Healthy Behaviors Programs
AmeriHealth Caritas Florida offers Healthy Behaviors programs whereby members are eligible to earn rewards for completing certain health milestones.
All of the Healthy Behaviors programs require members to fill out a completion form (PDF) and return it to AmeriHealth Caritas Florida before joining. The form should be filled out entirely and returned to the AmeriHealth Caritas Florida Quality Department at 1-855-358-5854, or mailed to:
AmeriHealth Caritas Florida
P.O. Box 7181
London, KY 40742
For the three programs listed below, members who are interested must see their primary care providers (PCPs), must qualify to participate in the program they are interested in, and must agree to participate in AmeriHealth Caritas Florida’s Care Management program before joining and committing to the program.
A designated Care Coordinator or Care Manager will reach out to each member to discuss the selected programs in more detail once AmeriHealth Caritas Florida receives the completed form. The designated Care Coordinator or Care Manager will contact the PCP’s office to confirm the member has received services required for receipt of the reward. Once the services have been verified, a gift card will be mailed to the member (or to the minor member’s parents or guardians). If the services cannot be verified, the member must provide documentation that the services were received.
These three programs don't expire or have a form deadline.
Members may participate in more than one program if they qualify.
- Weight loss (provider signature required on form).
- Smoking cessation.
- Alcohol and substance use recovery.
The following programs require members to fill out and return a completion form (PDF).
These programs have a completion form (PDF) return deadline of January 31, 2022. The last day for completing services is December 31, 2021, which is also when these programs expire.
- Maternity.
- Postpartum.
- Well-child visits (31 days to 15 months old).
- Well-child visits (15 months old to 30 months old).
- Child and adolescent well-care visits.
- Adult access to preventive or ambulatory services.
- Lead screening.
- Diabetes testing.
- Diabetes eye exam.
- Behavioral health follow-up.
- Breast cancer screening.
- Cervical cancer screening.
After the member has completed the required number of visits for one or more programs, you can fax completion forms (PDF) to the Quality Department at 1-855-358-5854, or the member may mail the signed form in the prepaid envelope provided to the AmeriHealth Caritas Florida address listed above. The completion form (PDF) may be used for participation in multiple programs as well.
Once the form is returned to AmeriHealth Caritas Florida and once the services have been verified, a gift card will be mailed to the member (or to the minor member’s parents or guardians). If claims for services cannot be verified, the member will be responsible for providing proof of service. Members may enroll in more than one Healthy Behaviors program (if they qualify), and can receive a reward of up to $50 per program, per year. Members may only join each Healthy Behaviors program once per year.
Program details
The Commit to Be Fit program provides members with weight loss resources and support, as well as rewards for dietary and nutritional counseling, behavioral therapy, and physical activity.
BMI screenings will be conducted by the PCP at each visit to document improvement. Members can be referred to a participating dietitian or nutritionist and will earn a gift card for attending this appointment as well.
The AmeriHealth Caritas Florida Care Management team will follow the member's progress by communicating with the member’s PCP. The overall goal is for members to reduce their BMI and decrease their risk of comorbidities.
This program will provide members with resources for smoking cessation. A designated Care Coordinator or Care Managers will help members sign up for the Tools to Quit and Quit Smoking Now programs. A provider may also prescribe smoking cessation medication. Members will be coached by their designated Care Coordinator or Care Managers on following through with health goals and taught how to earn rewards for completing certain activities, such as attending a smoking cessation seminar and submitting a certificate of completion to AmeriHealth Caritas Florida.
Please refer to the tobacco quick reference guide (PDF) for more information on smoking cessation.
This program will provide members with resources for alcohol and substance use recovery services. Members will be referred to AmeriHealth Caritas Florida’s current behavioral health vendor for program management. Treatment options include attending community support groups, such as Narcotics Anonymous and Alcoholics Anonymous. Providers will monitor each member's medication management, therapy, and psychosocial rehabilitation.
In collaboration with the current behavioral health vendor, AmeriHealth Caritas Florida Care Management will follow each member's progress through communication with the member’s treating provider. A designated Care Coordinator or Care Manager will also educate the member about rewards for completing health milestones, such as maintaining sobriety for 30, 90, and 180 days.
The goals of this program are to successfully engage the member in substance use treatment from the treating provider and help the member achieve sobriety and become healthier.
AmeriHealth Caritas Florida asks that all PCPs and treating providers screen members for signs of alcohol or substance use as part of prevention evaluation at the following times:
- Initial contact with new member.
- Routine physical exams.
- Initial prenatal contact.
- When the member evidences serious overutilization of medical, surgical, trauma, or emergency services.
- When documentation of emergency room visits suggests the need.
This program is for pregnant members, regardless of the member’s pregnancy risk. Each member will receive a gift card for attending at least 10 of 13 prenatal visits and a postpartum visit. The postpartum visit must have occurred within 7 and 84 days after giving birth.
The member must have delivered a child on or between October 8, 2020, and October 7, 2021.
See how you can help members stay on track with our Bright Start® pregnancy program.
This program is for members who complete a postpartum visit between 7 and 84 days after giving birth. The member must have delivered a child on or between October 8, 2020, and October 7, 2021.
(Members who complete the Maternity reward program will not be eligible for the Postpartum reward program.)
This program is for members who complete six well-child visits from 31 days to 15 months old. The member must turn 15 months old during the measurement year from January 1, 2021, through December 31, 2021.
This program is for members who complete two or more well-child visits with a provider. Members will receive $20 for having the visit on or between January 1, 2021, and June 30, 2021, or $10 for having the visit on or between July 1, 2021, and December 31, 2021. The member must be 3 to 6 years old on or between January 1, 2021, and December 31, 2021.
This program is for members who complete at least one well-care visit with a PCP or an OB/GYN provider. Members will receive $20 for having the visit on or between January 1, 2021, and June 30, 2021, or $10 for having the visit on or between July 1, 2021, and December 31, 2021. The member must be 3 to 21 years old on or between January 1, 2021, and December 31, 2021.
This program is for members who complete at least one ambulatory or preventive care visit with a provider. Members will receive $20 for having the visit on or between January 1, 2021, and June 30, 2021, or $10 for having the visit on or between July 1, 2021, and December 31, 2021. The member must be 20 years or older on or between January 1, 2021, and December 31, 2021.
This program is for members who complete one or more capillary or venous blood tests for lead poisoning in 2021. The member must be 2 years old on or between January 1, 2021, and December 31, 2021.
A female member must complete one mammogram screening for breast cancer in 2021. The member must be 50 to 74 years old on or between January 1, 2021, and December 31, 2021.
A female member must complete one cervical cytology screening for cervical cancer in 2020. The member must be 21 to 64 years old on or between January 1, 2020, and December 31, 2020.
This program is for members 18 to 75 years old with diabetes who have both of the following diabetes tests completed in 2021:
- Hemoglobin (HbA1C) blood test
- Microalbumin urine screening/monitoring (kidney disease screening)
The member must be 18 to 75 years old on or between January 1, 2021, and December 31, 2021.
This program is for members 18 to 75 years old with diabetes who complete a retinal or dilated annual eye exam in 2021.
The member must be 18 to 75 years old on or between January 1, 2021, and December 31, 2021.
This program is for members age 6 and older who were hospitalized for treatment of select mental illness diagnoses and had a follow-up visit with their provider within seven days of discharge from an acute behavioral or mental health inpatient setting or emergency department in 2021. The member must be at least 6 years old on or between January 1, 2021, and December 31, 2021.
Members may enroll in more than one Healthy Behaviors program (if they qualify), and can receive a reward of up to $50 per program, per year. Members may only join each Healthy Behaviors program once per year. Member rewards cannot be used for certain products. These include alcohol, tobacco, gambling (including lottery), drug (except over-the-counter drug), firearm, or ammunition purchases.
For more information, refer to the Healthy Behaviors Program handout or Goal Completion Grid (PDF). Members may download a completion form (PDF), or call us to request a form be mailed. You may also contact your Provider Network Management Account Executive or call Provider Services for more information at 1-800-617-5727.