KanCare: Reinventing Medicaid for Kansas

Consumers

Frequently Asked Questions

Notice of Privacy Practices

Who do I call if I have questions?
If you have questions about the KanCare program we want you to get the information you need. See this Contact List for information and phone numbers to call to get your questions answered.

What is KanCare?
KanCare is the name of the new way you receive Medicaid services. KanCare is managed care that combines health care (like doctor visits) with community long-term services and supports (like help in your home). You choose a KanCare health plan that provides your services.

Can I change my health plan after the enrollment period ends?
You will be in the health plan you have chosen for one year. You will have a chance to change plans again each year. There are a few reasons that you can change plans in the middle of the year. To change in the middle of the year you need to have what is called a “good cause” reason to change. For more information, you can look at this list of common questions about this topic.

What is managed care?
Managed care is a way of providing health care and long-term services and supports through a health plan. In a health plan, a group of providers offers health care services and community long-term services and supports. Under managed care, your services are coordinated by your primary care doctor and a service coordinator.

Why is KanCare different that old Medicaid?
All of the services covered through your medical card, including in-home and nursing home services are being coordinated and paid for by one of three KanCare health plans also known as managed care organizations (MCO).  These KanCare health plans are Amerigroup, United HealthCare and Sunflower State Health Plan.

When did KanCare begin?
KanCare began January 1, 2013.

Can I change doctors?
You can choose to go to any doctor on the provider list for the KanCare health plan you’ve chosen.  You can change doctors any time, as long as the new doctor is on the health plan’s provider list.  Call your health plan if you want to choose a different doctor.

I take some important medicine.  Can I still get that medicine?
All KanCare health plans include prescription medicine.  As long as your doctor prescribes that medicine, you can continue to take it.  Your health plan may talk with your doctor about medicines that do the same thing, but may be cheaper.  If the medicine is for a mental illness you can continue to get it.

Does KanCare offer rides to see my doctor?
Yes.  Each KanCare health plan will help you get to your doctor and other health care providers.  They will give you a phone number to call to get a ride.

What has happened to HealthWave and Unicare and Coventry?
The HealthWave name went away.  UniCare and Coventry no longer manage any Kansas Medicaid services.

What about HealthConnect?
That program ended December 31, 2012.

What if I don’t want to be in a KanCare health plan?
Almost every Medicaid member is in a KanCare health plan.  There will be no copays and you could get additional services that were not previously provided.

When do I choose a KanCare health plan?
You were assigned to one of the KanCare health plans when you became leigile for KanCare. You were also given information about the other two health plans that explained what you needed to do if you wanted to choose a different health plan. You will have another chance to change your plan again next year.

How do I choose a KanCare health plan?
For current consumers: You have complete information in the enrollment packet you got in the mail. Read the packets carefully to see if the services you use are covered by the health plans. Check to see if your doctors and other providers are providers with the health plan you are thinking of choosing.  Contact the health plans (their numbers are in your packet) if you have questions about how they will take care of your special health care needs. Use all of the information to choose a health care plan that works best for you.  For additional information, please contact 1-866-305-5147 for KanCare.
For Future consumers: You are asked to choose a health plan at the time you come in to complete your initial application.  If approved, you will have 90 days after approval date to choose or change health plans.

Are all three KanCare health plans the same?
They all have to cover all the services that were in Medicaid previously, but some of the extra services they provide are different. They also have to provide service statewide.

What if I have Medicare and Medicaid?
If you are in both programs, you will use Medicare for many of your health care needs and prescription drugs, just as you did before. You will use KanCare for your Medicaid long-term service and support needs.

What if I don’t need community long-term services and supports?
You don’t have to use them. If you need community long-term services and supports in the future –contact your health plan and ask to speak to your care manager.

What is a care manager?
This is someone who works for the KanCare health plan. A care manager makes sure you get the medical care and community services you need to stay healthy and take care of any conditions you have, like diabetes or asthma.

Will I be able to continue to see special doctors?
You will be able to see special doctors or other providers for treatment or follow-up if you need to.

Will I have to pay anything for services?
If you have to pay a monthly premium now, you still will pay that premium unless your family’s income changes. If the service you receive is a covered service, you will not have to pay anything for it. If you have a monthly client obligation to pay or must spend down to continue to receive Medicaid, you will still need to do that.

Will I be able to get dental services in KanCare?
Children receive dental services. That continued in KanCare. The new thing about KanCare is that all three health plans also provide dental exams and cleanings for adults at least once a year.

Are there any other new services?
Yes, each KanCare health plan offers some other services and those were explained to you in the information thatl helped you choose a health plan.

I am on a Home and Community Based Services (HCBS) waiver; did my waiver services change?
All HCBS waiver services are being managed by the KanCare health plans. When your plan of care is due for review, there might be changes, but the health plan care manager will make sure you get the services you need.

My mother is in a nursing home; did anything change for her under KanCare?
It should not, as long as the nursing home contracts with the KanCare health plan your mother chooses.  The health plans must work to contract with all of the nursing homes.

I self-direct my HCBS waiver services; can I continue to do that?
Yes and the KanCare health plan will help you to do that.

What if I have a complaint?
You should call the KanCare health plan’s customer service number, talk to your care manager or file a written grievance. The handbook you received explains how to do that.

Will consumers have any say in how KanCare operates?
Yes.  Each KanCare health plan must have a Member Advisory Council, made up of people who receive services or their families.  People who receive services are also represented on the Governor’s KanCare Advisory Council.

What If I Don’t Agree With a Decision About My Health Care?
You have the right to voice concerns about your health care.

You may file a grievance if:

  • You are concerned about the type of care you are getting,
  • You are concerned about the quality of the care you are getting, or
  • You have other concerns about your health plan or your provider.

You may ask for a fair hearing or an appeal if:

  • You do not agree with an action such as a denial or limit on services,
  • You feel you had to wait too long to get services, or
  • Your KanCare plan is not paying for a service you got.

A fair hearing is like a trial in court.  The hearing is your chance to tell a third party why you disagree with the agency. 
You must request a fair hearing within 30 days of when you were told of the decision.  For more information on the fair hearing process, please contact Customer Service at 1-800-766-9012.
Your KanCare plan can help you with this process.


Frequently Asked Questions During 2012-2013 Medicaid Reforms