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Eligibility and Services

CMS Plan

Children's Medical Services Managed Care Plan is designed for those individuals who are Medicaid eligible and have special health care needs.

How does a child qualify?    

  • Must meet Medicaid financial requirements
  • Must be under age 21
  • Must meet CMS clinical screening requirements or have a physician attest to child's qualifying medical conditions

How do I request a clinical eligibility screening or rescreening?

To request a CMS Plan clinical eligibility screening for the CMS Plan for Medicaid, KidCare or Safety Net*, please contact your local CMS Plan area office. You may request a rescreening at any time. If you have already participated in a screening and would like to request a rescreening, please call your local CMS Plan area office or 1-855-901-5390. Phone numbers for local CMS Plan area offices are listed below.   

  • CMS Plan Area Offices

Daytona Area Office: (866) 827-5197 or (386) 238-4980

Ft. Lauderdale Area Office: (800) 204-2182 or (954) 713-3011

Ft. Myers Area Office: (800) 226-3290 or (239) 433-6273

Ft. Pierce Area Office: (800) 226-1354 or (772) 467-6092

Gainesville Area Office: (800) 523-7545 or (352) 334-1400

Jacksonville Area Office: (800) 340-8354 or (904) 360-7070

Lakeland Area Office: (800) 741-2250 or (863) 413-3580

Marathon Area Office: (305) 349-1330

Miami-Dade Area Office: (866) 831-9017 or (305) 349-1330

Naples Area Office: (239) 624-6730

Ocala Area Office: (888) 326-7485 or (352) 369-2100

Orlando Area Office: (800) 226-6530 or (407) 858-5555

Panama City Area Office: (800) 299-4700 or (850) 872-4700

Pensacola Area Office: (800) 381-3685 or (850) 484-5040

Sarasota Area Office: (800) 235-9717 or (941) 361-6250

St. Petersburg Area Office: (800) 336-1612 or (727) 217-7800

Tallahassee Area Office: (800) 226-2604 or (850) 487-2604

Tampa Area Office: (866) 300-6878 or (813) 396-9743

Viera Area Office: (321) 639-5888

West Palm Beach Area Office: (877) 822-5203 or (561) 881-5040

What Services are covered? 

Each child has 24 hours/7 days a week access to a personal primary care physician who provides or authorizes all medically necessary services for the child. Additionally each child and family has an assigned CMS care coordinator who assists the child and family in a wide range of activities including teaching, coordination of services, arranging and advocating for services with specialists, schools, community programs, health care facilities and providers.

  • Services include the following:
Advanced registered nurse practitioner services
Laboratory and imaging services
Ambulatory surgical treatment center services
Medical supplies, equipment, prostheses and orthoses
Assistive Care Services
Mental health services
Birthing center services
Nursing care
Chiropractic services
Optical services and supplies
Dental services
Optometrist services
Early periodic screening diagnosis and treatment services for recipients under age 21
Palliative care
Emergency services
Physical, occupational, respiratory, and speech therapy
Family planning services and supplies (some exception)
Physician services, including physician assistant services
Healthy Start Services (some exception)
Podiatric services
Hearing services
Prescription drugs
Home health agency services
Renal dialysis services
Hospice services
Respiratory equipment and supplies
Hospital inpatient services
Rural health clinic services
Hospital outpatient services
Substance abuse treatment services
Immunization services
Transportation to access covered services

Member Resources 

Ped-I-Care Handbook
(North and Central Florida counties)

Ped-I-Care ID Card

Community Care Plan Handbook(CCP)
(South Florida counties)

Community Care Plan ID Card

*The Children’s Medical Services (CMS) Safety Net Program is for
Florida residents, ages 0 to 21, who meet both
clinical and financial eligibility and sliding fee criteria.  CMS provides “benefits authorized in section 391.0315, Florida Statutes, for children with chronic and serious medical conditions who do not qualify for Medicaid or Title XXI of the Social Security Act.  Children eligible for assistance using these funds must be uninsured, or insured but not covered for medically necessary services, or unable to access services due to lack of providers or lack of financial resources regardless of insurance status.  Families shall participate financially in the cost of care based on a sliding scale established by CMS."  Contact a CMS Plan area office for more information.