2021 Sunflower Medicaid Value-Added Services
Date: 03/04/21
Extra Benefits and Services for Sunflower's KanCare Members
Value-added services, or value-added benefits, are offered to help improve the health status and quality of life for members. Sunflower Health Plan provides all Medicaid-covered benefits, plus these other services to support the unique needs of our members.
Value-added services are approved by the state Medicaid agency and may be actual healthcare services, benefits or positive incentives to promote healthy lifestyles and improved health outcomes among KanCare members.
We'd like to help your patients and clients access the value-added services we offer. The following information is for providers in our network who are helping Sunflower members access these services.
| SERVICE OR BENEFIT AREA | DESCRIPTION, WITH LIMITATIONS NOTED IF ANY | HOW IT’S ACCESSED |
|---|---|---|
| Dental Visits | Two dental visits (cleanings, screenings) for adults 21 and older every year. Children are covered under regular Medicaid benefits on most dental services. | Members may schedule with a participating network dentist. |
| My Health Pays Rewards® | Members can earn rewards on a My Health Pays® Visa® Prepaid Card* when they get health checkups and screenings. Members can earn $10-$50 or more in My Health Pays rewards. Rewards can be used for utilities, transportation, telecommunications, childcare services, education, rent or everyday items at Walmart. | Dollar rewards are added to the member’s rewards card after we process the claim for each completed activity. The My Health Pays® Visa® rewards card* will be mailed to them after they earn their first reward and will be added to for each reward thereafter. |
| Cell Phones | Free smart phone through SafeLink®. These come with free limited data and voice minutes per month, unlimited texting and free calls to and from Sunflower. |
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| Maternal & Child Health | Start Smart® for Your Baby - This program gives support, education and gifts for moms, babies and families. The program includes these services at no cost to the member:
| Prompted by Notification of Pregnancy submission. You may submit this through the portal or via the online form. Members can also notify us of their pregnancies through the member portal or by using the member form. Members simply need to call ModivCare to scheduled their trip to and from their WIC appointments. |
| Community Programs for Children | Sunflower offers free services to promote healthy lifestyles for kids, such as membership fees to Boys & Girls Clubs and the Adopt-a-School Program. | Boys & Girls Clubs: Members must sign up at their local Boys and Girls Club. Each club has vouchers. Adopt-a-School: If a school is interested they can call Sunflower’s Customer Service and request a Community Health Services representative contact them to set them up. |
| Sunny’s Kids Club | Subscribers receive a welcome packet with a club membership card and educational books four times a year. | Sunflower members and the public are welcome to sign up here. |
| Farmers Market Vouchers | We promote healthy eating. Members can receive produce vouchers worth $10 at special events with participating Farmers Markets. | Members should watch our website or Facebook page or for postcards we mail when we’ll be at a farmers market near them. If they visit our table the day of the market, they’ll receive $10 to shop for fresh fruits and vegetables that day. |
| Community Health Services Home Visiting | Community-based health services staff can provide in-home member visits to assist with scheduling healthcare appointments and transportation. They also assist members with accessing food, shelter or other health or social programs. This service is complementary to case management and is performed by certified Community Health Workers. | Providers can call Customer Service to request a visit for a member or have member call Customer Service directly. |
| In-home Tele-Health | In-home telehealth is available for adults. This service helps members stay at home when they need help to manage their chronic conditions. | Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. |
| Medication Review | A comprehensive medication review with a local pharmacist is available to eligible members. The review includes a 30-minute face-to-face consultation with a local pharmacist. | If the member qualifies, their community pharmacist who is contracted with OutcomesMTM will initiate this service. |
| Healthy Solutions for Life - Chronic Disease Management & Depression Support | Healthy Solutions for Life is a disease-management program for members with asthma, COPD, diabetes, depression, heart disease or high blood pressure. Members can enroll in any of these programs. Weight management is also available. The program also helps members determine how emotions impact their conditions. It helps with stress, poor sleep and appetite. As a part of the program, participants are assigned a health coach who works with the entire healthcare team to ensure members have everything they need to feel their best. | Members may be referred by their physician, referred by the health plan, or self-enrolled in any of these programs. Members can request by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. This is administered by Envolve PeopleCare. These are opt in programs – the member must consent. |
| MyStrength Program | Our MyStrength online program offers eLearning to help members overcome depression and anxiety. This online program includes simple tools, weekly exercises, mood trackers and daily inspirational quotes and videos. The program may be used independently or with other care. | Members can access this through our website or visit https://app.mystrength.com/go/epc/kansas directly. They can follow the on-screen prompts for access. Their member number will be required. Providers may also set up access at the above web address. |
| Nursing Home-to-Community Transition Support | Sunflower offers nursing home transition support by partnering with providers to:
| Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. |
| Caregiving Collaborations® | Caregivers are supported through various channels in the Caregiving Collaborations program. This benefit is available to one primary, informal support caregiver per member. Benefits include the Caregiver Resource Center and a Caregiver Journal. In addition to the program benefits, each member and caregiver will continue to receive coordination of respite services available through the individual care plan. | Speak to a Sunflower care manager or visit our Caregiver Resources page. |
| Employment Support & Transportation | Sunflower Transition to Employment Program (STEP) is an employment support resource program. We help members identify and remove employment barriers through a discussion with an internal employment specialist. Benefits include enhanced transportation coverage, GED Ready and GED test vouchers, connection with career counseling services, and information on the STEP scholarship program. Members may be connected with a benefits specialist to learn how their income may impact their benefits. | If a member is interested in using one of these services they can contact our employment support email box or call Customer Service. |
Members on the Frail & Elderly (F/E) and Physical Disability (PD) Waivers
| SERVICE OR BENEFIT AREA | DESCRIPTION, WITH LIMITATIONS NOTED IF ANY | HOW IT’S ACCESSED |
|---|---|---|
| Dentures (F/E & PD Waivers) | Dentures may be covered for eligible members receiving F/E and PD Waiver benefits. Eligibility is based on medical necessity. | F/E & PD members are eligible for select oral health services, but the office will have to have the services prior approved and fill out a Crisis Exception Process with a narrative of medical necessity and treatment plan. |
| Home-delivered Meals (F/E Waiver) | Meals delivered to the home of F/E waiver members who are discharged from a nursing facility or inpatient stay. This covers 14 meals over a week. KanCare covers this service for PD and Brain Injury (BI) waiver members. | Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. |
| Respite Care (F/E & PD Waivers) | Up to 24 hours of respite care for non-paid caregivers who provide supports for persons on the F/E and PD waivers. | Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. |
| Transportation to Community & Social Events (F/E & PD Waivers) | Enhanced transportation to local community events and social activities for members receiving F/E and PD waiver benefits. Sunflower also assists members with finding events and activities. (Three round trips per year.) | Member must have a social community goal on their care plan or personal interest inventory (PII). Members can schedule rides or arrange for mileage reimbursement by calling ModivCare. Sunflower will prior authorize up to three round trips per member per year. |
| Home Modification & Assistive Services (F/E & PD Waivers) | Home modification and assistive services for members on the F/E & PD waivers to enable individuals to remain living at home. Examples include wheelchair ramps, stair lifts, walk-in or wheelchair accessible bathtubs and showers. | Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. |
| Peer Support Program (F/E & PD Waiver) | Peer Support Program for members receiving F/E & PD waiver benefits, as well as members on the waiting list for PD waiver services. This social interaction includes monthly phone calls with other members, facilitated by a Sunflower Member Liaison. | Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. |
| Hospital Companionship (F/E, IDD & PD Waiver) | Up to 16 hours of hospital companionship for persons on the F/E and PD waivers. Added in 2021: also available for members on IDD waiver. | Members can request this by calling their care manager. If they don’t have one, or don’t know who it is, they should call Customer Service. When a member requests this service, the care manager will review the need and provide authorization for the hospital companion services needed. An authorization approval letter will be sent to the member’s chosen, qualified provider. The provider may directly bill Sunflower for the service using the S5151 Procedure Code on the CMS 1500 form or via the Secure Provider Portal. |
If you have questions about this bulletin or other provider resources, please contact Customer Service at 1-877-644-4623.
*The My Health Pays Rewards Visa Prepaid card is issued by The Bancorp Bank pursuant to a license from Visa U.S.A. Inc. The Bancorp Bank; Member FDIC. Card cannot be used everywhere Visa debit cards are accepted.