Member Handbook - Go here to see the member handbook. You can also download and print from there.
Member Reward Programs - Jump to the section on our healthy behavior programs. You may earn a reward for taking part in them.
Special Care Programs - Jump to the section on programs that can help you live better.
Covered Medical Services - Jump to the section on the regular Medicaid benefits that we cover.
Extra Benefits - Jump to the section that lists all the extra benefits we offer.
Extra Benefits and Special Programs Guide - Download this PDF to learn about our extra benefits. It also tells about special health care programs that we have.
Member Portal - Register for access to the member portal. There you can find info on claims, change your primary care provider, and more.
Florida Health Price Finder - Many services are covered by Lighthouse. But there may be times you need services that we do not cover. Find out how much out-of-pocket cost you may have by using the Florida Health Price Finder. This is a free service of the Agency for Healthcare Administration.
Member Reward Programs
We offer programs to help keep you healthy and to help you live a healthier life (like losing weight or quitting smoking). We call these healthy behavior programs. You can earn rewards while participating in these programs. Our plan offers the following programs:
• Medically-approved smoking cessation
• Medically-directed weight loss program
• Alcohol or Substance Abuse recovery program
You may earn $25.00 per qualifying activity up to $50.00 a year distributed on a reloadable debit card. Please remember that rewards cannot be transferred. If you leave our Plan for more than 180 days, you may not receive your reward. If you have questions or want to join any of these programs, please call us at 1-844-243-5176. Or TTY at 711.
Special Care Programs
Disease Management Programs
We have special programs available that will help you if you have one or more of these conditions:
• High blood pressure
• Behavior health issues
• End-of-life issues
Our special programs are here for you if you have a new diagnosis or need ongoing help. Our Care Team will ensure you get the right care at the right time. Our Care Team will help you understand your condition and how to best manage it. Our Care Team will also refer you to local community services based on your needs.
Quality Enhancement Programs
We want you to get quality health care. We offer additional programs that help make the care you receive better. Download a document for more information, click here. The programs are:
- Early Intervention Services: If you have a child who needs special care, we are here for you. We will link you to agencies like Women, Infant and Children (WIC). We will also link you to programs like Early Steps. No matter what you need, we will work closely with you and your child’s doctor. Together, we will help your child reach his or her best health.
- Domestic Violence Screening and Support Services: You should never be treated badly. It is never okay for someone to hit you or make you feel afraid. We train our providers to recognize signs of violence. If you have been put in danger, we can help. We will work with local agencies to help you be safe.
- Healthy Start Services: We want moms and babies to be healthy. If you are pregnant or have a young child, we will work with you and your local Healthy Start. We will make sure you have access to quality care and the help you need. This includes getting:
- Helpful information for you and your child
- Referrals for services, like WIC
- Support for healthy life choices, like food and smoking
- Help with breastfeeding
- Home visits
- Help for At-Risk Members: If you are in trouble with the law or heading down that path, we can help. We want to stop you from getting deeper into the justice system. We will work with you and local, special agencies to address your needs. If you need special referrals, we can help with that, too.
- Help for Members who are Homeless: Not having a steady home can be scary. If you need help with housing, we will link you to agencies who can help with housing, food, life skills, and resources.
- Pregnancy Care Services: Being pregnant can be exciting and scary. If you are pregnant, we will support you. Our support starts as soon as we know you are pregnant. We will help you through delivery and after your baby is born. If you need special services, we will link you to local community agencies who focus on moms and babies.
- Nutrition Assessment and Counseling: Diet and nutrition are important for health. This is especially true if you are pregnant or recently had a baby. Healthy eating is also important for kids. We know eating healthy is not always easy. We partner with providers and the community to make sure you have:
- enough safe nutrition for infants
- nutrition review
- diet counseling and a nutrition care plan
- referrals to the local WIC program
- Pregnancy Prevention Support: Family planning and pregnancy prevention are important for your health. This is why we offer all members pregnancy prevention activities. We work with our providers and local agencies to make sure you get age-specific screenings, education, and referrals.
- Remote Health Monitoring: Sometimes you need extra help to manage your health. If you have asthma or COPD, you may be eligible for our Remote Health Monitoring program. We will help you manage your asthma or COPD from your home. We will work with you and your doctor to see if this program is right for you.
You also have a right to tell us about changes you think we should make. To get more information about our quality enhancement program or to give us your ideas, call Member Services.
Covered Medical Services
Below are the medical services covered by our plan. For complete details, click here.
Ambulance Transportaiton Services
Aubulatory Surgical Center Services
Assistive Care Services
Behavioral Health Assessment Services
Behavioral Health Overlay Services
Child Health Services Targeted Case Management
Durable Medical Equipment Medical Supplies Services
Early Intervention Services
Emergency Transportation Services
Evaluation and Management Services
Family Therapy Services
Group Therapy Services
Home Health Services
Individual Theapy Services
Inpatient Hospital Services
Medical Foster Care Services
Medication Assisted Treatment Services
Medication Management Services
Mental Health Targeted Case Management
Non-Emergency Transportation Services
Nursing Facility Services
Occupational Therapy Services
Outpatient Hospital Services
Pain Management Services
Physical Therapy Services
Prescribed Drug Services
Private Duty Nursing Services
Psychological Testing services
Psychosocial Rehabilitation Services
Radiology and Nuclear Medicine Services
Regional Perinatal Intensive Care Center Services
Respiratory Therapy Services
Specialized Therapeutic Services
Speech-Language Pathology Services
Statewide Impatient Psychiatric Program Services
Therapeutic Behavioral On-Site Services
Visual Aid Services
Visual Care Services
Behavioral / Assessment Services
Behavioral / Crisis Intervention Services
Behavioral / Intensive Outpatient Treatment
Behavioral / Medical Services (Drug Screening)
Behavioral / Medication Assisted Treatment
Behavioral / Medication Management
Behavioral / Peer Support Services
Behavioral / Psychosocial Rehabilitation
Behavioral / Screening Services
Behavioral / Targeted Case Management
Behavioral / Therapeutic Behavioral On-Site Services
Behavioral / Therapy (Individual/Family)
Behavioral / Treatment Plan Development
Behavioral / Treatment Plan Review
Cellular Phone Service
CVS Discount Program
Home Health Nursing/Aide Services
Home Delivered Meals – Post Facility Discharge (Hospital or Nursing Facility
Home Visit By a Clinical Social Worker
Housing Assistance After Discharge from Hospital
Meals – Non- emergency Transportation Day-Trips
Medically Related Home Care Services/Homemaker: HEPA A/C Filter for Members with Asthma
Vaccine – Influenza
Vaccine – Pneumonia
Vaccine – Shingles
Vaccine - TDap
Over-the- Counter Benefit
Pain Management / Accupuncture
Pain Management / Massage Therapy
Physical and Occupational Therapy
Primary Care Services
Speech Language Pathology Services
Therapy / Psychotherapy
Therapy / Art Therapy
Therapy / Equine Therapy