Florida Medicaid and EBA Benefits

By 2005, Medicaid spending accounted for almost one-fourth of Florida's state budget and was on track to be one-third of the budget by 2010 and more than three-fourths by 2025. In 2006, Florida passed a Medicaid reform bill to contain costs. The bill included an innovative, five-year experimental program that rolled out in Duvall and Broward counties in the fall of that year.

Enhanced Benefits Accounts (EBAs)

• One of the goals of the program is to increase patient participation in maintaining their own health. Enhanced Benefits Accounts (EBAs) were established to reward eligible recipients for responsible behavior. Everyone has an an account and can accumulate up to $125 in credits annually. The credits are used to purchase health-related items not normally covered under Medicaid. Even if someone drops out of Medicaid, the fund remains available for up to three years or until the person's income exceeds 200 percent of the federal poverty level, whichever comes first.

Qualified EBA Activities

• Florida compiles the list of behaviors and activities qualifying for credits. Lifestyle changes such as quitting smoking, achieving and maintaining a healthy weight, and proper diabetes management earn credits. Voluntary participation in drug and alcohol rehab programs also earn credits, as does responsible health maintenance behavior. Those behaviors include getting annual preventive screenings and dental and eye exams. Parents earn credits for keeping their children current with vaccinations and wellness physician visits.

Eligible Participants

• People living in Baker, Broward, Clay, Duvall and Nassau counties who are eligible for Medicaid can earn EBA credits. Two organizations determine eligibility for Florida Medicaid, the Social Security Administration---on behalf of SSI recipients---and the Florida Department of Children and Families. Individuals and families with low incomes and limited resources who meet proscribed criteria are eligible, as are children and pregnant women. Social security beneficiaries over the age of 65 who receive SSI are eligible for Medicaid assistance to pay for Medicare Part B and for prescription coverage. Certain disabled people who do not receive SSI can qualify for Medicaid. Benefits can also be extended to non-citizens requiring emergency medical treatment.

Eligible EBA Items

• EBA credits are most often used for babies and toddlers.

  Florida publishes a list of more than 31,000 health-related products that can be purchased with EBA credits. Qualifying over-the-counter medications include aspirin, cold tablets and arthritis heat wraps. Non-medicinal items such as herbal remedies and vitamin are also acceptable, as are personal hygiene items and baby care products. Of the 25 most popular items purchased with EBA credits, 14 were for babies and toddlers. Disposable diapers were the number one item.

EBA Expansion

• There is great debate throughout the state as to the success of the program. It is difficult to analyze results because of the huge impact the recession which bean in 2008 has had on the state's economy. The Florida legislature requested a three-year extension from the Centers for Medicare and Medicaid, which approved the initial program. If granted, the program expands into additional counties and runs through 2014.