2023 Sunflower Medicaid Value-Added Benefits

Date: 03/07/23

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.	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: In-home help with healthcare and social service benefits. Special texting program for Start Smart participants Group baby showers for pregnant mothers. Start Smart birthday programs for children Transportation to WIC appointments. (Four round trips)	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.
Community Programs for Children	Youth members, ages 5 to 18, can receive a $50 credit per year for programs, like YMCA, Boys and Girls Clubs, Girl Scouts or Scouts BSA. Strong Youth Strong Communities Program™ (SYSC). SYSC works with the Pro Football Hall of Fame and other youth-serving groups. SYSC resources are found on the SYSC website and mobile app.	Each local Boys and Girls Club has vouchers. Visit the Strong Youth Strong Communities website.
Sunny's Kids Club	Subscribers receive a welcome packet with a club membership card & activity book. Sunny’s web page features books and fun activities.	Members and the public are welcome to sign up here.
Weight Management & Nutrition	We offer an adult weight-management program. It provides phone outreach, education and support to members. These services improve nutrition and exercise patterns to manage weight and minimize health-risk factors. For members 18 and older. Raising Well^® is a child weight-management program. It helps overweight and obese children achieve better long-term health. It works with parents toward permanent healthy habits.	Speak to a Sunflower care manager.
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) 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.

Extra Services for Waiver & Foster Care Members

SERVICE OR BENEFIT AREA	DESCRIPTION, WITH LIMITATIONS NOTED IF ANY	HOW IT’S ACCESSED
Dentures (FE or PD Waivers)	Dentures may be covered for eligible members receiving Frail Elderly (FE) and Physical Disability (PD) Waiver benefits. Eligibility is based on medical necessity.	FE & 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 (FE & PD Waivers)	Up to 60 hours of respite care for non-paid caregivers who provide supports for persons on the FE and PD waivers. No more than 48 hours can be used in one month.	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 (FE & PD Waivers)	Social transportation: Three round trips per year for FE and PD waiver members to attend local events and social activities. Sunflower can help members find events and activities to attend.	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.
Nursing Home Transition	Sunflower helps members return to their own homes by working with providers to: Conduct advance planning. This may include finding housing and household items, confirming informal supports and helping to hire caregivers. Do follow-up visits. These ensure services and equipment are meeting the member’s needs. Confirm or set up PCP appointments. Members may qualify for more financial help or benefits, based on need, when moving to independent living.	Members can request this by calling their care manager. If you don’t have one, or don’t know who it is, please call Customer Service.
Home Delivered Meals (FE Waiver)	Home-delivered meals for FE waiver members returning home from a nursing home or inpatient stay. Covers up to two meals per day for up to seven days. 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.
Peer Support Program (FE & PD Waivers)	Peer Support Program for members receiving FE & 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 (FE, IDD & PD Waivers)	Up to 16 hours of hospital companionship for persons on the FE, Intellectual/Developmental Disability (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.
Behavioral Health and Foster Care Training & Support Programs	These include peer-support calls for foster & adoptive families, a recorded training library, interactive training via Fostercare.com, live caregiver training and provider training to facilitate foster care education.	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.

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.