Fall 2025
Welcome to our latest edition of Whole You, a newsletter from CMS Health Plan. As the year comes to an end, we want to share some helpful info about your child’s health and benefits.
Read on to learn about the importance of lead screening and how to access your child’s monthly OTC benefit. You will also get information on our healthy rewards program and how we support caregivers.
In case you missed it, check out our summer 2025 newsletter.
A simple blood test, called the hemoglobin A1c or HbA1c test, is the best way to tell how your child is managing their diabetes. It measures their average blood sugar levels (glucose) over the last three months.
Why does my child need an A1c? This is the only way your child’s doctor can tell how your child is doing with their diabetes. It will help the doctor decide how much insulin your child needs. It will also help them know what your child should eat and how much they should exercise.
How does my child get an A1c test? Your child can get a fingerstick at their doctor’s office. The doctor also may ask you to take your child to a lab for the test if other lab work is needed.
What is a healthy A1c? Doctors recommend an A1c of 7% or lower for children and teens with diabetes. But every child is different. Work with your child’s doctor to set the right A1c target for them.
Why does A1c matter? Keeping your child’s A1c in check will help prevent them from having low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia). It will also reduce their risk for other health issues and complications later in life.
How can my child lower their A1c? Ask your child’s doctor for advice. They can give you tips on your child’s diet, exercise and medications to keep their A1c in the right range.
Remember: Diabetes increases the risk of vision problems. It’s important that your child has diabetic retinopathy screenings at least once a year. Call their doctor if you have questions.
Get rewarded: CMS Health Plan members 13-20 years old can earn $20 a year for completing both an HbA1c test and a retinopathy screening.
Lead is all around us. It is in paint, old furniture, even some children’s toys. Exposure to it can cause long-term health issues for children, like learning problems, hearing loss and speech delays. Here are two ways to protect your child:
- All children should be tested for lead poisoning by the time they turn 2 years old. A simple blood test is the only way to detect it because other signs don’t show up right away.
- Keep an eye out for lead in day-to-day life. It can be found in many places, including:
- Paint used in buildings and homes built before 1978
- Soil
- Drinking water
- Cookware, like pots and pans
- Painted toys
- Costume jewelry
- Imported candy
Get rewarded: CMS Health Plan members earn $20 for lead screening by age 2 years old. Learn more about the Rewards Program.
Source: Florida Health
It’s normal to feel lonely sometimes. If your child is feeling lonely this holiday season, it may help them to talk to someone about their feelings and troubles. HAPPY, a national emotional support program, is a great option. It is available to CMS Health Plan members 18 and older.
HAPPY connects members with people called Support Givers, who are there 24/7 to listen and offer compassion and encouragement. All you have to do is download the free HAPPY mobile app on your smartphone or tablet. You can also call HAPPY at 1-855-953-4567 to get help for your child right away.
We know that caring for a child with special medical needs can be hard. Sometimes you need support, too. CMS Health Plan is here to help.
Caregiver-focused benefits:
- Therapy for Caregivers*: Individual or group therapy for caregivers of CMS Health Plan members who are not on Medicaid themselves.
- Health and Wellness Coaching: Health and wellness coaching to provide education and guidance to caregivers on healthy choices.
- Financial Counseling: Counseling to help you better understand and manage your finances.
- Nutritional Counseling: Assessment of your child’s nutrition needs with education and guidance to caregivers about healthy eating.
- Benefit Counseling: Counseling to help you better understand your child’s benefits.
- Respite Care*: Temporary rest from caregiving. Up to 200 hours of in-home care and 10 days of out-of-home care.
*Benefit requires prior authorization from CMS Health Plan. Contact your child’s Care Manager for details.
Other ways to get help:
- Enter your ZIP code to search for free and reduced-cost services near you with Sunshine Health Connects.
- Call the Community Connections Help Line at 1-866-775-2192.
CMS Health Plan rewards members who make healthy choices, like going to a yearly Well Child visit, pledging to lose weight or completing a disease management program.
Reward dollars can be used to help pay for:
- Utilities
- Transportation
- Telecommunications
- Childcare services
- Education
- Rent
Or you can use them to shop for everyday items at Walmart, like food and household goods. *This card may not be used to buy alcohol, tobacco, or firearms products.
Once your child completes one of the healthy activities we reward for, a prepaid gift card (shown below) will be mailed to you. If your child earns additional rewards, those dollars will be added to the same card. Learn more about healthy rewards.
Is your child pregnant? CMS Health Plan has resources for members who are expecting. Start Smart for Your Baby provides customized support during pregnancy and through their baby’s first year of life.
These services are provided by an experienced and licensed medical staff who will work with you, your child and your child’s doctors to create a safe birth plan.
Start Smart for Your Baby provides:
- Information about pregnancy
- Support with prenatal care
- Education on newborn care
- Breastfeeding support and resources
- Help access housing, food, clothing and other supplies
- Text and emails with health tips for your child and their newborn
CMS Health Plan members ages 13-20 who are pregnant also qualify for free doula services. A doula is a non-medical professional who can give your child emotional and physical support during pregnancy and childbirth.
Visit Pregnancy and Newborn Services to learn more. Contact your child’s Care Manager with questions.
If your child has a complex or life-threatening condition, there may be special help available. It’s through a CMS Health Plan program called Partners in Care: Together for Kids, or PIC: TFK.
Only kids enrolled in CMS Health Plan have access to this unique program. It helps children and families get special care focused on giving them the best quality of life possible. To qualify, your child must be a CMS Health Plan member, be diagnosed with a serious condition and live in an area where there is a PIC: TFK provider.
If your child is enrolled into the PIC: TFK program, CMS Health Plan will work with their PIC: TFK provider to give your child and family support to meet physical, emotional and spiritual needs.
Here are some of the services available:
- Support counseling
- Expressive therapies (play, art, music)
- Respite support (short-term relief for caregivers)
- Hospice nursing services
- Sibling support
- Support for the entire family
- Chaplain services
Do you think your child would benefit from the PIC: TFK program? Talk to your child’s CMS Health Plan Care Manager or their doctor.
See the OTC booklet (PDF) for a full catalog of covered items and instructions on how to order. Options include:
- Order online or on the OTC Health Solutions mobile app to have items shipped to your home.
- Order by phone at 1-888-262-6298, Monday through Friday, 9 a.m. to 8 p.m. Eastern to have items shipped to your home.
- Shop in person at select CVS stores. Check the store locator or call OTC Health Solutions at 1-888-262-6298 (TTY: 711) to find a store nearby.
Use your child’s $25 a month to get items like baby wipes, allergy products, pain relief medicine and more. You can also get everyday items like laundry detergent, soap and toothbrushes.