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Benefits overview

Expanded benefits

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

 

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