Benefits: Overview of Florida Health Care Plan

Florida Health Care Plan (FHCP) is a community-owned Health Maintenance Organization (HMO) serving 50,000 plus members in over 300 companies in Volusia, Seminole, and Flagler counties. FHCP, a federally qualified HMO, has been awarded Accreditation with a Commendation by the Joint Commission on Accreditation of Health Care Organizations.

Add up the advantages of FHCP Membership:

• NO pre-existing conditions clauses
• NO deductibles
• NO claim forms

This Overview webpage provides brief definitions of terms and coverage for the Florida Health Care Plan. Please note that this overview is a summary, NOT a plan document.
   

• Alcohol & Drug Abuse Treatment
• Ambulance
• Annual Screening
• Dental Examinations
• Emergency Room at Contract Facilities
• Emergency Room at Non-Contract Facilities
• Inpatient Hospital Benefits
• Mental Health
• Occupational Therapy
• Out-of-Pocket Expense Limit

• Physical Therapy
• Prescription Drugs
• Primary Care Physician
• Specialist
• Speech Therapy
• Urgent Care Centers
• Vision Care
• Well Baby Care & Child Health Supervision
• Well Woman's Assessment

Primary Care Physician

$10.00 co-payment. Choose from our growing list of Primary Care Physicians. The FHCP website offers a list of health care providers, facilities, and more.

Annual Adult Physical Health Screening

$10.00 co-payment.

Annual Out-of-Pocket Expense Limit

$1,500 / Individual and $3,000 / Family

Well Woman's Assessment

• When performed by your Primary Care Physician, $10.00 co-payment.
• When performed by a specialist, $20.00 co-payment.

Specialist

$20.00 co-payment per office visit. 

Vision Care

• Co-payment of $10.00/exam for eyeglasses.
• Co-payment of $50.00/exam for contact lenses.
• Co-payment of $10/exam for eye disease, visual disturbances, etc.  

Dental Examinations

• Co-payment of $10.00/exam.
• One routine preventative examination every six months to include a dental cleaning and X-rays.

Mental Health Outpatient Visits

Co-payment of $20.00.

Alcohol and Drug Abuse Treatment (Outpatient)

• $15.00 co-payment.
• Limited to 44 visits per year with a maximum allowance of $35.00 per visit.
• Combined lifetime maximum benefit of $2,000 for inpatient and outpatient care.

Outpatient Physical Therapy, Speech Therapy, Occupational Therapy

$15.00 co-payment.

Prescription Drugs

• FHCP In-House Pharmacies
  • $10.00 for up to a 31-day supply of generic medications
  • $30.00 for up to a 31-day supply of brand name medications
  • Prescriptions may be filled at the FHCP pharmacies located in our Daytona Beach, Holly Hill, Orange City, New Smyrna Beach, DeLand, Port Orange and Palm Coast facilities.
• FHCP Mail-Order Program
  • $9.00 for up to a 31-day supply of generic medications
  • $29.00 for up to a 31-day supply of brand name medications
• Select Walgreens Pharmacies (under contract with FHCP)
  • Prescriptions may only be filled at participating Walgreen pharmacies.
  • $15.00 for up to a 31-day supply of generic medications
  • $35.00 for up to a 31-day supply of brand name medications

Inpatient Hospital Benefits

$200 per Admission for inpatient hospital care for illness, injury or maternity, semi-private room and misc. hospital services, intensive care unit or similar unit, pre-admission testing.

Emergency Room at Contract Facilities

$60.00 co-payment. The FHCP website provides a list of contract facilities.

Emergency Room at Non-Contract Facilities

$75.00 co-payment.

Ambulance

$25.00 co-payment

Well Baby Care and Child Health Supervision Visits

$25.00 co-payment. 

Urgent Care Centers

$25.00 co-payment.