2022 Value-Added Services
Date: 05/16/22
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.
If members need help accessing these extra benefits, they may call Sunflower Customer Service toll-free at 1-877-644-4623 (TTY 711). There are no grievance and appeal rights for these value-added benefits.
| SERVICE OR BENEFIT AREA | DESCRIPTION, WITH LIMITATIONS NOTED IF ANY | HOW IT’S ACCESSED |
|---|---|---|
| Dental Visits | Two (2) dental visits each year, which include the exams and cleanings, bitewing x-rays and a panoramic x-ray every 36 months for adults 21 and over. Adult members have a maximum benefit of $500 per calendar year. Children are covered under regular benefits on most dental services. Dentures are covered for members receiving FE & PD waiver benefits. Eligibility is based on determination of need. | Members may schedule with a participating network dentist. |
| My Health Pays Rewards® | Members can earn rewards on a prepaid card when they get health checkups and screenings. Members can earn $10-$75 (up to $75 annually) in My Health Pays rewards. Find all the details for this program on the My Health Pays® webpage. | Rewards are added to the member’s rewards card after we process the claim for each completed activity. The rewards card is mailed to them after they earn their first reward. |
| 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. 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 can call ModivCare to schedule their WIC trips. |
| MyStrength - Digital Behavioral Health | 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 through MyStrength. Their member number is required. Providers may also set up access. |
| Boys & Girls Club Membership | Free services and events to promote healthy lifestyles for kids, such as covering membership fees to the Boys & Girls Club. | Each local Boys and Girls Club has vouchers. |
| Sunny's Kids Club | Subscribers receive a welcome packet with a club membership card & health-education books four times a year. | Members and the public are welcome to sign up here. |
| Healthy Eating - Farmers Market Vouchers | Members can receive vouchers at events with participating farmers markets. Members who visit our table the day of the event receive $10 to shop for fresh fruits & vegetables. | Locations announced on our website, Facebook page & by postcards we mail. |
| 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 | GROW (GED, Rides, Opportunities, Work) (renamed from 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 and connection with career counseling services. 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 or PD Waiver) | 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. |
| 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 Frail Elderly (F/E) and Physical Disability (PD) waiver benefits. This benefit includes three round trips a 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. |
| Peer Support Program (F/E & PD Waivers) | Peer Support Program for members receiving F/E & PD waiver benefits and 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 Waivers) | Up to 16 hours of hospital companionship for persons on the F/E, IDD 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. 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 your Provider Relations Representative or call Customer Service at 1-877-644-4623.