Medicaid Coverage Throughout the Florida Panhandle

Marcos Otero Posted: April 9, 2019

Lighthouse Health Plan Provides Medicaid Coverage Throughout the Florida Panhandle

Source:  Annie Marks Weidlein, Health Plan Marketing Manager

On February 1, 2019,Lighthouse Health Plan announced its launch as a doctor-led Medicaid health plan based in the Florida Panhandle. By linking providers with the new Lighthouse Health Plan, we create a new, local way of thinking about health care and the role of health plans in our communities.

Headquartered in Pensacola, Fla., Lighthouse Health Plan is a community-based Medicaid insurance plan created and run by doctors. On February 1 2019, Lighthouse officially began providing Medicaid coverage to approximately 24,000 beneficiaries in Medicaid Regions 1 and 2.

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Approximately 200,000 people in the Florida Panhandle qualify for Medicaid. Of those, 70 percent are at-risk children, many of whom face food and housing insecurities and social and economic disadvantages, creating challenges to receiving basic health care. 

“Medicaid patients in Northwest Florida have the highest number of preventable emergency room visits in the state; the highest rate of premature births; and high rates of smoking, obesity and substance use disorders. I think this needs to change,” said Christie Spencer, CEO, Lighthouse Health Plan. 

“By working directly with doctors, Lighthouse does not have to navigate all the things traditional insurance companies do,” Spencer furthered. “We can convene the right set of health care and community resources to make sure patients receive the care they need.”

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Lighthouse is partnering with a broad network of doctors, hospitals and other providers to serve members. Thousands of providers have already joined the Lighthouse network. These organizations are coming together because of the need for a more coordinated, lower cost care for Medicaid beneficiaries that are locally based.

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“I put a high value on a community-based health plan model,” said Dan Sontheimer, Chief Medical Officer for Lighthouse Health Plan. “That’s why I have chosen to join Lighthouse with a doctor-led approach that offers new resources and higher levels of local support than traditional health plans, allowing doctors to do what they do best, providing patients with high quality care.”

About Lighthouse Health Plan:  Lighthouse Health Plan is a local, community-based health plan created and run by doctors. Lighthouse will serve Escambia, Okaloosa, Santa Rosa and Walton counties in Medicaid Region 1 of Florida; and Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Wakulla, and Washington counties in Medicaid Region 2 as a Provider Service Network (PSN).

The PSN plan was created by Florida state legislature in 1997 when the Legislature authorized the Florida Medicaid program to establish a Medicaid PSN demonstration project to capitalize on high-volume Medicaid providers and their ability to manage the medical care of Medicaid beneficiaries they serve. “Provider Service Network” means an entity qualified pursuant to s.409.912(2) of which a controlling interest is owned by a health care provider, or group of affiliated providers, or a public agency or entity that delivers health services. Health care providers include Florida-licensed health care professionals or licensed health care facilities, federally qualified health care centers, and home health care agencies.

For more information about Lighthouse Health Plan, please call 1-844-243-5176 or visit lighthousehealthplan.com.

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