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Is Florida Medicaid the same as Sunshine Health?

Sunshine Health is a Florida Medicaid health plan that has been providing services in Florida since 2009.

Does Sunshine Medicaid require referrals for specialists?

Remember, you may need a referral from your Primary Care Provider (PCP) or approval from us before you go to an appointment or use a service. Services must be medically necessary (PDF) in order for us to pay for them.

What kind of insurance is sunshine health?

Sunshine Health is among the largest comprehensive healthcare plans in Florida. We provide quality healthcare coverage with expanded benefits to individuals and families to help them get well and stay well through through our Medicaid, Long Term Care and specialty plans.

sunshine outpatient authorization form

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Is Sunshine State Health Medicaid?

Sunshine Health enrolls members who are eligible for Medicare and Medicaid. Medicaid includes Full-Benefit Dual Eligible, Qualified Medicare Beneficiary Plus (QMB+) and Specified Low-Income Medicare Beneficiary Plus (SLMB+). Currently, this plan has 2,679 members in 20 counties.

Who bought Sunshine Health?

Centene Corporation finalized its acquisition of WellCare Health Plans, Inc. on January 23, 2020. Centene is the parent company of Sunshine Health; WellCare is the parent company of WellCare of Florida and Staywell Health Plan.

What services does not require prior authorization?

No pre-authorization is required for outpatient emergency services as well as Post-stabilization Care Services (services that the treating physician views as medically necessary after the emergency medical condition has been stabilized to maintain the patient's stabilized condition) provided in any Emergency Department ...

Is Sunshine State Health Medicaid?

Sunshine Health enrolls members who are eligible for Medicare and Medicaid. Medicaid includes Full-Benefit Dual Eligible, Qualified Medicare Beneficiary Plus (QMB+) and Specified Low-Income Medicare Beneficiary Plus (SLMB+). Currently, this plan has 2,679 members in 20 counties.

Does Sunshine Health require authorization?

Prior approval is required for all services by a provider who is not in the Sunshine Health network. The only exception is for emergency care. Emergency room or urgent care visits do not require prior authorization.

Sunshine prior authorization form 2025

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Is Sunshine State Health Medicaid?

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