Healthcare
The guide to insurance, doctors appointments, and other medical care
Insurance
All foster children in Orlando are covered under Medicaid.
Medicaid
Foster parent’s should recieve Medicaid insurance information from their child’s caseworker at the time of placement. This includes:
- Plan name
- Plan/Member ID
If you do not receive this information at the time of placement, follow-up with the child’s caseworker to make sure you receive it. Insurance information will be required for all doctors visits and medical care.
The default plan for foster children is the Sunshine Health: Child Welfare Specialty Plan. This plan includes enhanced mental health benefits for foster children.
The child will likely start with a different plan and then be transferred into the Sunshine Health plan one month after the child is auto enrolled into Medicaid.
Florida’s Medicaid program is run by a variety of private organizations including Staywell, Aetna Better Health, Simply Healthcare, Sunshine Health, and Humana Medical Plan. You can choose any of these plans during your annual enrollment period. This is important if there is a provider that you want to see who only takes one form of Medicaid.
| Service | Description | Coverage/ Limitations |
Prior Authorization |
| Care grant | Up to $150 per calendar year per child for services or supplies for social use or physical activities. |
Ages 0 to 21. Up to $150 per calendar year. |
Yes |
| CVS discount program | 20% discount on certain over-the-counter items. | All ages. | No |
| Doula services | Pregnancy, postpartum and newborn care and assessment provided in your home by a Doula. |
Ages 13 and older. No limits. |
Yes |
| Durable medical equipment – breast pump |
Breast pump, hospital grade rental. Breast pump rental |
1 per calendar year; ages 10 to 59. 1 per 2 calendar years; ages 10 to 59. |
Yes |
| Home delivered meals post inpatient discharge | Meals delivered to your home after a hospitalization. |
Ages 0 to 21. No limits. |
Yes |
| Life Skills Development | For children or adolescents with developmental disabilities to provide life skills help for the child or adolescent to keep, learn or improve skills and functioning for daily living. These services will be provided in the home or outpatient setting. |
Ages 12 to 21. Must have a diagnosed developmental disability. Up to 160 hours per calendar year. |
Yes |
| Newborn circumcision | Can be provided in a hospital, office or outpatient setting. |
Birth to 28 days old. 1 per lifetime if medically necessary. |
No |
| Non-emergency transportation – non-medical purposes | Transportation provided for non-medical purposes such as social outings or family visits. |
Ages 5 to 21. Three round-trips per month. |
Yes |
| Non-emergency transportation meals | Meals as part of a non-medical transportation trip. |
Ages 0 to 21. Up to $200 per day up to $1,000 per calendar year for trips over 100 miles. |
Yes |
| Over-the-counter benefit | Up to $25 per household, per month, for cold, cough, allergy, vitamins, supplements, ophthalmic/otic preparations, pain relievers, gastrointestinal products, first aid care, hygiene products, insect repellant, oral hygiene products and skin care. | Ages 0 to 21. | No |
| Prenatal/perinatal visits | Prenatal/perinatal office visits for pregnant women. |
Ages 10 to 59. 14 visits for low-risk pregnancy. 18 visits for high-risk pregnancy. |
No |
| Postpartum visits | Doctor visits after delivery of your baby. |
Ages 10 to 59. Three visits within 90 days of delivery. |
No |
| Transition Assistance | One-time payment of up to $500 per youth who is transitioning out of foster care at age 18 or out of extended foster care at age 21. Funds to support moving to a new home. |
Ages 18 to 21. Must be in out-of-home licensed foster care for a minimum of 6 months before transitioning out of foster care. |
Yes |
Doctor’s Visits
Foster parent’s are responsible for making sure the children they care for receive the appropriate medical care and evaluation.
Initial Evaluation
Unless a child is exhibiting signs or symptoms of illness, an initial health care assessment by a licensed health care professional shall be completed for every child placed with a relative, non-relative, or in licensed care within five (5) working days of the removal. A child who appears to be sick or in physical discomfort shall be examined by a licensed health care professional within 24 hours.
Regular Checkups
Children over age 2 are required to have doctor checkups every year. Infants should be seen every six weeks until they are 6 months old. Infants from age 6 months to 2 years should be see every 3 months.
Medical Treatment
Children and youth should also be seen as needed for any additional medical concerns that come up between regular checkups. Medicaid will also cover visits for counseling and other mental health disorders. Younger children can participate in play therapy.
Early Steps (Intervention)
Early steps services are meant to connect children with special needs to the services they require in a timely manner
Early Steps Assessments
Early Steps is Florida’s early intervention system that offers services to eligible infants and toddlers, age birth to 36 months, who have or are at-risk for developmental disabilities or delays. Early intervention supports families and caregivers to increase their child’s participation in daily activities and routines that are important to the family.
If you suspect your foster child has development delays, ask your child’s social worker to make a referral for Early Steps. Infants and toddlers are assessed in the following developmental domains to determine eligibility: physical, cognitive, communication, social-emotional and adaptive. More information here.
Once your child is determined eligible, Early Steps will put together a team of service providers to address your child’s needs.
Older Youth
Individuals who are under age 26 may receive Medicaid if they were in foster care under the responsibility of the State and receiving Florida Medicaid when they aged out of foster care. There is no income limit for this program.
Learn More About Foster Care
The following guides can help get you up to speed on several important aspects of foster care in Orlando.
Finances
Learn about financial support available for foster parents.
Healthcare
Learn about healthcare topics such as doctors visits and insurance.
The Legal System
Learn about family court, hearings, and child custody.
Caseworkers and Visits
Learn about the different types of caseworkers, home visits, and parent visits.
New Placements
Learn about what to ask when receiving a new placement and the first week in care
School and Daycare
Learn more about education, school, and daycare.
Adoption and Permanency
Learn about foster care, adoption, and foster-to-adopt.
Foster Care Policies
Learn about policies like travel and babysitters