Ambetter Sunshine State Health Plan is a Medicaid managed care plan in Florida that provides health coverage to individuals and families who qualify. It offers benefits including hospital and doctor visits, prescription drugs, mental health and substance abuse treatment, and other services. Individuals who are eligible for Medicaid in Florida can choose to enroll in Ambetter or another managed care plan or receive services through traditional Medicaid. Ambetter has a network of providers throughout the state, and its plans and services vary depending on the county of residence.
Ambetter Health Plans in Florida
Ambetter Health Plans are private health insurance plans in Florida that provide comprehensive healthcare coverage to individuals and families who qualify for Medicaid or Marketplace coverage. Ambetter plans are designed to provide affordable and accessible healthcare to Florida residents.
Benefits of Ambetter Health Plans
- Comprehensive coverage for a wide range of healthcare services, including doctor visits, hospital stays, prescription drugs, mental health care, and more.
- Low copays and deductibles to make healthcare more affordable.
- Access to a network of healthcare providers throughout Florida.
- 24/7 customer service to help you with any questions or concerns.
Am I Eligible for Ambetter Health Plans?
To be eligible for Ambetter Health Plans, you must meet the following requirements:
- Be a Florida resident.
- Be a U.S. citizen or eligible immigrant.
- Meet the income and asset limits for Medicaid or Marketplace coverage.
How to Apply for Ambetter Health Plans
You can apply for Ambetter Health Plans online, by phone, or through a paper application.
Online:
www.ambetterhealthplans.com/florida/
Phone:
1-877-223-1937
Paper Application:
You can download a paper application from the Ambetter Health Plans website or request one by calling the customer service number.
Ambetter Health Plans Costs
The cost of Ambetter Health Plans varies depending on your income, family size, and the plan you choose. You may be eligible for premium assistance to help lower your monthly costs.
Ambetter Health Plans Provider Network
Ambetter Health Plans has a network of healthcare providers throughout Florida. You can find a list of providers in your area by visiting the Ambetter Health Plans website or calling customer service.
Ambetter Health Plans Customer Service
Ambetter Health Plans has a 24/7 customer service team to help you with any questions or concerns. You can reach customer service by phone, online, or through the mail.
| Method | Contact Information |
|---|---|
| Phone | 1-877-223-1937 |
| Online | www.ambetterhealthplans.com/florida/ |
| Ambetter Health Plans P.O. Box 12047 St. Petersburg, FL 33733 |
Eligibility for Ambetter Medicaid in Florida
To be eligible for Ambetter Medicaid in Florida, you must meet certain requirements. These requirements include:
- Being a Florida resident
- Being a citizen or qualified non-citizen of the United States
- Meeting income and asset limits
- Not being eligible for other types of health insurance, such as Medicare or employer-sponsored insurance
You can apply for Ambetter Medicaid online, by mail, or by phone. You will need to provide documentation of your income, assets, and other information.
Coverage Under Ambetter Medicaid in Florida
Ambetter Medicaid provides comprehensive coverage for a wide range of health care services, including:
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health and substance abuse treatment
- Dental care
- Vision care
- Long-term care
The specific services that are covered under Ambetter Medicaid vary depending on your age, income, and other factors. You can find more information about the coverage that is available to you by contacting your local Medicaid office.
| Category | Services |
|---|---|
| Doctor visits | Well-child visits, sick visits, and specialist visits |
| Hospital care | Inpatient and outpatient care, surgery, and emergency room visits |
| Prescription drugs | Generic and brand-name drugs, both long-term and short-term |
| Mental health and substance abuse treatment | Inpatient and outpatient care, counseling, and medication |
| Dental care | Cleanings, fillings, and extractions |
| Vision care | Eye exams, eyeglasses, and contact lenses |
| Long-term care | Nursing home care, assisted living care, and home health care |
Ambetter Medicaid in Florida: Benefits and Services
Ambetter Medicaid is a health insurance program offered by Ambetter, a subsidiary of Centene Corporation, in partnership with the Florida Medicaid program. Ambetter Medicaid provides comprehensive medical coverage to eligible individuals and families in Florida who meet certain income and eligibility requirements.
Benefits and Services of Ambetter Medicaid in Florida
Ambetter Medicaid offers a wide range of benefits and services, including:
- Medical and surgical coverage
- Hospitalization
- Physician visits
- Specialist care
- Emergency services
- Laboratory and X-ray services
- Prescription drug coverage
- Mental health services
- Substance abuse treatment
- Vision care
- Dental care
- Transportation services
- Home health care services
- Nursing home care services
- Personal care services
In addition to the above, Ambetter Medicaid also offers a number of benefits and services specifically designed for children, such as:
- Well-child exams
- Immunizations
- Dental care
- Vision care
- Hearing screenings
- Developmental screenings
Ambetter Medicaid also offers a range of benefits and services for pregnant women, such as:
- Prenatal care
- Labor and delivery care
- Postpartum care
- Family planning services
The specific benefits and services covered under Ambetter Medicaid may vary depending on the individual’s or family’s eligibility and the county in which they reside. For more information about the benefits and services covered under Ambetter Medicaid, please visit the Florida Medicaid website or contact Ambetter directly.
Eligibility for Ambetter Medicaid in Florida
To be eligible for Ambetter Medicaid in Florida, individuals and families must meet certain income and eligibility requirements. These requirements include:
- Being a Florida resident
- Being a U.S. citizen or a qualified non-citizen
- Meeting certain income limits
- Meeting certain asset limits
| Household Size | Income Limit | Asset Limit |
|---|---|---|
| 1 | $2,523 | $2,000 |
| 2 | $3,435 | $3,000 |
| 3 | $4,347 | $4,000 |
| 4 | $5,259 | $5,000 |
| 5 | $6,171 | $6,000 |
| 6 | $7,083 | $7,000 |
| 7 | $7,995 | $8,000 |
| 8 | $8,907 | $9,000 |
| Each additional person | $981 | $1,000 |
To apply for Ambetter Medicaid in Florida, individuals and families can submit an application online or by mail. Applications are available on the Florida Medicaid website or at local Medicaid offices. Once an application is submitted, it will be reviewed by the Florida Medicaid program to determine eligibility. If an individual or family is found to be eligible, they will be enrolled in Ambetter Medicaid and will receive a Medicaid ID card.
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