PHC Florida

Robert Heglar
AHF Provider

Frequently Asked Questions

    1. What is PHC Florida?
    2. Who is eligible to be a PHC Florida Member?
    3. Does PHC Florida cover services that MediPass used to?
    4. What’s the difference between PHC Florida and other Medicaid managed care plans?
    5. How do I enroll in PHC Florida?
    6. I’m under the care of a specialist or facility that isn’t in PHC Florida’s network.  Can I enroll and finish my treatment?
    7. If I enroll in PHC Florida and decide that I want another plan, can I leave?
    8. Can my family or household members enroll in PHC Florida?
    9. Can I change my primary care provider (PCP) when I’m in the plan?
    10. Will PHC Florida cover me if I travel to other parts of Florida outside the plan’s service area or other states in the US?
    11. Will PHC Florida cover prescription drug refills if I fill my medications outside of the plan’s service area or in other states?
    12. If I move, can I stay with PHC Florida?
1.  What is PHC Florida?

PHC Florida is a Florida HIV Specialty Medicaid managed care plan.  PHC Florida is operated by AHF MCO of Florida, Inc.  This is a subsidiary of AIDS Healthcare Foundation.  AHF MCO of Florida, Inc., has a contract with the Florida Agency for Health Care Administration to operate PHC Florida.

2.  Who is eligible to be a PHC Florida member?

To be eligible for PHC Florida, a person must be eligible for Medicaid, have HIV and live in Broward, Miami-Dade or Monroe County.

3.  Does PHC Florida cover services that MediPass used to?

Yes.  The plan covers all of the services MediPass used to and more through its expanded benefits.

4.  What’s the difference between PHC Florida and other Medicaid managed care plans?

PHC Florida is a Medicaid HIV Specialty managed care plan.  It offers care coordination.  It also has case management services.  These specifically address the medical needs of people living with HIV.  Each member gets a Registered Nurse.  The nurse helps coordinate care with providers.  He or she helps the member follow his or her treatment plan.  The plan also has expanded benefits designed for people with HIV, like no limits to primary care provider (PCP) visits.

5.  How do I enroll in PHC Florida?

Call the Choice Counseling Helpline at (877) 711-3662.  See more information how to enroll.

6.  I’m under the care of a specialist or facility that isn’t in PHC Florida’s network.  Can I enroll and finish my treatment?

Yes.  If you enroll in PHC Florida, contact Member Services as soon as possible to tell us.  We will work with your treating provider or facility to let you finish your treatment plan.

7.  If I enroll in PHC Florida and decide that I want another plan, can I leave?

Yes, if you change plans within 90 days from your enrollment in PHC Florida.  Otherwise, you will have to wait for your next Open Enrollment Period.  Or have a State-approved good cause reason to change plans.  The plan’s Enrollee Handbook has a complete explanation of voluntary disenrollment.

8.  Can my family or household members enroll in PHC Florida?

Yes, if they meet eligibility rules.  They must have Medicaid and HIV and live in Broward, Miami-Dade or Monroe County.

9.  Can I change my primary care provider (PCP) when I’m in the plan?

Yes.  You may change your PCP for any reason.  You can change as often as you like.

10.  Will PHC Florida cover me if I travel to other parts of Florida outside the plan’s service area or other states in the US?

Yes.  PHC Florida will cover emergency and urgent care services when you travel outside of Broward, Miami-Dade or Monroe County.

11.  Will PHC Florida cover prescription drug refills if I fill my medications outside of the plan’s service area or in other states?

We will cover prescription drug refills when you fill your prescription at an AHF Pharmacy or CVS pharmacy anywhere in Florida.  We do not cover medications filled out of the state.  The exception is if they are prescribed because of an emergency room or urgent care facility visit.

12.  If I move, can I stay with PHC Florida?

Depends.  If you move within Broward, Miami-Dade or Monroe Counties, you can stay a member in the plan.  Just be sure Member Services has your current address.  If you move out of these counties, you will have to choose a new plan.  You will choose a new plan through Choice Counseling (Florida’s Medicaid managed care plan enrollment broker).  Regardless where you move, you must tell the Department of Children and Families (DCF) or the Social Security Administration (SSA).  They must have your current address.  (By clicking on the above links, you will be taken to the Florida Medicaid Choice Counseling, DCF or SSA website, none of which are operated by PHC Florida.)

AHCA 062614 PHC MMA Form 17.0