Beginning Jan. 1, all Medicaid service in the state of Kansas will be provided through KanCare health plans. KanCare is Kansas’ innovative new system to provide Medicaid services with a proactive approach toward health care.
And, according to the KanCare website, the state's 395,000 beneficiaries won't receive any fewer services than they did in past years. But is that statement true for Ford County residents who rely on Medicaid for coverage?
Current beneficiaries received information packets in the fall, and have been pre-enrolled in one of three managed health care plans with which the state is contracting. The plans are Amerigroup Kansas, Inc., Sunflower State Health Plan, and United Healthcare of the Midwest.
However, beneficiaries have until April 4, 2013 to choose which plan they want to be in. Any choices made after Jan. 1 will take effect the first day of the following month, according to a statement from KanCare.
In Dodge City, both Western Plains Medical Complex and Dodge City Medical Center accept all three plans. The same is true for Family Practice Associates of Western Kansas and Medical Heights Medical Center.
The three KanCare managed care organizations (MCOs) are required to meet federal and state distance or travel time standards in ensuring specialty care is available for all members. If an MCO does not have a specialist available to members within those standards, it must allow members to see out-of-network providers. Similarly, emergency services are not limited to in-network hospitals.
And although a majority of Dodge City health care providers take all three insurance plans, KanCare beneficiaries should take a close look at which plan they have been assigned and contact their doctors to double check coverage. A patient who stays with a plan with which an office is not contracting will be expected to pay for services up front, according to KanCare.
KanCare is set up to cover all services previously provided by Medicaid, as well as some "value-added" services that may vary with each plan. Coverage for children will be provided under KanCare; HealthWave is now out of the picture. For all KanCare members, the three MCOs must honor all plans of care, prior authorizations and established provider-member relationships during the transition to KanCare; even if an established provider is not in a health plans network, the provider will still be paid at 100 percent of the Medicaid fee-for-services rate through the first 90 days (until April 4).
Current Medicaid beneficiaries who have yet to receive a new KanCare card by Jan. 4 should contact the MCO using the number on the back of the packet mailed out in November.
Helpful numbers for KanCare beneficiaries
- KanCare Consumer Assistance Line; 1-866-305-5147
- KanCare Ombudsman James Bart: 1-855-643-8180. Bart can help with unresolved access, service and benefit problems, especially for beneficiaries in the Home and Community Based Services (HCBS) Waiver program and others receiving long-term care services.