What are the plans from sunflower health plan?
Our plans are called Kansas Medicaid, Ambetter from Sunflower Health Plan, and Allwell from Sunflower Health Plan. Take charge of your health by enrolling in a Kansas health insurance plan today. The coronavirus is affecting our communities in Kansas, and Sunflower Health Plan wants us to all stay as safe and healthy as possible.
Does sunflower offer Medicaid in Kansas?
Medicaid. Sunflower Health Plan offers health insurance for Kansans receiving services in KanCare, the State of Kansas Medicaid program. Program eligibility depends on your age, income, family size and any special health needs you may have.
What types of claims does sunflower accept?
Sunflower accepts electronic claims, claims submitted through our Secure Provider Portal or claims submitted through KMAP. Sunflower uses payer ID number 68069. Our preferred electronic claims warehouses are: SSI, Gateway, Emdeon, Availity, and Smart Data Solutions.
What if I am not enrolled with sunflower health plan?
If you are not enrolled with Sunflower Health Plan, review Get Insured for more information. If you do not know what program you are enrolled in, contact us. We can help! Allwell from Sunflower Health Plan is a Medicare Advantage plan for people who are eligible for Medicare Part A and Medicare Part B or Medicare and Medicaid.
Is sunflower the same as KanCare?
As a KanCare health plan, Sunflower Health Plan is a provider of Kansas Medicaid. Our members receive benefits and services from Sunflower Health Plan's network of providers.
What is the most popular Medicaid plan?
Kaiser Foundation Health Plan of the Mid-Atlantic States, Inc. attained the highest overall rating among Medicaid plans for HPR 2021. The plan demonstrated high-quality preventive care, with five stars for nearly every prevention measure for which it provided data.
What does Kansas Medicaid cover for adults?
These include physical health services such as doctor appointments and hospital visits, behavioral health services, dental and vision care, pharmacy, transportation, and nursing facility care. All the services offered through the State's Home and Community Based Services waivers are part of KanCare.
Who qualifies for Medicaid Kansas?
Be responsible for a child 18 years of age or younger, or. Blind, or. Have a disability or a family member in your household with a disability, or. Be 65 years of age or older.
Who is the biggest Medicaid provider?
Medicaid Managed Care: 2020 Results for the “Big Five”Aetna/CVSHealth (Market Cap $ 91.8 billion) CVS Health has three segments; the Health Benefits Segment includes Aetna, which CVS Health acquired in 2018. ... Anthem, Inc. ... Centene (Market Cap $33.8 billion).More items...•
What is the difference between Medicaid and New Jersey Family Care?
What Is the Difference Between Medicaid and New Jersey FamilyCare? There's no difference. New Jersey FamilyCare is just another name for New Jersey Medicaid.
Does Kansas have Medicaid for adults?
The program for Medicaid in Kansas is called KanCare. KanCare offers health insurance coverage for children, pregnant women, families with children, elderly, and adults and children with disabilities in the state of Kansas.
Does Kansas Medicaid cover dentures?
Dentures are covered for eligible members receiving Frail & Elderly Waiver benefits. Eligibility is based on medical necessity. Any member over age 21 can visit a participating dental provider once a year for a screening and cleaning, which includes scaling and polishing teeth.
Does KS Medicaid pay for braces?
The answer is yes! If braces are deemed medically necessary for your child, Medicaid can assist in getting them. Some orthodontists will offer a no-cost consultation to discuss your child's needs.
What is the maximum income to qualify for Medicaid in Kansas?
Who is eligible for Kancare (SCHIP)?Household Size*Maximum Income Level (Per Year)1$32,7522$44,1283$55,5034$66,8784 more rows
Who can get KanCare in Kansas?
KanCare is available to adult, non-disabled, non-elderly parents or caregivers of children younger than 19. Benefits and coverage are the same as those for children in KanCare. Enrollment for adults is limited to those who meet Medicaid eligibility guidelines.
What is considered low income in Kansas?
While a Low Income family of 3 could make no more than $41,200 per year in 2018, a Low Income family of 8 could make no more than $60,400 per year. Grant County. While a Low Income family of 3 could make no more than $48,750 per year in 2018, a Low Income family of 8 could make no more than $71,500 per year.
What is the number to call for Sunflower Health Plan?
Call Customer Service at 1-877-644-4623 ( TTY: 711 ).
How old do you have to be to get dental care at Sunflower Health Plan?
Dental Care. Sunflower Health Plan offers different services for dental care, depending on age. For members under 21 years of age, Kansas Medicaid dental benefits vary by age and membership category. Call Customer service at 1-877-644-4623 for details about dental coverage for members under the age of 21.
How many eyeglasses does Sunflower Health Plan offer?
Sunflower Health Plan members 21 years and older receive one complete eye exam and, if needed, one pair of eyeglasses each year. For member under age 21, Sunflower provides exams, eyeglasses and repairs as needed, and up to three pairs of eyeglasses each calendar year.
Is ambulance transportation covered by Sunflower Health Plan?
Ambulance transportation to the hospital emergency room in non-emergency situations is not covered by Sunflower Health Plan. Ambulance transportation from a healthcare facility to another healthcare facility is covered only when it is medically necessary.
Does Sunflower Health Plan pay for care coordination?
Care coordination and disease coaching are part of your health benefits and are provided to you at no cost. Sunflower Health Plan pays for these services. We provide services for many conditions, such as asthma, diabetes, COPD, high-risk pregnancy and many more. Call Customer Service at 1-877-644-4623 ( TTY: 711 ).
Can you travel to a health care appointment in Kansas?
There are rules about how far you can travel to a health care appointment and get a ride. Transportation is available for services received within the State of Kansas or to an approved Kansas border city provided that the member is traveling to the closest available provider for his or her medical condition.
Does Sunflower Health Plan cover medical visits?
Doctor Visits & Screenings. Preventative care visits are covered by Sunflower Health Plan for Kansas Medicaid members. This means visiting the doctor for a regular check-up, rather than waiting until you are sick. Sunflower Health Plan covers an annual physical for adults.
Is Allwell a Medicare Advantage Plan?
Allwell from Sunflower Health Plan is a Medicare Advantage plan for people who are eligible for Medicare Part A and Medicare Part B or Medicare and Medicaid. Allwell plans are designed to give you affordable healthcare coverage, coverage for prescription drugs and extra benefits that aren’t covered by Medicare Part A or Part B (Original Medicare).
Does Sunflower Health Plan cover Medicaid?
Sunflower Health Plan offers health insurance for Kansans receiving services in KanCare, the State of Kansas Medicaid program. Program eligibility depends on your age, income, family size and any special health needs you may have.
What is the phone number for sunflower?
The local Provider Network Specialists can be reached at 1-877-644-4623 ( TTY: 711 ) Monday through Friday 8:00 a.m. to 5:00 p.m.
How often can you change your MCO on medicaid?
Medicaid members can change their MCO during their 90 days of eligibility/assignment, then once/year during open enrollment. Members can change their PCP/providers at any time. To view Sunflower's provider directory, please click here.
What are the provider's responsibilities related to Advance Directives for KanCare members?
What are the provider's responsibilities related to Advance Directives for KanCare members?#N#Sunflower is committed to ensuring members are aware of and are able to avail themselves of their rights to execute Advance Directives. Sunflower is equally committed to ensuring participating providers and their staff are aware of and comply with federal and state laws regarding Advance Directives; and that the Sunflower Medical Management staff are trained on our policies and procedures related to Advance Directives.# N#PCPs and providers delivering care to Sunflower members must ensure members age 18 years and older receive information on Advance Directives and are informed of their right to execute an Advance Directive. Providers must document such information in the patient’s permanent medical record. See the Provider Manual for a list of recommendations for providers.
Does Sunflower Health Plan coordinate with primary insurance?
If the primary payor denies for administrative reasons, Sunflower will NOT coordinate with the primary insurance. If the primary payor denies for non-administrative reasons, the provider will be required to obtain an authorization for any service Sunflower Health Plan would otherwise require an authorization if we were the primary payor.
Does Sunflower have credentialing?
Yes, you must be credentialed by Sunflower. Upon your written authorization, Sunflower will access your credentialing information on the CAQH (Council for Affordable Quality Health) website. Sunflower will also use the Kansas Final Joint Approved Credentialing Application for hospitals and ancillary providers.
Can I use my medicaid ID number in Sunflower?
Yes. The State has provided current provider Medicaid ID numbers. These Medicaid ID numbers will be cross walked in the Sunflower claims system in order to match AuthentiCare claims without the NPI number.
Do primary care physicians need paper referrals?
Must Primary Care Physicians issue Paper Referrals for their Medicaid patients to access specialty services?#N#Paper referrals are not required for services at participating/contracted specialists. Members are educated to always consult with their primary care physician before accessing specialty services.
