MomCare

MomCare is a special health insurance program for low-income women. The goal is to improve birth outcomes and reduce infant mortality rates through a simplified application, guidance, education and care coordination services.  MomCare is sponsored by the Florida Department of Health and the Agency for Health Care Administration and is managed locally by the Healthy Start Coalition of Sarasota County.

MomCare provides women seeking coverage for their pregnancy a simplified application process which includes a one-page application and notification of eligibility within 10 business days.  Once accepted into the program clients will receive guidance selecting a prenatal care provider, assistance scheduling initial prenatal visits, and information about state programs for which they may be eligible.

• Information for Pregnant Women
• Information for Physicians
• Information for Social Workers

Information for Pregnant Women

If you are pregnant, you may qualify for this special health insurance program.  To see if you are eligible, review the income guidelines below.  You can apply for this program if your family meets these guidelines, even if you or other family members are working.

Once you are enrolled, the program will cover medical care and hospitalization during your pregnancy.  It may also cover health care bills you received up to three months before your enrollment.  There is no cost for this coverage.  Your baby may also be eligible for free insurance after he or she is born.

Is There a Fee for MomCare?

MomCare services are funded by Medicaid and are free of charge to all eligible participants.

Where Do I Apply?

How Do I Apply?

MomCare is available to women who meet the following requirements:

• Have proof of a positive pregnancy test on a physicians or pregnancy centers letterhead that states expected delivery date.
• Have a maximum household income at or below 185% of the poverty level. See Income Chart below.
• Be a United States citizen or a legal alien.
• Be a Florida resident.

Filling out the Application

• Fill out applicant information in full. Answer questions 1-10 completely. Do not omit any information or skip any questions or approval of the application will be delayed or denied.
• Don't forget to sign the form!
• Attach your positive pregnancy test results received from a health professional's office (results must be on letterhead) to the application.
• Affix postage and mail the application or fax to the Department of Children and Families address for the your home zip code. If you don't know the address, contact us.

Additional Considerations

Avoid being denied! It is vital that all areas are filled in completely and the necessary documentation is attached. If information is misrepresented, vague, or missing, benefits can be denied.

• Telephone: Please list a phone number and any alternate phone numbers where you can be reached.
• Other Income to Report: Social Security Numbers of the Pregnant Woman, the husband or the father of the baby, when he lives in the home with the pregnant woman; any Social Security or Child Support Income received for the pregnant woman's other children in the home.
• Pregnant Woman Under Age 21: If the pregnant woman resides with her parent(s), list the names of the parent(s.)
• Question #2: If you already have Medicaid, stop. You are already covered and do not need to submit the form.
• Question #5: is very important! List all people living in the household, related or unrelated, regardless of age or affiliation.
• Question #8: it is vital to list all sources of income for everyone in the home.

MomCare Income Chart

You are eligible if you make less money than indicated here.

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Information for Physicians

What is MomCare?

MomCare began in October 2001 in the State of Florida. It provides women seeking Medicaid, due to pregnancy, a simplified Medicaid application process which includes a one-page application and a faster notification of eligibility. Once accepted into the program, clients will receive guidance selecting a prenatal care provider, assistance scheduling initial prenatal visits, and information about state programs for which they may be eligible.

What Does this Mean for Physicians?

MomCare eligible women will now have access to health insurance, through Medicaid, within days not months. This means earlier entry into care and less 2nd and 3rd trimester physician changes.

Does MomCare pay the same fees as Medicaid?

Yes! MomCare patients are Medicaid patients so your practice will receive the same Medicaid fees. A MomCare patient is exactly the same as a regular Medicaid patient as it relates to Medicaid. However, these clients receive extended services with a Maternity Care Advisor who provides case management throughout their pregnancy.

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Information for Social Workers

How Does MomCare Work?

1. MomCare candidate fills out a one-page eligibility form, available to any woman with a positive pregnancy test from a health care provider. The application is mailed to the address on the front of the application.
2. Department of Children and Families enters client information and determines if client is eligible.
3. If eligible, Counselor sends letter and brochure to client with Coalition name and number. Information will be sent within 3-days of receipt of data.
4. Healthy Start Coalition registers and enrolls MomCare client. Maternity Care Advisor Counseling services begin within 5 working days of receipt of data.
5. Maternity Care Advisor Counseling services:
   • Explain program to client, answer questions, register grievances
   • Assist in choice of prenatal provider
   • Register provider choice
   • Assign provider if not chosen in 30 days
   • Facilitate 1st prenatal care appointment
   • Arrange or provide Healthy Start Screen
   • Ensure WIC
6.  

What Does MomCare Provide?

• Medicaid: MomCare allows for a simplified Medicaid application process. Applicants complete a 1-page Medicaid application. Proof of a positive pregnancy test on a health care providers letterhead must be attached and it is then mailed to the address indicated on the application. The application will be processed within 5 business days. If information is missing, vague or misrepresented on the form benefits can be delayed or denied.
• Counseling Services: The Maternity Care Advisor assists the client in selecting a prenatal provider, manages all changes and resolves conflicts. If the client does not select a provider within 30 days one will be selected for them. Physicians who are currently Medicaid providers are registered on the MomCare provider list. The list of current providers is supplied by the State of FloridaÕs Agency for Health Care Administration (AHCA).
• Case Management: The Maternity Care Advisor facilitates the clients prenatal care by assisting with appointment scheduling, appointment monitoring, and assistance accessing Healthy Start and other community resources.

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