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Women’s Health and Cancer Rights Act Annual Notice

Do you know that your plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy‐related services including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedemas? Call your Plan Administrator, Florida Health Care Plans at 1- 877 615-4022 for more information.

Newborn and Mothers Health Protection Notice

The Newborn and Mothers Health Protection Act has set rules for group health plans and insurance issuers regarding restrictions to coverage for hospital stays in connection with childbirth. The length of stay may not be limited to less than: 48 hours following a vaginal delivery OR 96 hours following a cesarean section.

Determination of when the hospital stay begins is based on the following:

  • For an in the hospital delivery: The stay begins at the time of the delivery. For multiple births, the stay begins at the time of the last delivery.
  • For a delivery outside the hospital (i.e. birthing center): The stay begins at the time of admission to the hospital. Requiring authorization for the stay is prohibited.

If the attending provider and mother are both in agreement, then an early discharge is permitted.

Group Health Plans may not:

  • Deny eligibility or continued eligibility to enroll or renew coverage to avoid these requirements.
  • Try to encourage the mother to take less by providing payments or rebates.
  • Penalize a provider or provide incentives to a provider in an attempt to induce them to furnish care that is not consistent with these rules.
  • These rules do not mandate hospital stay benefits on a plan that does not provide that coverage.

The group plan is not prohibited from imposing deductibles, coinsurance, or other cost-sharing related to the benefits.

Children’s Health Insurance Program

This is an insurance program that provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid but not enough to buy private insurance. In some states, CHIP covers pregnant women.

Florida KidCare is the State of Florida’s children’s health insurance program for uninsured children who meet income and eligibility requirements. The 1998 Legislature created Florida KidCare in response to the passage of Title XXI of the Social Security Act in 1997. Florida KidCare provides health insurance to children in families with incomes up to 200 percent of the federal poverty level. Three state agencies and the Florida Healthy Kids Corporation, a non-profit organization, form the Florida KidCare partnership. MediKids, Florida Healthy Kids and Title XXI Children’s Medical Services Managed Care Plan compose the Title XXI Children’s Health Insurance Program (CHIP). CHIP is not an entitlement program and the families pay a monthly family premium of $15 or $20 depending on the family’s income. Florida KidCare also includes Medicaid for children.

Visit www.floridakidcare.org or call 1-888-540-5437 for more information.

Notice of Privacy Practice

The Notice of Privacy Practices (NPP) describes how medical information about you may be used and disclosed and how you can access this information. The NPP is available online at FHCP.com or you can request a hard copy by contacting FHCP Member Services