Due to Hurricane Matthew, Florida, Governor Rick Scott declared a state of emergency in all Florida Counties

Your health and safety are our primary concerns and if you leave your home to avoid this emergency, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional.

For our members who live in one of these impacted areas, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers. You must still use Medicare certified facilities and providers.

Prior authorization for medical services or medication may still be needed for medical necessity. This change is in effect until the emergency notice is closed or November 3rd, whichever is earlier.

For public health emergencies, the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first.

Debido al huracán Matthew, en Florida, el gobernador Rick Scott declaró el estado de emergencia en todos los condados de Florida

Su salud y seguridad son nuestras preocupaciones principales y, si abandona su hogar para evitar esta emergencia, no queremos que haya ningún obstáculo inapropiado que le impida obtener su medicamento o consultar a un profesional médico.   

Para nuestros afiliados que viven en una de estas áreas afectadas, hemos suspendido las revisiones por reabastecimiento demasiado pronto para sus medicamentos con receta de la Parte D y hemos eliminado los requisitos de autorización fuera de la red para los proveedores que no pertenecen a la red.  Debe continuar usando centros y proveedores certificados por Medicare.

Es posible que aún se requiera autorización previa para servicios médicos o medicamentos para determinar su necesidad médica. Este cambio estará vigente hasta que se cierre el anuncio de emergencia o hasta el 3 de noviembre, lo que ocurra antes.

Para emergencias de salud pública, la suspensión de las revisiones por reabastecimiento demasiado pronto para sus medicamentos con receta de la Parte D estará vigente hasta que la emergencia ya no exista o hasta el vencimiento del período de 90 días que comienza desde la declaración inicial, lo que ocurra primero.

Sunshine Health

Welcome! Whether you are looking for help to improve your health overall or focused on staying healthy, Sunshine Health is here for you. We know that everyone is in a different place on their journey to good health so we provide just the support you need no matter where you are. Our Medicare Advantage plans have benefits to keep you healthy and programs to help you manage your health if you have an ongoing condition. And, we have friendly, professional staff members who are always ready to help you get the most of your benefits and help coordinate the care you might need. If you’re looking for a new Medicare Advantage plan, our helpful, licensed sales representatives will sit down with you to understand your needs and help you make a good decision about which health benefit plan is right for you.

Who is Sunshine Health? We are a group of people dedicated to helping you feel your best by providing Medicare Advantage plans that allows you to get the healthcare you need. We know the unique health challenges that people in Florida face because we live here, too. We are a local health insurance plan serving the people we see every day ― at our grocery stores, movie theaters, and community events.

We offer a Medicare Advantage Prescription Drug (MAPD) in Florida for people who are eligible for Medicare. And, we offer an MAPD plan known as a Dual Eligible Special Needs Plan (D-SNP) that is specifically for people who are eligible for both Medicare and Medicaid. This Medicare Advantage plan works with your existing Medicaid coverage to give you even more benefits. Both of our MAPD plans include Medicare Part A (hospital insurance) and Medicare Part B (medical/outpatient insurance) PLUS other important benefits that help you take care of yourself, with extras like a gym membership, vision care and prescription drug coverage.

Sunshine Health is contracted with Medicare for HMO and HMO SNP plans, and with the Florida Medicaid program. Enrollment in Sunshine Health depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits may change on January 1 of each year. This plan (HMO SNP) is available to anyone who has both Medical Assistance from the State and Medicare.

This information is available for free in other languages. Please call customer service at 1-877-935-8022 (TTY: 711) for HMO SNP members, or 1-844-293-2636 (TTY: 711) for HMO members. October 1 – February 14, 7 days a week, 8 a.m. to 8 p.m.; February 15 – September 30, Monday – Friday, 8 a.m. to 8 p.m..

Esta información está disponible gratis en otros idiomas. Por favor llame a nuestros Servicios para Afiliados al 1-877-935-8022 (afiliados de la HMO SNP) (TTY 711), 1-844-293-2636 (afiliados de la HMO) (TTY: 711). 1 de octubre - 14 de febrero, 7 días a la semana, 8 a. m. - 8 p. m.; 15 de febrero - 30 de septiembre, lunes - viernes, 8 a. m. - 8 p. m.

Last Updated: 09302016