Services And Benefits Summary
1 THESE SPECIALTIES REQUIRE A DOCTOR'S REFERRAL AND THE APPOINTMENT MUST BE DONE THROUGH A FHS REPRESENTATIVE
Featured Services
Florida Health Solution believes in Preventive Medicine., Our Prepaid Health Clinic Plan works fundamentally based on preventive medicine and we offer to our members some different benefits called Panels, provided through our fully credentialed participating network providers. It is advisable to review periodically some vital aspects to keep us informed of the condition of your health. We offer our members a group of periodic examinations.
Panel A:
After a one (1) month waiting period commencing from the member’s coverage effective date, a member is eligible for one preventive care check-up per contract year. The physical examination must be performed by a participating provider physician, general practitioner or pediatrician.
PREVENTIVE PANELS B,C,D, AND F:
After a three (3) month waiting period commencing from the member’s coverage effective date, a member is eligible to have one of Panels B - F every 3 months per contract year. Panels A-F cannot be repeated and/or accumulated during each contract year. The procedure must be performed in a participating provider physician/specialist’s based upon age specifications.
PANEL H:
After a one (1) month waiting period commencing from the member’s coverage effective date, a member is eligible to have during an office visit either singular or multi lab tests (Panel H) performed 3 times per contract year. The first and second office visits whereby Panel H tests are performed are covered after the one month waiting period. The third office visits whereby Panel H tests are performed are covered only if the lab tests are performed more than three months after the second office visit. The tests must be medically necessary and be performed in the participating provider primary care physician or general practitioner’s office. Panel H Lab tests can be combined with procedures from Preventive Panel female B and F, excluding other Panels.
PANEL J:
After a one (1) month waiting period commencing from the member’s coverage effective date, a member is eligible to have procedures described in Panel J once per contract year. The procedure must be performed by a participating provider dental office.
PANEL I:
After a one (1) month waiting period commencing from the member’s coverage effective date, a member is eligible to have procedures described in Panel I performed. This panel has a $200.00 credit every contract year. This credit accumulates every contract year. If the full $200.00 credit is not used during a contract year, the balance of the credit rolls over and is added to the next contract year’s $200 credit amount. The procedure(s) must be performed in a participating provider physician/specialist’s office or plan diagnostic center upon referral from a participating provider physician and subject to a previous appointment request, with the exception of child immunizations and flu shots. Must be medically necessary.
Panel A: All Ages
- Annual Check up
- Office Visit $20 Co-pay
- Blood Test (CBC, Comprehensive Metabolic Panel, Lipid Panel, Urinalysis)
Panel B: Older than 35
Woman
- Office Visit
- Mammogram (screening, digital)
- PAP Smear
Men
- Office Visit
- Prostate Test
- Coronary Risk Test
Panel C: Older than 40
- Office Visit
- Electrocardiogram Cholesterol and Triglycerides
- Chest X Ray (Smokers)
Panel D: Older than 50
- Office Visit
- Occult Blood
- Fecal Immunochemical Test (FIT)
Panel F: Woman Between 21 and 34
- Office Visit
- PAP Smear
Our Plan includes Programmed Surgeries
What we offer
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Providers
Provider Directory. Select the center that best suits your needs, having in mind the location and business hours.
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Pharmacy
Pharmacy benefits with up to 65% discount on generic medications and up to 13% on brand-name medications.