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Medicaid Family Planning Waiver Program

The family planning waiver program covers family planning services to eligible women, ages 14 through 55. Services are provided up to 24 months. Eligibility is limited to women with family incomes at or below 191 percent of the Federal Poverty Level who have lost or are losing Florida Medicaid State Plan eligibility and are not otherwise eligible for Medicaid, Children’s Health Insurance Program, or health insurance coverage that provides family planning services.

Recipients losing SOBRA (pregnancy Medicaid) eligibility will have passive enrollment during the first 12 months of losing Medicaid. Non-SOBRA women will have to actively apply for the first year of benefits at their local county health department. All women enrolled in the family planning waiver will have active re-determination of eligibility through their local county health department after 12 months of family planning waiver eligibility. In order to receive the second year of benefits, recipients must reapply at their local county health department.

Legal Authority:  Section 381.0051, Florida Statutes, (F.S.)
Contraceptive information and services may be rendered to minors by practitioners licensed to practice medicine under the provisions of Section 458 or 459, Florida Statutes, (F.S.) as well as by the Department of Health through its family planning waiver program, provided the minor:

  •  Is married
  •  Is a parent
  •  Is pregnant
  •  Has the consent of a parent or legal guardian or
  •  May, in the opinion of the physician, suffer probable health hazards if such services are not provided.

The family planning waiver program covers the following services:

  • Family planning initial or annual examinations;
  • Family planning counseling visits;
  • Family planning supply visits;
  • Various methods of birth control;
  • Family planning laboratory tests;
  • Family planning related pharmaceuticals;
  • Evaluation and management visits for sexually transmitted disease (STD)treatment and follow-up;
  • Approved sterilization; and
  • Colposcopies.

The family planning waiver program does not cover the following services:

  • Emergency room visits;
  • Inpatient services; and
  • Any other non-family planning related services or family planning services not listed on family planning waiver reimbursable services.

For additional information, please call 1-877-254-1055 (8:00 a.m. ET - 5:00 p.m. ET).

Five-Year Extension Request (1/1/18 – 12/31/2022): Florida Medicaid’s 1115 Family Planning Waiver (Project Number 11-W-00135/4), Public Notice Document

Approval Documents

Evaluation

Archived Documents

Applications

Provider Notice

Reimbursable Services