​Eligibility

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​Florida Medicaid provides services to eligible recipients under the age of 21 years, if such services are medically necessary to correct or ameliorate a defect, a condition, or a physical or mental illness. Included are diagnostic services, treatment, equipment, supplies, and other measures described in section 1905(a) of the SSA, codified in Title 42 of the United States Code 1396d(a). As such, services for recipients under the age of 21 years exceeding the coverage described within this policy or the associated fee schedule may be approved, if medically necessary

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Coinsurance and Copayments

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There is no coinsurance or copayment for this service in accordance with section 409.9081, F.S. For more information on copayment and coinsurance requirements and exemptions, please refer to Florida Medicaid’s General Policies on copayment and coinsurance.

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Parental Responsibility

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Florida Medicaid reimburses for personal care services rendered to a recipient whose parent or legal guardian is not able to provide ADL or IADL care, and to supplement care provided by parents and legal guardians. Parents and legal guardians must participate in providing care to the fullest extent possible. Providers must offer training to enable parents and legal guardians to provide care they can safely render without jeopardizing the health or safety of the recipient when needed

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Florida Medicaid reimburses for up to 24 hours of personal care services per day, per recipient, in order to provide assistance with ADLs and age appropriate IADLs when the recipient meets the following criteria:

• Has a medical condition or disability that substantially limits their ability to perform ADLs or IADLs and do not have a parent or legal guardian able to provide the required care

• Is under the care of a physician and has a physician’s order for personal care services

• Requires more extensive and continual care than can be provided through a home health

  visit

• Requires services that can be safely provided in their home or the community

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Personal Care Services covered include:

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• Bathing

• Dressing

• Eating

• Grooming & Skin Care

• Positioning

• Transfers

• Toileting & Maintaining continence

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For more information about our Personal Care Services, request a consultation today and one of our care coordinators will reach out to you as soon as possible.