Enhanced Benefits Reward$ Program

Program Update

**Enhanced Benefits Program Phase Out - First Notice, July 31, 2013, Broward** [38KB PDF]

**Enhanced Benefits Program Phase Out - Second Notice, November 27, 2013, Baker, Clay, Duval, & Nassau counties** [36KB PDF]

Florida Medicaid has a new program called the Enhanced Benefits Reward$ Program. This program is designed to reward you for taking part in activities that can improve your health. These activities, known as healthy behaviors, will earn credits that you can later use to buy health-related items at the pharmacy. You do not have to do anything to enroll in this program.

Healthy Behaviors [241KB PDF]

Beneficiaries with disabilities can receive these materials in alternative formats upon request at no additional charge. These formats include, but are not limited to: Braille, large print, CD-ROMs, and audiotapes. To receive these services contact:

Enhanced Benefits Call Center
1-866-421-8474

Enhanced Benefits Reward$ Program Welcome Letter (English and Spanish) [262KB PDF]

Florida Medicaid Reform Enhanced Benefits Universal Form (English and Spanish), June 2013 [100KB PDF]

Enhanced Benefits Over-the-Counter Products

You can use your Enhanced Benefits credits to buy health-related items at any Florida Medicaid participating pharmacy. You must have your Gold Card or a government issued ID to use your earned credits. To find out what types of products you can buy with your credits, please see the links below.

If you wish to save the spreadsheet to your computer, right click on the product list and choose "Save as..." from the pop up menu.

If you need help using this list, call the Enhanced Benefits Call Center at 1-866-421-8474 and they will be happy to help you.

Complete List of Over-the-Counter Products, April 2014 [2.18MB MS Excel 2010] Updated 4/1/2014

Complete List of Over-the-Counter Products, April 2014 [6.62MB PDF] Updated 4/1/2014

Products listed on this list may or may not be at the pharmacy of your choice, this list represents products available through the Enhanced Benefits Rewards Program.

Pharmacist's New EBA Billing Instructions, Effective January 25, 2011 [46KB PDF]

Frequently Asked Questions

Who is eligible?

If you are enrolled in a Florida Medicaid Reform Health Plan, you are eligible to earn and use credits in the Enhanced Benefits Account Program.

How do you earn credits?

You earn credits by taking part in a healthy behavior. Healthy behaviors may be offered by your health plan, community center, or other not- for-profit organizations. The program records your participation in two ways:

  • Your health plan reports when you visit the doctor or have a procedure that is an approved healthy behavior to earn credit; or
  • You submit an Enhanced Benefits Universal Form to your health plan that shows you participated in an approved healthy behavior outside of your health plan.

How many times can you earn credit for each healthy behavior?

You may earn credit for each healthy behavior up to the limit for each behavior until you reach the $125.00 credit limit per year.

How much can you earn?

You may earn credits worth up to $125.00 per year (September 1, 2006 through June 30, 2006).

How will you know when you have credits in your account?

When you earn a credit, you will get a letter from the Agency. Deposits will occur on the first day
of each month. It may take up to 90 days after you complete a healthy behavior before the credits show up in your account.

How do you buy items using your credits?

You must provide your Florida Medicaid ID number and a picture ID. Take the item or items to the pharmacy counter to check out.

What can you buy with the credits you earn?

Credits in your account may be used to buy certain health-related items. Items include first aid supplies, cough and cold medication, dental supplies, and many other over-the-counter items. See list of products at the top of this page.

Where can you use your credits?

You may use your credits at any Florida Medicaid participating pharmacy.

What is the Enhanced Benefits Universal Form?

The Enhanced Benefits Universal Form is used to record an approved healthy behavior that is not provided by your health plan.

How do you get the Universal Form?

The Enhanced Benefits Universal Form is available at the top of this page or from your health plan web site or through the health plan customer service number listed in this brochure.

Can the Enhanced Benefits Universal Form be submitted for healthy behaviors not listed on the Form?

No. Only behaviors listed on Universal Form will be processed for credit when the Universal Form is used. See the list of healthy behaviors at the top of this page.

How will credits be earned for behaviors not listed or submitted on the Universal Form?

Approved healthy behaviors that are not listed on the Universal Form will be reported by your health plan.

What is the timeframe for submitting the Universal Form?

A health plan has up to one year from the date of service (the day you participated in the healthy behavior) to submit to the Agency.  Submit  the completed form to your health plan as soon you complete the healthy behavior to ensure you receive credit. 

There are five easy steps to earn credits.  They are listed below.

  1. You participate in an approved healthy behavior.
  2. You submit a completed Enhanced Benefits Universal Form or your provider submits a claim to your health plan.
  3. Your health plan reports the behavior to the Agency.
  4. The Agency approves the credits, updates your account and mails you a
    statement.
  5. You may begin using the credits you have earned.

If you want to use your credits to buy an approved health product or supply, you must wait until the program sends you an account balance letter stating that credits are in your account. It may take up to 90 days after you complete a healthy behavior before the credits show up in your account.

Email your comments and suggestions on Enhanced Benefits to
enhancedbenefit@ahca.myflorida.com

Please include your complete name and a daytime phone number where you can reached.




Reporting Medicaid Fraud