Does Your Child Qualify?
Most families who qualify never pay a dollar. Here is how to tell, in plain language, before you pick up the phone.
Four Things Have To Be True
All four, not just some. If you are unsure about any of them, call us and we will check for you.
- 1
A daily skilled nursing need
This is the requirement families are most often surprised by. PPEC is a nursing program, so your child must need care that legally requires a licensed nurse — things like tube feedings, a tracheostomy, ventilator support, oxygen, catheter care, seizure rescue medication or a complex medication schedule. Therapy needs alone do not qualify a child.
Most misunderstood - 2
Age 0 to 21
PPEC serves children from birth until their 21st birthday. Authorizations are approved in periods and renewed as long as the medical need continues.
- 3
Florida Medicaid
Straight Medicaid or a Medicaid managed care plan. We verify your coverage for you before day one, so you are not the one making the phone calls.
- 4
A doctor's order
A prescription from your child's physician stating that PPEC services are medically necessary. We coordinate this request with your pediatrician or specialist.
Diagnoses we commonly see
These conditions often come with the kind of daily nursing need that qualifies a child. The diagnosis itself is never what decides it — the nursing need is.
- Tracheostomy
- Ventilator dependent
- G-tube / NG feedings
- Oxygen dependent
- Cerebral palsy
- Down syndrome
- Seizure disorders
- Chronic lung disease
- Congenital heart defects
- Muscular dystrophy
- Genetic disorders
- Premature birth complications
- Neurological disorders
- Immune disorders
- Renal conditions
- Feeding & swallowing disorders
- Complex medication schedules
- Developmental delays with medical needs
Not on the list? Call us. Eligibility is based on your child's medical need, not on a diagnosis code.
When PPEC May Not Be the Right Fit
We would rather tell you this now than after you have driven out here. PPEC is a medical nursing program, not a therapy clinic and not a daycare. A child usually does not qualify if:
- The child needs therapy only — speech, occupational, physical or ABA — with no daily nursing need.
- The child has autism or a behavioral diagnosis but is medically stable and needs no nursing care.
- The child has a developmental delay without a medical condition requiring a licensed nurse.
- The family does not have Florida Medicaid.
Where to look instead
If that sounds like your child, you are not out of options — you just need a different door. Depending on age and diagnosis, these are usually the right ones:
Outpatient therapy clinics
Speech, OT and PT delivered by appointment and billed to Medicaid or private insurance without a nursing requirement.
Standalone ABA providers
For an autism diagnosis, ABA is typically authorized through your plan directly with a behavior analysis provider.
Early Steps (birth to 3)
Florida's early intervention program for infants and toddlers with developmental delays.
School district services (3 and up)
An IEP through your local school district can cover therapy and classroom support during the school day.
Still not sure? Call us anyway. A five-minute conversation with one of our nurses is usually enough to tell you which of these you need, and we will point you there even if it is not us.
Call (941) 979-8421How Enrollment Works
Four steps, and we do most of them for you.
Call or text us
A short conversation about your child's medical needs and insurance. Ten minutes, no paperwork, and we will tell you honestly whether PPEC fits.
We verify coverage
We contact your Medicaid plan and confirm benefits. You do not make the calls or sit on hold.
Tour the center
You come see the nursing station, the therapy rooms and the team. Tours take about 30 minutes and you can bring your child.
We request the order
We coordinate the prescription and the authorization with your child's physician, then agree on a start date and build the transportation route.
Does My Child Qualify?
The questions that come up on almost every first call.
What actually makes a child eligible for PPEC?
Four things have to be true: your child needs care that requires a licensed nurse on a daily basis, your child is between birth and age 21, your child has Florida Medicaid, and your child’s physician writes an order saying PPEC is medically necessary. The nursing need is the requirement families are most often surprised by.
My child has autism and needs therapy. Do you take him?
Only if there is also a daily medical need that requires a licensed nurse. PPEC is a nursing program, so a child who is medically stable and needs therapy or behavioral support alone will not be approved, no matter how much the therapy would help. If that is your situation, call us anyway and we will point you toward outpatient therapy, an ABA provider, Early Steps or your school district, whichever fits your child’s age and diagnosis.
What kinds of medical needs count as skilled nursing?
Tube feedings, tracheostomy care, ventilator support, oxygen, suctioning, catheter care, seizure rescue medication, wound care and complex medication schedules are common examples. If you are unsure whether your child’s needs count, a five-minute call with one of our nurses will tell you.
What if we do not have Medicaid?
Call us. We can walk you through the Florida Medicaid application process and tell you whether your child is likely to qualify medically before you invest time in the paperwork.
How long does enrollment take?
It depends on how quickly the physician’s order and the Medicaid authorization come through. We handle the verification and coordinate the paperwork with your child’s doctor, and we keep you updated at each step rather than leaving you to chase it.
Start With One Phone Call
We do the verification, the paperwork and the coordination with your doctor. You make one call — and if we are not the right fit, we will tell you who is.
We answer in English and Spanish, usually the same business day.