PHC Florida

Robert Heglar
AHF Provider

Medicaid Fair Hearing

Asking for a Medicaid Fair Hearing

You have the right to ask for a Medicaid Fair Hearing at any time within 120 calendar days of receipt of PHC Florida’s notice of plan appeal resolution letter. You may do this after seeking resolution through PHC Florida’s appeals process.

You can request a Medicaid Fair Hearing by:

  • Calling (877) 254-1055.
  • Sending a letter to:
    Agency for Health Care Administration
    Medicaid Hearing Unit
    P.O. Box 60127
    Ft. Myers, FL 33906
  • Sending a fax to (239) 338-2642.
  • Emailing [email protected].

You or someone you want to represent you can ask for a Medicaid Fair Hearing.  A provider (with your written permission) can ask for a Medicaid Fair Hearing for you.  The parties to a Medicaid Fair Hearing include you, your representative or a representative of a deceased member and representatives from PHC Florida.

For more details about a Medicaid Fair Hearing, look in the Enrollee Handbook (effective July 1, 2018).  See Chapter 10.


You will need the Adobe Acrobat Reader program to view the above forms. To download this free program click here or use the link above – the link will open a new window and take you to the Adobe website.

 

AHCA 062614 PHC MMA Form 17.0