PHC Florida

Robert Heglar
AHF Provider

Expanded Benefits

PHC Florida offers the following expanded benefits in addition to the plan’s covered medical services and prescription drugs.  There are no copays.  There are no deductibles.

The benefit information below is effective December 1, 2018.

Expanded Benefits
Hearing Services – For enrollees 21 and older, plan provides one (1) hearing exam every year one (1) hearing aid every two years.
Home- and Community-Based Services – Up to 12 hours per year; limited to chore,
homemaker and personal care services.
Home Health Care (Non-Pregnant Adults) – Up to three (3), two (2)-hour visits per week; any combination of nurse, home health aide, and/or private duty nurse.
Meal Service after Hospital Discharge – Plan provides two (2) meals per day for up to 14 days delivered to member after hospital discharge.
Medically-Related Lodging and Food – Plan provides lodging and maximum of two (2) meals up to $100 per day for the family member of an enrollee who has been approved for a specialized hospital stay more than 150 miles from the enrollee’s home.
Newborn Circumcision – Circumcision covered for a newborn male in the first 30 days of life.
Nutritional Counseling – Up to three (3) visits per year with a registered dietician, nutritionist or other qualified provider.
Outpatient Services – For enrollees 21 and over, plan provides an additional $300 per year for outpatient surgery; radiologic imaging services; and physical, respiratory, speech and occupational therapies.  This benefit enhances standard outpatient services benefits covered under the plan’s medical benefit.
Over-the-Counter (OTC) Pharmacy Items – Members can choose from a list of OTC pharmacy items up to $25 per month.  OTC items are things like cold medications, vitamins, toothpaste, sun block lotion, decongestant, etc.
Physician Home Visits – Up to two (2) visits per month.
Physician Primary Care Services – No limit to visits to your primary care provider (PCP), which   enhances the standard Medicaid benefit.
Prenatal/Perinatal Care – No limit to prenatal care doctor visits, which enhances the standard Medicaid benefit.
Vaccines for Influenza, Pneumonia and Shingles – Influenza vaccine covered once every year.  Pneumonia vaccine covered once every five (5) years.  Shingles vaccine covered once per lifetime; must be ordered by a HIV primary care provider.
Vision Services – Plan provides one pair of eyeglass frames every two years, one pair of eyeglass lenses per year.  Contact lenses may be substituted for eyeglasses if medically ncessary.  This benefit enhances the standard vision benefit covered under the plan’s medical benefit.

 

Next, see the providers, hospitals and pharmacies that make up PHC Florida’s provider and pharmacy network.

If PHC Florida looks like the right plan for you, see how to enroll.

The benefit information provided is a brief summary, not a complete description of benefits.  Limitations and restrictions apply.  Benefits, formulary, and/or pharmacy network may change.

AHCA 110718 PHC MMA Form 17.1