 for Humana Healthy Horizons

Our members who are 18 and younger who have a yearly well visit with a pediatrician or PCP can earn $20 in rewards through Go365 for Humana Healthy Horizons.  To earn rewards:

• Download the Go365 for Humana Healthy Horizons App for Apple iOS or Android.
• Create an account to access and engage in the program

Members under the age of 18 must have a parent or guardian register on their behalf to participate and engage with the program, and the person completing the registration process on behalf of a minor must have the minor’s Medicaid Member ID.

Learn more about Go365 for Humana Healthy Horizons

Have questions?

To learn more about enrollment options for children, call an enrollment broker. An enrollment broker can help you figure out what you need to do to enroll a child in a Florida health plan. Call Florida’s enrollment broker at 877-711-3662 (TTY:866-467-4970)

Humana Healthy Horizons in Florida offers coverage to eligible children in Florida. If you have questions about our child wellness coverage, call Member Services at 800-477-6931 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m., Eastern time.