Frequently Asked Questions

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What is Florida KidCare?

Florida KidCare is the state of Florida’s high-quality, low-cost health and dental insurance program for children. There are four Florida KidCare partners. Each partner provides insurance to different groups of children:

The Florida Healthy Kids Corporation runs Florida Healthy Kids for children ages 5 through the end of age 18.
The Agency for Health Care Administration runs Medicaid for children from birth up to age 1 and MediKids for children ages 1 up to 4.
The Department of Health runs the Children’s Medical Services Managed Care Plan for children from birth up to age 19 with special health care needs.
The Department of Children and Families runs the Behavioral Health Network for children ages 5 up to 19.

What is Florida Healthy Kids?

Florida Healthy Kids is health and dental insurance for children whose families meet certain income and other eligibility requirements. The health and dental insurance benefits are provided by insurance companies using a managed care model.

What is managed care?

The goal of managed care is to provide high-quality health care at low costs. The Florida Healthy Kids insurance companies use many approaches to do this, but two of the main approaches are:

Creating a provider network. Network doctors and other health care providers agree to certain rules, like how quickly the doctor must give enrollees an appointment or, if a specialist is needed, the doctor must refer enrollees to a network specialist. Except for emergencies, enrollees must see a network provider.
Having rules about when and what kinds of services, supplies, devices, and other products are covered. Florida Healthy Kids insurance companies only pay for medically necessary services.

Is my child’s insurance company Florida Healthy Kids?

No. Your child’s health insurance company is Community Care Plan. Community Care Plan is your primary source of information about the covered benefits and services available to your child.

When and how can I change insurance companies?

You can change insurance companies only at certain times and for certain reasons.

Log into your online account to change insurance companies during your child’s first 90 days of enrollment or during your child’s annual renewal period.

Call Florida KidCare at 1-888-540-KIDS (5437) to change companies if your child no longer lives in the plan’s service area.

You may also call Florida KidCare to change companies for one of these reasons:

Your child’s doctor does not, because of moral or religious obligations, provide a service your child needs.
Your child needs related services to be done at the same time and your child’s primary care provider determines that receiving the services separately would subject your child to unnecessary risk, but not all related services are available in the plan’s network.
Your child has an active relationship with a health care provider who is not in the plan’s network, but who is in the network of another plan in the area.
The plan is no longer available in the area where your child lives.
The Florida Healthy Kids Corporation requires the insurance company to take action to improve quality of care.
Other reasons determined by the Florida Healthy Kids Corporation, including, but not limited to, lack of access to services or providers with the appropriate experience to provide care to your child.

Can I pick any of the health insurance companies?

You can pick one of the health insurance companies available where you live. You can find out which insurance companies are available in your area at www.floridakidcare.org, or by finding your county on the list on pages 10 and 11 of the Member Handbook.

Can Community Care Plan disenroll my child?

No, Community Care Plan cannot disenroll your child directly.

If Community Care Plan believes that your child is not eligible for Florida Healthy Kids, Community Care Plan may ask the Florida Healthy Kids Corporation to review and verify your child’s eligibility. When an eligibility review request is made, Community Care Plan must include the reason why the child may not be eligible and how the information was obtained.

The Florida Healthy Kids Corporation will determine whether a child can remain enrolled.

How do I disenroll my child from Florida Healthy Kids?

Call Florida KidCare at 1-888-540-KIDS (5437) and tell them you want to disenroll your child. Coverage ends at 11:59 p.m. on the last day of the month during which you call to cancel coverage. In other words, if you call on January 15th to cancel your child’s coverage, your child will have coverage through January 31st.

If I cancel my child’s coverage, can my child enroll in Florida Healthy Kids again later? Do I have to reapply?

You may re-enroll your child in Florida Healthy Kids as long as eligibility requirements are met. Call Florida KidCare at 1-888-540-KIDS (5437) to find out if you need to go through the application process again and when your child’s coverage can start.

What would cause my child to lose eligibility for Florida Healthy Kids and when would coverage end?

The chart below shows some of the reasons a child may lose eligibility for Florida Healthy Kids and when coverage ends.

Enrollees lose eligibility when he or she:	Coverage Ends*
Turns age 19	The end of the month in which the enrollee turns 19
Is no longer a Florida resident	The end of the month in which the enrollee is no longer a Florida resident
Gains other insurance coverage	The end of the month prior to the start of the other insurance coverage, or the first of the month after FHKC has been notified of the coverage

*Does not include any applicable eligibility and enrollment dispute period

What services does the program cover?

Florida Healthy Kids covers important benefits like:

Well-child visits
Office visits to your PCP (Primary Care Provider)
Office visits to specialists (doctors who focus on one area of health)
Immunizations (shots your child gets to avoid illnesses like the flu or measles)
Prescription drugs
And more!

The chart on page 15 of the Member Handbook lists all covered services.

We just moved from a different state where my child’s plan didn’t cover some services because of moral or religious objections. How do I obtain those services in Florida?

Community Care Plan provides all covered benefits and does not exclude any benefits (see page 15 of the Member Handbook because of moral or religious objections). If your child’s doctor will not provide services because of moral or religious objections, call Community Care Plan. Community Care Plan will help you access those services.

Do I have to see certain doctors?

Except for emergency situations, your child must see a network provider for the services to be covered. You may also need to get a referral from your child’s PCP to see a specialist. See Provider Network section of the Member Handbook for more information about this requirement.

Do I have to pay the doctor anything?

It depends. Some services require a copayment, a specified amount you pay to the provider when your child receives services. A copayment is sometimes called a copay. Not all services require a copayment. Preventive services, like well-child visits and routine vision screenings, are free! American Indians and Alaskan Natives who meet certain requirements do not pay any copayments.

The Medical and Prescription Benefits sections includes information about the required copayments for common covered services.

Are there limits to how much I have to pay?

Yes. Your out-of-pocket costs are limited to 5 percent of your family’s gross annual income (income before taxes and other deductions) each plan year. Out-of-pocket costs for a Florida Healthy Kids health plan include any copayments you pay. Monthly premium wouldn’t apply to a full-pay family’s out-of-pocket costs. For subsidized enrollees, the monthly premium also counts.

The plan year is your child’s continuous eligibility period. The continuous eligibility period is the 12 months following enrollment approval.

What do I do if I think I’ve paid five (5) percent of my family’s income?

Call Florida KidCare at 1-888-540-KIDS (5437). Community Care Plan and the Florida Healthy Kids Corporation will verify that you have paid 5 percent of your family’s annual income. You may need to provide receipts or other documents for the copayments you paid.

Once your information has been verified, you will receive a letter stating you do not owe any copayments for the rest of the plan year. You can show this letter to providers. Community Care Plan – Florida Healthy Kids will also tell your providers you do not owe any copayments. Monthly premium wouldn’t apply to a full-pay family’s out-of-pocket costs. Subsidized families will also stop paying monthly premiums for the rest of the plan year.

Remember, you will need to begin paying premiums and copayments again when your child’s new continuous eligibility period starts. The continuous eligibility period is the 12 months following enrollment approval. If your child’s continuous eligibility period begins on January 1st, be sure to pay your January premium in December.

Does the preferred drug list change?

The preferred drug list may change from time to time. The current preferred drug list is available on the Pharmacy page of our website: CCPcares.org. You will be notified if Community Care Plan makes a change to the preferred drug list that will impact your child’s current prescriptions.

Who decides what drugs go on the preferred drug list?

Community Care Plan has a committee of physicians and medical professionals including pharmacists that decides which medications go on the preferred drug list. The committee considers issues like:

How well a medication works for most people;
Potential side effects or bad reactions; and
The cost of a particular drug relative to comparable drugs.

My child’s doctor says my child needs to take a brand name medication instead of a generic medication. Will Community Care Plan cover the brand name medication?

Community Care Plan will cover the brand name medication if your child’s provider specifies “dispense as written” on the prescription. The phrase “dispense as written” tells the pharmacist not to make any substitutions. If your child’s doctor does not indicate “dispense as written” and you ask the pharmacist for the brand name medication, you may have to pay the full cost of the medication.

What is a network provider?

A network provider is a doctor, other health care professional, hospital, other health care facility, pharmacy, or medical supply company that has a contract with Community Care Plan to see Florida Healthy Kids enrollees.

How do I know if my doctor is a network provider?

Community Care Plan has a provider directory on its website so you can search for network providers in your area by name or provider type. The online provider directory is updated regularly when Community Care Plan receives new information from providers.

Community Care Plan also has a printable copy of the provider directory available. You can find this document on www.ccphealthykids.org or you can call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

and request a copy. Community Care Plan will mail a copy to you for free. The copy is updated at least monthly, but it may not be as accurate as the online provider directory.

Remember to ask your doctor’s office if they still accept Community Care Plan – Florida Healthy Kids. Be sure to say Community Care Plan and Florida Healthy Kids, not just Florida Healthy Kids.

I looked at the provider directory, but I still need help.

Please call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

My child has been to a doctor I really like, but the doctor is not in the network for Community Care Plan. What can I do?

Ask the doctor to email a letter of interest to Community Care Plan at CCP.Provider@ccpcares.org. The letter should state that the provider would like more information on joining the Community Care Plan – Florida Healthy Kids network of providers.

How do I choose a PCP for my child?

When your child becomes a member of Community Care – Florida Healthy Kids, you have the right to choose from any PCP in our network. If you did not choose a PCP for your child, we will assign one. The name and phone number of the PCP are located on your child’s ID card.

Can I change my child’s PCP?

You can choose a new PCP by visiting our provider directory at www.ccphealthykids.org. To choose a new PCP for your child, please call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

You can also call Community Care Plan Member Services and we can assist you in locating a new PCP for your child.

Can I choose any PCP?

You may choose any network PCP that is accepting new patients. If your child already sees a network PCP who is not accepting new patients with the plan, your child’s doctor may be willing to continue seeing your child. Call and ask the doctor’s office. If your doctor agrees, call Community Care Plan and we can confirm with your child’s doctor and assign him or her as your child’s PCP. Not all doctors are able to accommodate this request. If your child’s doctor is not able to continue seeing your child, you must choose a new PCP.

You can search for a provider online at https://providerdirectory.ccpcares.org/fhk or you can call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

How do I make an appointment?

Call the doctor’s office and tell them:

You want to make an appointment;
If your child is a new patient;
Why you want to see the doctor; and
The name of your child’s plan which is Community Care Plan – Florida Healthy Kids

Ask these questions:

Do I need to bring anything to the appointment?
Are there forms I can fill out ahead of time?
What do I do if I need to change or cancel?
Is there a fee if I cancel an appointment?

Have your schedule in front of you when you call so you know which days and times an appointment will work for you.

Remember to take your child’s member ID card with you to the appointment.

Your child’s doctor needs this card and may not see your child if you do not have it with you.

Why does my child need a referral?

Your child’s PCP or primary dentist can provide most of your child’s medical services. He or she is the person who can help you make the best decisions about your child’s care, including when your child should see a specialist. Florida Healthy Kids requires a referral for most services that are not provided by your PCP or primary dentist because this helps ensure your child receives the most appropriate care. Plus, your PCP and primary dentist are the most up-to-date on your child’s medical and dental health.

My child needs to see a specialist. How do I get a referral?

1. Call your child’s PCP. Sometimes you will need to make an appointment to see the PCP. Depending on the type of specialist your child needs and how familiar the PCP is with your child’s issue, the PCP may not need to see your child first.

2. If your child’s PCP thinks your child should see a specialist, he or she will refer your child to a network specialist. Some PCP offices give you the referral for you to take with you to the specialist appointment. Others send the referral to the specialist for you. Be sure to confirm that the specialist’s office receives the referral.

3. Call the specialist to make an appointment. Be sure to do this in a timely manner or you may need to make another appointment with your child’s PCP. Some PCP offices will do this for you, but you need to let them know the days and times you can get to the appointment.

4. If the PCP gave you a referral, remember to take it with you to your child’s appointment.

Does my child always need to get a referral?

Your child will need a referral for most services not provided by your child’s PCP. If your child sees a specialist without a referral, you may have to pay the full cost of that visit, which is much higher than your copayment. Your child may see some specialists without a referral. Please refer to the plan-specific handbook for more information.

Are there other requirements like referrals I need to know about?

Your child’s PCP may need to get prior authorization from Community Care Plan before Community Care Plan pays for a specific service. Your child’s provider is responsible for requesting prior authorizations, so you do not need to do anything. If Community Care Plan does not approve or cover a service, your child can still have the services, but you will have to pay for those services.

You can always call Community Care Plan Member Services if you have questions or concerns.

My child needs services from a specialist, but there are no network specialists in my area.

Florida Healthy Kids plans are required to make sure your child gets the services he or she needs. If there are not any network providers, please call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

Community Care Plan will make other arrangements for your child to receive medically necessary covered services.

What if I have concerns about my child’s treatment or treatment plan?

You can ask for a second opinion. A second opinion is when you take your child to another doctor about the same issue for which your child has already seen a doctor.

You can request a second opinion for a provider that is not in our network if a network provider is not available to provide the service for your child. Please ask your child’s PCP to request a second opinion for your child.

You should feel comfortable discussing your child’s health and treatment options with your child’s doctor. Ask questions when you do not understand something and ask about the pros and cons of a treatment option. Consider choosing a new doctor for your child if you often do not feel comfortable asking questions or you do not get the information you need.

What rules does Community Care Plan network have to meet?

Community Care Plan is required to have a network with enough providers to ensure enrollees have timely access to covered services.

Sometimes it is not possible for Community Care Plan to meet these requirements. Often, this is because not enough health care providers work in the area. Sometimes not enough health care providers will see children or accept the plans offered through Florida Healthy Kids.

If your child needs services from a certain type of provider, Community Care Plan can help you find one in your area. If there are no providers in the network nearby, Community Care Plan will arrange for your child to see an out-of-network provider. You must go through Community Care Plan to see an out-of-network provider unless your child requires emergency services.

Community Care Plan makes sure most enrollees can get to their doctors within a certain amount of time or a certain distance from their home. For example, if you live in a city (urban), you should be able to get to a network PCP in about 20 minutes or within 20 miles from your home. These are called network access standards.

The Florida Healthy Kids network access standards are:

	Time Standards – in minutes		Distance Standards – in miles
Provider	Rural	Urban	Rural	Urban
PCP – Pediatricians	30	20	30	20
PCP – Family physicians	20	20	20	20
Behavioral health – Pediatric	60	30	45	30
Behavioral health – other	60	30	45	30
OB/GYN	30	30	30	30
Specialists – Pediatric	40	20	30	20
Specialists – other	20	20	20	20
Hospitals	30	30	30	20
Pharmacies	15	15	10	10

I always have to wait a long time to get an appointment at my child’s doctor office. What can I do?

Network providers agree to provide Florida Healthy Kids enrollees with appointments within the timeframes listed below. If a network provider tells you that you must wait longer than these timeframes, please call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

If your child experiences a life-threatening emergency and needs immediate care, please go to the nearest emergency room or call 911.
Routine care – care that may be delayed without expectation that your child’s condition will get worse without care within a week – must be provided within seven (7) days of your request for services.
Routine physical exam – an annual well-child exam – must be provided within four weeks of request for services.
Follow-up care – care provided after treatment of a condition – must be provided as medically appropriate and as directed by your child’s health care provider.
Urgent care – care required within twenty-four (24) hours to prevent the condition from becoming an emergency – must be provided within twenty-four (24) hours of request. Know where the closest urgent care center for this type of care is located. Urgent care centers are often open late and on weekends.

How can my child get care after normal business hours?

There are a few ways to access care after normal business hours, depending on your child’s needs:

Providers with extended hours
- Some providers offer evening or weekend office hours.
- Call the provider’s office or visit their website to find out when they are open.
Urgent care centers
- Urgent care centers see patients who need immediate, but not emergency attention and their PCP is not available.
- Some urgent care centers require you to make an appointment while others allow walk-ins. Be sure to call ahead and ask.
Emergency room
- If you child is experiencing a life-threatening emergency, call 911 or go to your nearest emergency room.

When should I take my child to the emergency room?

Call 911 or take your child to the emergency room if he or she has an emergency medical condition. This means an injury or illness, including severe pain, that needs care right away to avoid serious danger to your child’s life or pregnancy, or to avoid serious damage to your child’s health.

Avoid taking your child to the emergency room for common illnesses, such as colds or earaches with low fever. Your child’s PCP can effectively treat most childhood illnesses. Plus, your PCP knows the most about your child’s health history so they can help you make the best medical decisions. Using your child’s health history and routine screenings results in better treatment for your child, and the PCP may catch and treat other health issues before they become a problem.

What is a Health Risk Assessment or HRA and why is it important?

A Health Risk Assessment or HRA is a series of questions about your child’s health as well as lifestyle. The answers to these questions aid our health care team in finding out what activities may put your child’s health at risk as well as what services we can offer you and your child to live his/her best life.

Where can I take an HRA for my child?

The HRA is included in the Welcome Package that you receive when your child is enrolled in Community Care Plan – Florida Healthy Kids. Community Care Plan offers incentives for completing this survey within ninety (90) days of enrollment. The quicker you complete it, the higher the incentive. If you need assistance or prefer to complete the HRA by phone, you can call:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

What happens to my child’s scheduled services and appointments when my child changes plans?

If your child moves from one Florida Healthy Kids plan to another Florida Healthy Kids plan without a break in coverage (this means your child did not go a month or more without Florida Healthy Kids coverage in between changing insurance companies), the plans will follow a standard transition of care policy to ensure your child gets the care he or she needs.

Your child’s new plan will cover any ongoing course of treatment the previous plan authorized for sixty (60) days. This means your child can:

Receive planned services or treatment;
Continue to see the same provider, even if the provider isn’t in the new plan’s network; and
Continue to take the same prescription. You may be required to use a network pharmacy.

The best way to make sure this transition goes smoothly is to call your child’s new plan to tell them about the types of continued care your child needs.

I made an appointment with my child’s specialist before changing plans, but the appointment is more than sixty (60) days away. Do I need to schedule a new appointment?

It depends. Your child’s new plan will have your child’s PCP, or another appropriate doctor, review your child’s treatment plan during the first sixty (60) days after the plan change. This review will help ensure that needed services continue to be authorized. Your child may be required to see a network provider.

Are there any exceptions to the 60-day transition of care period?

Yes. Exceptions to the standard sixty (60) days are:

Maternity care: including prenatal and postpartum care through completion of postpartum care (six (6) weeks after birth);
Transplant services: through the first post-transplant year;
Radiation and chemotherapy: through the current round of treatment;
Orthodontia: services will be continued without interruption until completed (or the benefit is exhausted, whichever comes first), but your child may be required to see a network orthodontist after the first sixty (60) days;
Controlled substance prescriptions: if a new, printed paper prescription is required by Florida law, the new plan will help you schedule an appointment with the original prescribing provider, or a new provider if needed, so your child can get a new prescription without a medication gap.

Do I have to coordinate sending my child’s medical records and getting bills paid myself?

No. Your child’s previous plan and new plan are responsible for coordinating the transfer of medical records and other necessary information between themselves and can assist providers with obtaining necessary medical records. In some situations, you may need to ask your child’s previous providers to send medical records to the new providers just like you would if your child were changing providers for any other reason.

Your child’s new plan will cover care performed by certain out-of-network providers during the transition of care period, as described in this section. If you receive a bill from one of these providers, call your child’s new plan and be prepared to send them a copy of the bill.

What are grievances and appeals?

A grievance is a formal complaint you make to Community Care Plan – Florida Healthy Kids about some aspect of your child’s health care services.

An appeal is a request you make to Community Care Plan to review Community Care Plan’s decision to deny a service or payment.

When can I file a grievance?

You may file a grievance when you are dissatisfied about something other than your child’s benefits, such as:

A doctor’s behavior;
The quality of care or services your child receives; or
Long office waiting times.

How do I file a grievance?

You can file a grievance anytime by mail, phone, fax or email:

Mail:

Community Care Plan – Florida Healthy Kids
ATTN: Grievance and Appeals Coordinator
1643 Harrison Parkway Suite H-200
Sunrise, FL 33323

Phone:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

Fax:

1-954-251-4848

Email:

grievancesandappeals@ccpcares.org

How long does the grievance process take?

Community Care Plan will send you an acknowledgment letter within five (5) calendar days of getting your verbal or written grievance. From this date, Community Care Plan will review and make a final decision about your grievance within ninety (90) calendar days.

When can I file an appeal?

You may file an appeal when you receive an adverse benefit determination, such as when:

A request for service has been limited or denied;
An existing service has been decreased or discontinued; or
Community Care Plan has issued a denial of payment.

How do I file an appeal?

Appeals may be filed in writing or verbally within sixty (60) calendar days from the date that you receive a notice of adverse determination for your child. You may file an appeal in the following ways:

Mail:

Community Care Plan – Florida Healthy Kids
ATTN: Grievance and Appeals Coordinator
1643 Harrison Parkway Suite H-200
Sunrise, FL 33323

Phone:

Community Care Plan Member Services
Available Monday through Friday from 7:30 AM to 7:30 PM EST
1-866-930-0944 or TTY/TDD 711

Fax:

1-954-251-4848

Email:

grievancesandappeals@ccpcares.org

How long does the appeal process take?

Community Care Plan will make a decision and notify you within thirty (30) calendar days of receiving your appeal request.

If Community Care Plan doesn’t have enough information to process the appeal and the delay is in your best interest, they may ask for fourteen (14) more calendar days. If you need to provide more information, you may also request an extension of fourteen (14) calendar days.

What if I need help filing a grievance or an appeal?

You may appoint an authorized representative or a provider to act on your behalf.

Community Care Plan can also help you complete forms and answer questions related to the grievances and appeals process. Call our Member Services Line and ask for the Grievance & Appeals Coordinator.

What if it’s an emergency?

You can request an expedited (fast) appeal if you or your provider feels that waiting the standard thirty (30) calendar days for an appeal decision would put your child’s life, pregnancy, or health at risk.

If Community Care Plan agrees that the appeal needs to be expedited, we will make a decision and inform you within seventy-two (72) hours after receiving the appeal. If Community Care Plan does not agree with the request for an expedited appeal, Community Care Plan will let you know, and the timeframe will go back to the standard appeal timeframe of thirty (30) calendar days.

What if I’m dissatisfied with my appeal results?

If your appeal request was not approved, you can request an independent review. The appeal decision notice you receive from Community Care Plan will tell you how. You may also call our Member Services Line and ask for the Grievance & Appeals Coordinator.

How do I dispute a decision?

Send a letter or an email to the Florida Healthy Kids Corporation with the reasons you think the decision is wrong. Your dispute must be received within ninety (90) calendar days from the date on the decision notice (letter or email from Florida KidCare). You can:

Email the letter to contactus@healthykids.org; or
Mail the letter to:
Florida Healthy Kids Corporation,
P.O. Box 980
Tallahassee, Florida 32302.
Remember to put your family account number in your letter.

What happens next?

The Florida Healthy Kids Corporation will respond to your dispute in writing. If the decision is not in your favor, you can send a second dispute to senior management at the Florida Healthy Kids Corporation. If that decision is not in your favor, you can send your dispute to the Agency for Health Care Administration. Each of these steps will be described in detail in any denial letters sent to you.

What is an example of fraud?

Anna notices that documents from her son’s insurance company show that he received an MRI two (2) weeks ago. Anna is sure that her child did not receive an MRI. If the doctor intentionally billed the plan for an MRI that her child did not receive, the doctor committed fraud.

What is an example of abuse?

Anna’s son had his annual well-child check-up last month, which included a routine basic metabolic panel (a blood test that evaluates important measurements like blood sugar and calcium levels). The results came back great.

Today Anna’s son has a sore throat and she takes him to the doctor to be tested for strep throat. The doctor orders the strep test and also orders another basic metabolic panel. The doctor might be committing abuse since Anna’s son recently had good results and this test won’t help the doctor figure out the cause of a sore throat.

Why is being aware of fraud and abuse important?

Most Florida Healthy Kids families pay monthly premiums of $15 or $20, but the total cost of coverage is much higher! The rest of your child’s Florida Healthy Kids coverage is paid for with state and federal tax dollars. When providers or other people receive payments or benefits, they should not, those tax dollars are wasted instead of going to children who need services.

What should I do if I think someone has committed fraud or abuse?

If you think a doctor or someone else who works at a medical office or facility, like a hospital or surgical center, may have committed fraud or abuse, you can report it to Community Care Plan. Call Community Care Plan Special Investigations Unit at 954-622-3489 or email your report to ccp.siu@ccpcares.org.

If you think Community Care Plan has committed fraud or abuse, please report the details to the Florida Healthy Kids Corporation by calling 1-850-701-6104 or emailing resolve@healthykids.org.

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