CMS Plan for Children with Special Health Care Needs

The Centers for Medicare and Medicaid services is a part of the Health and Human Services.

Florida’s Children’s Medical Services Managed Care Plan (CMS Plan) provides children with special health care needs a family-centered, comprehensive, and coordinated system of care.

The CMS Plan is designed to serve children under age 21 whose chronic physical or developmental disabilities require preventive and ongoing care.

Eligibility Requirements 

  • Must meet medical financial requirements
  • Under the age of 21
  • Must meet CMS physical screening requirements or have a physician attest to the child’s qualifying condition. To request a physical screening please contact your local CMS office. You may request it at any time.

Goal

  • To provide children up to age 21 with special health care needs a family-centered, culturally competent, comprehensive and coordinated statewide managed system of care that links community-based care with multidisciplinary, regional and tertiary pediatric specialty care.

Objectives

  • Each member has a care coordinator to assist them and their family to navigate through the health system.
    Members receive medically necessary, high-quality services.
  • Members have access to a wide range of primary, specialty and facility providers throughout Florida.
    Members are educated on preventive health services and disease management.
    Provider requests for service authorizations and payments are processed timely, which will lead to the appropriate utilization of services.

Services Covered 

  • Each child has 24 hours/7 days a week access to a personal primary care physician who provides or authorizes all medically necessary services for the child. Additionally each child and family has an assigned CMS care coordinator who assists the child and family in a wide range of activities including teaching, coordination of services, arranging and advocating for services with specialists, schools, community programs, health care facilities, and providers.

CMS Plan Contact Information:
850-245-4200
CMSPlan@flhealth.gov

Mailing Address
Office of the CMS Managed Care Plan                                                                                                                       4052 Bald Cypress Way, Bin A06
Tallahassee, FL 32399

More information is available at, http://www.floridahealth.gov/programs-and-services/childrens-health/cms-plan/eligibility-and-services/index.html