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Staywell Health Plan is Joining Sunshine Health!

We have good news. Your Serious Mental Illness Medicaid specialty plan, Staywell Health Plan, is joining Sunshine Health!

You get to keep the same great benefits you enjoy now. In most cases, your care manager, your doctors and the prescriptions you get will stay the same. Plus, our provider network is growing to give you even more choices.

On October 1, 2021, our Staywell name will go away and you will become a Sunshine Health member. In the weeks before October 1, 2021, you will receive two mailings. You will get a welcome letter from Sunshine Health, followed by a new Member ID card.

You do not need to do anything to start enjoying the benefits of becoming a Sunshine Health member.

What is changing on October 1, 2021

New Member Rewards Program: You will be automatically eligible for Sunshine Health's member rewards program that pays you for certain healthy behaviors. It's called My Health Pays®. For example, earn $20 just by attending an outpatient follow up visit with a behavioral health provider within seven days of discharge from an inpatient facility. See the full list of rewards.

New Easy Order OTC: It's easy to use your $35 per month per household (OTC) benefit. Download the Envolve OTC mobile app. Browse and select products to be shipped to your home, all from your phone. Learn more about the OTC benefit.

New Specialty Pharmacy Provider: AcariaHealth provides Sunshine Health's specialty medications. If you need these, you may be able to have medicines shipped to your home. Learn more about the pharmacy benefit.

New Vision Provider: Your vision benefits have not changed, but your new vision provider will be Envolve Vision. Their customer service number is 1-833-705-1354 (TTY 1-800-955-8770). Please see the "Continuity of Care" section for more information.

New Therapy Provider: Your therapy benefits have not changed, but your new therapy benefit administrator will be Health Network One. To confirm if your current therapy provider is a participating provider or if you have any questions regarding therapy services, please contact Member Services at 1-866-796-0530 (TTY 1-800-955-8770). Please see the "Continuity of Care" section for more information.

Continuity of Care

During this change period, please keep all scheduled doctor appointments. If you have a care manager, continue working with them. Staywell will keep providing your healthcare coverage until you join Sunshine Health on October 1, 2021. You can keep getting services that Staywell or your doctor already approved for up to 120 days. Sunshine Health will pay for these approved services. You can keep going to the same provider for up to 120 days, even if the provider is not in the Sunshine Health network. This 120-day period is called the Continuity of Care Period. After 120 days, you will need to get services through a Sunshine Health network provider. Please be aware, most Staywell providers are in the Sunshine Health provider network.

Quality Healthcare

Learn about Sunshine Health's Quality Program. Get details on your rights as our health plan member. Learn about filling prescriptions, knowing if a service is covered/denied, appeals, grievances, complaints, new services and more.

Will I lose benefits when I become a Sunshine Health member?

No. You will keep all the benefits you currently have as a Staywell Health Plan member, plus get more benefits offered by Sunshine Health. These new benefits are designed with your health in mind and include:

  • New Member Rewards Program: You will be automatically eligible for Sunshine Health's member rewards program that pays you for certain healthy behaviors. It's called My Health Pays®. For example, earn $20 just by attending an outpatient follow up visit with a behavioral health provider within seven days of discharge from an inpatient facility.
  • New Easy Order OTC: It'ss easy to use your $35 per month per household (OTC) benefit. Download the Envolve OTC mobile app. Browse and select products to be shipped to your home, all from your phone.
  • New Specialty Pharmacy Provider: AcariaHealth provides Sunshine Health's specialty medications. If you need these, you may be able to have medicines shipped to your home.
  • New Vision Provider: Your vision benefits have not changed, but your new vision provider will be Envolve Vision. Their customer service number is 1-833-705-1354 (TTY 1-800-955-8770). Please see the "Continuity of Care" section for more information.
  • New Therapy Provider: Your therapy benefits have not changed, but your new therapy benefit administrator will be Health Network One. To confirm if your current therapy provider is a participating provider or if you have any questions regarding therapy services, please contact Member Services at 1-866-796-0530 (TTY 1-800-955-8770). Please see the "Continuity of Care" section for more information.

When will I become a Sunshine Health member?

You will become a Sunshine Health member on October 1, 2021.

What do I have to do to become a Sunshine Health member?

You do not need to do anything to start enjoying the new benefits of becoming a Sunshine Health member. You will automatically become a Sunshine Health member on October 1, 2021.

Can I still fill my medicines at my current pharmacy?

Yes. You can keep getting medicines that Staywell or your doctor already approved for up to 120 days. During this time, Sunshine Health will pay for these approved medicines. Most Staywell pharmacies are in the Sunshine Health network. If your pharmacy is not in network, you can keep going to the same pharmacy for 120 days after October 1, 2021. This is called the Continuity of Care Period. After 120 days, you will need to get your medicines at a Sunshine Health network pharmacy.

Will my doctors change?

In most cases, your doctors will stay the same. Plus, our provider network is growing to give you even more choices. Most Staywell providers are in the Sunshine Health provider network. If your doctor is not in network, you can continue to see your doctor for up to 120 days after October 1, 2021. This is called the Continuity of Care Period. After 120 days, you will need to find providers in the Sunshine Health network.

Can I still receive my current treatment/services from my current doctor?

Yes. You can keep getting services that Staywell or your doctor already approved. Sunshine Health will pay for these approved services. In addition, you can keep going to your same provider for up to 120 days, even if the provider is not in the Sunshine Health network. This 120-day period is called the Continuity of Care Period. After 120 days, you will need to get services through a Sunshine Health network provider. Please be aware, most Staywell providers are in the Sunshine Health provider network.

Will my Care Manager stay the same?

Yes. Your Care Manager will not change.

Who can I call with questions?

Before October 1, 2021, call Staywell Member Services: 1-866-334-7927 (TTY 711) Monday-Friday, 8 a.m. to 7 p.m.

After October 1, 2021, call Sunshine Health Member Services: 1-866-796-0530 (TTY 1-800-955-8770) Monday-Friday, 8 a.m. to 8 p.m.

Do I need to keep my Staywell member ID card?

Yes. Keep your Staywell member ID card until October 1, 2021. We will mail you a new Sunshine Health ID card.

When will I get my new Sunshine Health ID Card?

You will get a new Sunshine Health ID card in the mail in mid to late September 2021.

Where can I get more details about my Medicaid benefits?

You will get a welcome letter in the mail in mid to late September 2021. The letter will have more details about your benefits and services.

Will there be any change in how you protect my privacy?

No. Your privacy is important to us. You have rights when it comes to protecting your health information, such as your name, plan identification number, race, ethnicity and other things that identify you. We will not share any health information about you that is not allowed by law. Learn more about our Privacy Policy.

You will not need to do anything to start enjoying the new benefits of becoming a Sunshine Heath member.

 

We're excited to welcome you to Sunshine Health! We look forward to helping you get and stay healthy.

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Y0070_WCM_42183E Last Updated On: 1/1/2020
WellCare will be performing maintenance on Saturday, October 16, 2021 at 6pm EST until Sunday, October 17, 2021 at 6am EST. You might not be able to access systems or fax during this time. We are sorry for any issues this may cause. Thank you for your patience. If you need assistance, contact us. ×