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Our health insurance programs are committed to transforming the health of the community one individual at a time.

Hurricane Michael Alert

Members

Sunshine Health will provide all life sustaining services without regard to provider network status or service limitations for impacted members during this emergency through Oct. 21, 2018.

Emergency Planning: As we prepare for Hurricane Michael, please remember to create and execute your Emergency Plan. If you do not already have one, visit the Florida Division of Emergency Management for help with making a plan and preparing for the storm.

Medication Refills: Gov. Rick Scott declared a state of emergency in 35 counties, which means if you are in an affected county you may refill your prescription medications (excluding controlled substances and specialty drugs) early in advance of the storm. Please contact your pharmacy for more information. If you have a medical emergency during the storm, please call 911.

Prior Authorizations: To help ensure the safety and well-being of our members, Sunshine Health is extending existing authorizations for home health services and durable medical equipment for members in affected counties through Oct. 26, 2018.

Affected counties: Escambia, Santa Rosa, Okaloosa, Walton, Holmes, Washington, Bay, Jackson, Calhoun, Gulf, Gadsden, Liberty, Franklin, Leon, Wakulla, Jefferson, Madison, Taylor, Hamilton, Suwanee, Lafayette, Dixie, Columbia, Gilchrist, Levy, Citrus, Bradford, Pasco, Hernando, Pinellas, Hillsborough, Manatee, Alachua, Union and Baker.

Office Closures: Sunshine Health’s Pensacola and Tallahassee offices are closed Wednesday, Oct. 10 and Thursday, Oct. 11. Member and Provider Services operations will not be impacted.

Providers

Prior Authorization: Due to the impact of Hurricane Michael, our Utilization Management department is prioritizing how we process requests for prior authorization for members in affected counties only.

Sunshine Health will provide critical Medicaid services that are life sustaining such as:  durable medical equipment and supplies, home health services, hospital services, nursing facility services chemotherapy, or dialysis, to a Sunshine Health member during this Hurricane Michael disaster period.  We will provide these services:

  • Without any form of authorization
  • Without regard to whether the services are provided by a Sunshine Health participating or non-participating provider
  • Without regard to any current Medicaid benefit limits

For those current home health authorizations, including private duty nursing, and/or DME authorizations that have end dates within the next two weeks, we have extended that end date to Oct. 26, 2018. This is for our Medicaid, Child Welfare, Long Term Care, Healthy Kids, Ambetter (Marketplace) and Allwell (Medicare) members.

Thank you for serving our members every day, and especially during this time.

Opioid Provider Toolkit

Opioid addiction is an epidemic that is hitting Florida especially hard. Community-based physicians play a pivotal role in stemming the record number of overdose deaths and getting treatment for our members, our families and our friends. Sunshine Health, in partnership with physicians, nurses and therapists, developed an Opioid Toolkit to share best practice intervention strategies and treatments for patients struggling with addiction. Read more...