Behavioral Health Benefits and Member Supports
Sunshine Health cares about the wellbeing and safety of our members. That’s why we offer behavioral health services and substance abuse treatment that supports coping, recovery, wellness management and independent living skills.
Urgent Behavioral Health Resources
Always Call 911 If Someone’s Safety is at Imminent Risk
Sunshine Health Behavioral Health Crisis Line
- Phone: 1-866-796-0530
- TTY: 1-800-955-8770
- Hours: 24/7 help 365 days a year
- Help: Learn how to help a friend
- Behavioral Health Crisis
988 Suicide & Crisis Lifeline
- Phone: 988
- Chat: 988lifeline.org
- Hours: 24/7 help 365 days a year
- Help: Trained counselors available
- Press 1 to reach the Veterans Crisis Line
CMS Health Plan Behavioral Health Crisis Line
- Phone: 1-866-799-5321
- TTY: 1-800-955-8770
- Hours: 24/7 help 365 days a year
- Help: Call if your child is in crisis
- CMS Behavioral Health Crisis
Learn More About Accessing These Resources
Community Connections Team
- Help Line: 1-866-775-2192
- Video Relay: 1-855-628-7552 (TTY: 711)
- Monday to Friday, 9 a.m. to 6 p.m. Eastern
- Community Connections
- Community Resource Database
Sunshine Health Member Services
- Call: 1-866-796-0530 (TTY: 1-800-955-8770)
- Monday to Friday, 8 a.m. to 8 p.m. Eastern
- Sunshine Health Member Services
CMS Health Plan Member Services
- Call: 1-866-799-5321 (TTY: 1-800-955-8770)
- Monday to Friday, 8 a.m. to 8 p.m. Eastern
- CMS Health Plan Member Services
In Lieu of Services Program (ILOS)
Sunshine Health offers medically appropriate substitutes for Medicaid benefits.
| Benefit | In Lieu Of |
|---|---|
Crisis Stabilization Unit (CSU) | Inpatient Psychiatric Hospital |
Free Standing Psychiatric Hospital | Inpatient Psychiatric Hospital
|
Detoxification or Addiction Receiving Facility | Inpatient Detoxification Hospital Care |
Partial Hospitalization Services | Inpatient Psychiatric Hospital Care |
Mobile Crisis Assessment and Intervention | Emergency Behavioral Health Care |
Ambulatory Detoxification Services | Inpatient Detoxification Hospital Care |
Self-Help/Peer Services | Psychosocial Rehabilitation Services |
Drop-In Center Services | Clubhouse Services |
Infant Mental Health Pre & Post Testing Services | Psychological Testing |
Family Training & Counseling for Child Development | Therapeutic Behavioral Onsite Services |
Community-Based Wraparound Services | Therapeutic Group Care Services or Statewide Inpatient Psychiatric Program Services |
Short-Term Residential Treatment (SRT) | Inpatient Detoxification Hospital Care |
Multi-Systemic Therapy | Inpatient or Residential Treatment |
Substance Abuse & Mental Health Intensive Outpatient Program (IOP) | Inpatient Detoxification or Psychiatric Hospital Care |
Nursing Facility Services | Inpatient Hospital Services |
Standard Benefits
- Primary Care Services (unlimited)
- Family Therapy Services
- Group Therapy Services
- Individual Therapy Services
Expanded Maternal/Child Benefits
- Biometric Equipment
- Art Therapy
- Acupuncture
- Chiropractic Services
- Equine Therapy
- Home Allowance
- Pet Therapy
Special Programs
- Happy: Offers 24/7 support for social isolation and loneliness.
- Long-Acting Injectable Antipsychotics (LAIA): Monthly injections for schizophrenia that can improve medication compliance, lower ED visits and stabilize members within the community. No prior authorization for members 18 years and older.
- Housing Assistance Pilot Program (PDF): For adult Medicaid members who are homeless or at risk of being homeless and who also have a behavioral health diagnosis or struggle with substance abuse. Provides housing for members and offers treatment.
- Region 5: Pasco, Pinellas counties.
- Region 7: Brevard, Orange, Osceola, Seminole counties.
Healthy Rewards
| Amount | Activity | Description |
|---|---|---|
| $50 | Substance Use Treatment for Pregnant Members Using Drugs | Complete five Medication Assisted Treatment visits before delivery; provide evidence of completed counseling and medication sessions. |
| $10 | Substance Use Health Coaching | Ages 12 years and up. Complete 3 coaching sessions with a Care Manager in 3 months; must enroll in Case Management and provide signed consent form. |
| $20 | Post Behavioral Health Admission Follow up Visit | Earn rewards for attending an outpatient follow up appointment with a behavioral health provider within 7 days after discharge from an inpatient facility. |
View the full list of Healthy Rewards.