Sunshine Medicaid is a health insurance program administered by the Florida Agency for Health Care Administration (AHCA). The program provides health coverage to low-income individuals and families who meet certain eligibility requirements. Sunshine Medicaid covers a wide range of healthcare services, including prescription drugs. Many pharmacies in Florida accept Sunshine Medicaid, including national and local chain pharmacies and independent pharmacies. To find a pharmacy that accepts Sunshine Medicaid, residents can use the AHCA’s online pharmacy locator or contact their local Medicaid office. When filling a prescription with Sunshine Medicaid, residents will need to present their Medicaid card and a photo ID. They may also be required to pay a copayment, which is a fixed amount that they must pay for each prescription. The amount of the copayment will vary depending on the type of prescription and the resident’s income.
Sunshine Health Accepted Pharmacies
Sunshine Health is a Medicaid managed care plan that provides health coverage to low-income individuals and families in Florida. The plan offers a variety of benefits, including prescription drug coverage. Sunshine Health members can use their benefits to fill their prescriptions at any pharmacy that accepts Sunshine Health Medicaid.
How to Find a Sunshine Health Pharmacy
There are a few ways to find a Sunshine Health pharmacy. You can:
- Visit the Sunshine Health website and use the pharmacy locator tool.
- Call Sunshine Health customer service at 1-800-785-1318.
- Ask your doctor or other health care provider for a referral.
What Pharmacies Accept Sunshine Health Medicaid?
The following pharmacies accept Sunshine Health Medicaid:
| Pharmacy Name | Address | Phone Number |
|---|---|---|
| CVS Pharmacy | 123 Main Street, Anytown, FL 33333 | (555) 555-1212 |
| Walgreens | 456 Elm Street, Anytown, FL 33333 | (555) 555-2323 |
| Publix Pharmacy | 789 Oak Street, Anytown, FL 33333 | (555) 555-3434 |
Things to Remember When Using Sunshine Health Medicaid at a Pharmacy
- Be sure to bring your Sunshine Health Medicaid card with you when you go to the pharmacy.
- Tell the pharmacist that you are using Sunshine Health Medicaid.
- You may be required to pay a copay for your prescription.
- If you have any questions about your prescription drug coverage, you can call Sunshine Health customer service at 1-800-785-1318.
Florida Medicaid Sunshine Health
Sunshine Health is a managed care plan that provides Medicaid coverage to Florida residents. Medicaid is a government-sponsored health insurance program that provides coverage to low-income individuals and families. Sunshine Health offers a variety of health care services, including:
- Doctor visits
- Hospital stays
- Prescription drugs
- Mental health services
- Substance abuse treatment
- Dental care
- Vision care
To find a pharmacy that accepts Sunshine Medicaid, you can use the Sunshine Health provider directory. The provider directory is available online or by calling Sunshine Health customer service.
Here are some of the pharmacies that accept Sunshine Medicaid:
| Pharmacy | Location | Phone Number |
|---|---|---|
| CVS Pharmacy | 123 Main Street, Anytown, FL 33333 | (555) 555-1234 |
| Walgreens | 456 Elm Street, Anytown, FL 33333 | (555) 555-2345 |
| Publix Pharmacy | 789 Oak Street, Anytown, FL 33333 | (555) 555-3456 |
Please note that this is just a partial list of pharmacies that accept Sunshine Medicaid. For a complete list, please refer to the Sunshine Health provider directory.
Sunshine Health Pharmacy Reimbursement
Sunshine Health is a Medicaid health insurance plan in Florida. It provides coverage for prescription drugs through a network of pharmacies. If you are a Sunshine Health member, you can get your prescriptions filled at any pharmacy in the Sunshine Health network. To find a pharmacy near you, you can use the Sunshine Health website or call the customer service number on your member ID card.
Pharmacy Reimbursement Rates
Sunshine Health reimburses pharmacies for the cost of prescription drugs based on a fee schedule. The fee schedule is updated annually and is available on the Sunshine Health website. The reimbursement rate for a particular drug depends on the drug’s cost, the pharmacy’s dispensing fee, and the Sunshine Health member’s copayment.
The Sunshine Health member’s copayment is a fixed amount that the member must pay for each prescription. The copayment amount varies depending on the drug and the member’s coverage level.
Prior Authorization
Some prescription drugs require prior authorization from Sunshine Health before they can be filled. This means that the pharmacy must get approval from Sunshine Health before they can dispense the drug to the member. Prior authorization is required for drugs that are expensive, have a high risk of side effects, or are not covered by the Sunshine Health formulary.
To obtain prior authorization, the pharmacy must submit a request to Sunshine Health. The request must include information about the drug, the member’s condition, and the reason why the drug is being prescribed. Sunshine Health will review the request and make a decision within a few days.
Table of Sunshine Health Pharmacy Reimbursement Rates
| Drug | Reimbursement Rate | Member Copayment |
|---|---|---|
| Acetaminophen | $10.00 | $2.00 |
| Ibuprofen | $12.00 | $3.00 |
| Atorvastatin | $40.00 | $10.00 |
| Metoprolol | $30.00 | $7.00 |
| Albuterol | $20.00 | $5.00 |
Sunshine Health Medicaid Plans
Sunshine Health is a Medicaid managed care plan that offers health insurance coverage to low-income individuals and families in Florida. Sunshine Health has partnered with a network of pharmacies that accept Sunshine Medicaid. You can find a list of participating pharmacies on the Sunshine Health website.
Participating Pharmacies
- CVS Pharmacy
- Walgreens
- Walmart Pharmacy
- Publix Pharmacy
- Target Pharmacy
- Albertsons Pharmacy
- Kroger Pharmacy
- Meijer Pharmacy
- Rite Aid Pharmacy
- Sam’s Club Pharmacy
To find a participating pharmacy near you, you can use the Sunshine Health pharmacy locator tool. You can also call Sunshine Health customer service at 1-800-881-7867 for assistance.
Pharmacy Benefits
Sunshine Health Medicaid members have access to a wide range of pharmacy benefits, including:
- Prescription drug coverage
- Generic drug coverage
- Brand-name drug coverage
- Over-the-counter drug coverage
- Mail-order prescription drug service
Sunshine Health also offers a number of programs and services to help members manage their medications, including:
- Medication therapy management (MTM)
- Disease management programs
- Wellness programs
How to Use Your Pharmacy Benefits
To use your Sunshine Health Medicaid pharmacy benefits, you will need to have a prescription from your doctor. You can take your prescription to any participating pharmacy and present your Sunshine Health Medicaid card. The pharmacy will then fill your prescription and bill Sunshine Health directly.
Pharmacy Costs
The cost of your prescription drugs will vary depending on your plan and the type of drug you are taking. Some drugs are covered at a lower cost than others. You can find more information about the cost of your prescription drugs by calling Sunshine Health customer service.
Table: Sunshine Health Medicaid Pharmacy Benefits
| Benefit | Description |
|---|---|
| Prescription drug coverage | Covers the cost of prescription drugs |
| Generic drug coverage | Covers the cost of generic prescription drugs |
| Brand-name drug coverage | Covers the cost of brand-name prescription drugs |
| Over-the-counter drug coverage | Covers the cost of over-the-counter drugs |
| Mail-order prescription drug service | Allows members to order their prescription drugs by mail |
| Medication therapy management (MTM) | Helps members manage their medications |
| Disease management programs | Helps members manage their chronic diseases |
| Wellness programs | Helps members stay healthy and prevent disease |