Expanded benefits CY19

Expanded benefits CY19

Expanded benefits are extra goods or services we provide to you, free of charge. Call Customer Service to ask about getting expanded benefits.

There are no copayments for Magellan Complete Care of Florida members.

Benefit Details
Service Coverage/Limitation Prior Authorization
Behavioral Health Assessment Services
  • Unlimited
No
Behavioral Health Day Treatment
  • Unlimited
Yes
Behavioral Health Medical Services (Verbal Interaction), Mental Health/Substance Abuse
  • Unlimited
No
Behavioral Health Screening Services
  • Unlimited
No
Brief Individual Psychotherapy
  • Unlimited
Yes
Cellular Phone Service  
  • Smartphone
  • 350 minutes per month
  • Unlimited texts
  • 1 GB of free data per month
 No – application is required
Chiropractic
  • Unlimited

No

Collaborative Care (Medical team conferences)
  • Unlimited

No

Home Delivered Meals Post Discharge (Hospital or Nursing Facility)
  • Three home delivered meals per day for enrollee and up to three family members
  • Limited to two days post discharge
  • Enrollee is required to give the Managed Care Plan 48 hours prior notice

Yes

Home Health Visits for Non-Pregnant Adults
  • Unlimited
  • Requires medical necessity determination by the Plan

Yes

Intensive Outpatient Psychiatric
  • Unlimited

Yes

Massage Therapy
  • Unlimited
  • Limited to those enrollees diagnosed with AIDS and who have had a history of AIDS related opportunistic infection.

Yes

Medication Assisted Treatment
  • Unlimited

No

Medication Management
  • Unlimited

No

Newborn Circumcision  

No

Nutritional Counseling
  • Unlimited

Yes

Occupational Therapy
  • Requires medical necessity determination by the Plan

Yes

Outpatient Hospital Services
  • Unlimited

Yes

Over-the-Counter Medication Supplies
  • Twenty-five dollars ($25) per household per month
  • Limited to an approved list of products from a Plan-approved vendor

No

Physical Therapy
  • Requires medical necessity determination by the Plan

Yes

Prenatal/Perinatal Services
  • Ten to fourteen (10-14) visits for routine pregnancy care
  • No limit for high-risk pregnancy care
  • One postpartum home health visit

No

Primary Care Services for Non-Pregnant Adults
  • Primary Care Services for Non-Pregnant Adults

No

Psychological Testing – Community Behavioral Health Setting
  • Unlimited

No

Psychosocial Rehabilitation
  • Unlimited with prior authorization and meeting medical necessity criteria

Yes

Speech Therapy
  • Requires medical necessity determination by the Plan

Yes

Therapy (individual/Family)
  • Unlimited

No – unless it exceeds 104 units per year

Therapy (Group)
  • Unlimited

No

Therapeutic Behavioral On-Site Services
  • Unlimited with prior authorization and meeting medical necessity criteria

Yes

Targeted Case Management
  • Unlimited

Yes

Vaccines - TDaP
  • One per pregnancy

No

Vaccine – adult pneumonia 
  •  Unlimited
Yes
Vaccine - adult influenza
  • Unlimited

No

Vaccine - adult shingles
  • One per year

Yes

Vision Services
  • One (1) pair of glasses every twelve (12) months
  • Additional pairs of glasses subject to medical necessity      

No
Yes