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What’s New For Sunshine Health Members in 2025

Date: 01/17/25

Sunshine Health is proud to launch new names for our existing health plan products, a new health plan for members diagnosed with HIV/AIDS, and new and improved benefits for your patients, our members. These changes take effect on February 1, 2025.

Here’s what you need to know about the coming changes:

New Health Plan Names

  • Sunshine Health Pathway to Shine: This is the new name for our Child Welfare Specialty Plan (CWSP) product. This health plan will continue to serve the physical and behavioral healthcare needs of children in or adopted from Florida’s child welfare system.
  • Sunshine Health Mindful Pathways: This is the new name for our Serious Mental Illness (SMI) product. This health plan will continue to serve the behavioral health needs of our members by providing coordinated behavioral, medical and pharmacy services.

A New Health Plan

Sunshine Health Power to Thrive: This new health plan will serve persons diagnosed and living with HIV/AIDS. Our Care Management team will focus on the entire continuum of care for persons with HIV, from accelerating access to treatment and antiretroviral medicine to engaging with members to preserve quality of life.

Improved Member Benefits

Starting February 1, 2025, members will have access to these enhanced benefits:

  • My Health Pays® Member Rewards Program: Members can earn even more dollar rewards for healthy behaviors, such as $30 every calendar year when they take their child to a well child visit (ages up to 21 years).
  • Transportation: Alivi will provide transportation services for Medicaid, Child Welfare and SMI members, starting January 1, 2025. Starting February 1, 2025, members will also be able to take three trips per month for non-medical purposes, such as going to work, a social event or grocery shopping.
  • Sunshine Health Works: Our Sunshine Health Works program can help members find career training and certification opportunities.
  • Over-the-Counter (OTC) Benefit: This will rise to $50 a month. Members can use this increased benefit on everyday items such as baby wipes, pain relief medicine, laundry detergent, soap, toothbrushes and more.
  • Sunshine Health’s Pathways to Purpose Program: This connects seniors and caregivers with community resources. It also matches members and caregivers with volunteer opportunities. And this includes three round-trip rides to pathways programs.

New Member Benefits

Starting February 1, 2025, members will have access to these new benefits and more:

  • Camp Scholarship: $150 voucher for children to attend camp.
  • Care Grant*: $150 for tutoring, gym memberships, swimming lessons, art supplies and more.
  • Caregiver Swim Lessons: Vouchers/reimbursements for caregivers to take group swim lessons.
  • Childcare: Childcare vouchers for parents who qualify via a Pathways to Prosperity screening.
  • Dental Kit: One dental hygiene kit per year for pregnant members.
  • Educational Vouchers: $150 voucher after completing Sunshine Health Works Launchpad Educational Modules.
  • Foster Care Comfort Kitst: A sturdy backpack or duffle bag filled with items to make entering a foster home easier, such as a blanket, journal and pen and/or earbuds.    
  • Grocery Benefit: $50 food gift card per household per year for members who identify as food insecure on Pathways to Prosperity screening.
  • Home Delivered Meals for Pregnant Members*: 266 meals for members who are at least 20 weeks pregnant with qualifying medical condition.
  • Housing Assistancet: A maximum of $250 per community-based enrollee per year to assist with housing related expenses (rent, utilities, etc.).
  • Joy for All Battery Operated Plus Companion PetA: Designed to bring comfort, companionship and fun to individuals experiencing social isolation or loneliness.
  • Palliative Care*: Up to 20 days per year of palliative care for members with chronic illness.
  • Respite Care*: Up to 200 hours of in-home care and up to 10 days of out-of-home care for members with special healthcare needs.
  • Sensory KitA: Choose from swinging/sensory swings; exercise balls for bouncing or rocking; weighted vests or blankets; warm compresses; manipulative toys; headphones; and/or ear plugs.
  • Tattoo Removal: Vouchers for up to $500 to remove tattoos for members who complete the Sunshine Health Works Launchpad Education modules.
  • Vital Records Support: $50 reimbursement to help members obtain driver’s license, birth certificate, etc.
  • Welcome Baby! Bundle: Gift package for pregnant members.
  • Welcome Home BasketC: A gift basket with up to $50 worth of items to help members get started in their new home.
  • YMCA Membership: Access to YMCA facilities for individuals/family of four.

*Prior authorization required.
tSunshine Health Pathway to Shine members only.
ASunshine Health Pathway to Shine and Long Term Care members only
CLong Term Care members only

Questions?

If you have any questions, please call Sunshine Health Provider Services at 1-844-477-8313 or visit the Secure Provider Portal. Our Provider Engagement staff can also answer questions. Visit the Find Your Account Manager tool to find who supports your specialty and region. Keep up with the latest Sunshine Health provider updates by reviewing and bookmarking Provider News.

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