Welcome to Children's Medical Services Health Plan (Medicaid)
Children’s Medical Services (CMS) Health Plan, operated by Sunshine Health, provides managed care services on behalf of the Florida Department of Health. Sunshine Health is a licensed Florida health plan.
Eligibility
The CMS Health Plan is for children who:
- Are under age 21 and eligible for Medicaid and
- Have special healthcare needs that require extensive preventive and ongoing care
The need for preventive and ongoing care could mean working with several different providers at once. It might also mean working with state agencies or finding local community resources. We’re here to help. Our goal is to coordinate healthcare that improves the lives of our members and families.
Note: There are two versions of the CMS Health Plan. The benefits and services offered are different.
- Members who qualified for CMS Health Plan through Florida Medicaid are enrolled in the Title 19 plan. If you do not pay a monthly premium for your child’s health insurance, then your child is enrolled in this plan and the information on this page applies.
- Members who qualified for CMS Health Plan through Florida KidCare are enrolled in the Title 21 plan. If you pay a monthly premium for your child’s health insurance, then your child is enrolled in this plan and not all the information on this page applies. See the KidCare homepage for more information.
Getting Started
Every CMS Health Plan member gets a dedicated Care Manager who helps manage their care. It’s important that you get to know your child’s Care Manager so they can make sure your family gets the support it needs. Your child’s Care Manager will contact you to set up a time to come to your home to meet you and your child.
If you need help getting in touch with Care Management, call Member Services at 1-866-799-5321 (TTY 1-800-955-8770) Monday through Friday 8 a.m. to 8 p.m. Eastern.
Important Links to Helpful Information
- Member Login: Create and log in to your child’s secure member account
- Member Handbook (PDF): Covered services, benefits and wellness programs
- Benefits Summary: Benefits available to your child
- Dental Care: Services available to your child
- Pharmacy: Covered medications, over-the-counter benefits and preferred drugs
- OTC Benefit: View the full catalog of covered items and instructions on how to order
- Member Resources: Forms, helpful links and more
- Member Rewards: Get rewarded for healthy behaviors
- Emergency Resource Guide: Build a kit, make a plan, register for a shelter
- Diagnosis Guides: Learn more about your child’s diagnosis
- School Resources: Checklists, special education guides and more
- Find-A-Provider Tool: Search for doctors, hospitals and pharmacies near you
- Partners in Care: Together for Kids (PIC:TFK): Florida’s pediatric palliative care program
Care Management Services
Your child’s Care Manager is your #1 resource. They will guide you through the healthcare system and work with your child’s providers to identify their needs.
Care Managers can also:
- Schedule doctor visits, medical tests and procedures
- Help you find specialists
- Suggest behavioral and developmental services
- Explain benefits and services
- Connect your family to support services
Questions?
Our Member Services team can help you get answers. Please call if you have questions about your plan. You can call 1-866-799-5321 (TTY 1-800-955-8770) Monday through Friday, 8 a.m. to 8 p.m. Eastern. Visit one of our Community Connections Center locations to get help in person.