Your plan may only provide benefits if you obtain a referral from your General Dentist prior to receiving treatment from a Specialist. Please refer to your Evidence of Coverage prior to contacting a Specialist if you are unsure, or call Member Services
By clicking “Submit”, I affirm that I am a Florida Medicaid enrollee.
I acknowledge that use of this form by anyone other than the enrollee named above is considered potentially fraudulent and may be subject to corrective action by the Plan.
Please only click Submit once