What is MediPass?

Most people enrolled in Medicaid must enroll in a managed health care plan. MediPass, Health Maintenance Organizations (HMO), and Provider Service Networks (PSN) are managed health care plans offered to people enrolled in Medicaid.  The difference between MediPass and the other managed health care plans is that MediPass is run by the State of Florida.  The Florida Medicaid program manages MediPass through the Agency for Health Care Administration.  MediPass is a statewide primary care case management program.  With MediPass, members are assigned to a primary care provider who is responsible for managing and coordinating all of the member's health care needs. Members and providers are allowed the opportunity to develop the doctor/patient relationship which ensures continuity of care and reduces duplication of services.

The same services that are available under Medicaid are also available under MediPass.  The following are services that are available to all MediPass members:

• Advanced registered nurse practitioner (ARNP)
• Ambulatory surgical centerBirth center services
• Child Health Check-Up services
• Chiropractic services (first ten visits per calendar year do not need MediPass authorization. A referral is required for all children under 21 years of age.)
• County health department services
• Durable medical equipment and medical supplies
• Federally qualified health center services
• Home health services
• Hospital inpatient services
• Hospital outpatient services
• Laboratory services (independent laboratory services do not need MediPass authorization)
• Licensed midwife services
• Physician services
• Physician assistant (PA) services
• Prescribed drug services
• Podiatric services (first four visits per calendar year do not need MediPass authorization)
• Rural health clinic services
• Therapy services (occupational, physical, speech, respiratory)
• X-ray services including portable x-rays services

Please refer to the Florida Medicaid Summary of Services for more information regarding the services available through Medicaid. (En Español)

In addition to the basic health care services, members living with certain chronic illnesses may also participate in one of the Disease Management programs.

The MediPass provider receives a per month per member management fee for each patient assigned to their panel. Medical doctors, doctors of osteopathy, physician assistants, advanced nurse practitioners, county health departments, rural health facilities and federally qualified health centers may enroll with MediPass as a primary care provider.“