Insurance Coverage

If you are enrolled in a managed care plan (HMO, PPO or POS), your treatment at The University of Kansas Health System in Kansas City may be covered by insurance. To verify whether you're eligible for treatment at our health system, follow these tips.

• Before scheduling an initial appointment, call your health plan/insurance company and ask if you have access to our services.
• We encourage you to refer to questions to ask your insurance company when speaking to your insurance provider.

If The University of Kansas Health System is not a participating provider in your plan, you may still be able to receive treatment here. Your insurance company may help with obtaining authorization. It is important to note that some benefit plans use what are referred to as "narrow" or "limited" networks. That means they narrow or limit the choices of doctors and hospitals that their customers can use. Additionally, some plans, such as HMOs, have primary care physician referral and/or other authorization guidelines. If you have an HMO insurance plan, please let us know when you schedule appointments. It may be necessary to plan your appointments at specific locations to ensure your fees are covered.

To make sure we are the best fit for your healthcare needs, speak with your insurance company.

Once you have verified The University of Kansas Health System is within your insurance network, patient access specialists will work with you to ensure you receive the full benefit from your insurance company by:

• Answering your questions about insurance verification and/or prepayment requirement
• Responding to insurer requests for additional medical information

DISCLAIMER: The University of Kansas Health System's participation with any product or insurance plan is subject to change without notice. Additionally, insurance companies offer a variety of plans and may change the names and benefits at any point. Your level of coverage depends on the specific benefits outlined in your plan.

To ensure that The University of Kansas Health System and its physicians and other providers are in-network, it is your responsibility to verify that The University of Kansas Health System is a participating provider and your benefit plan allows you access the day of a visit and/or admission. Contact your insurance plan to obtain this information.

Are you covered by health insurance?

If you're choosing a health insurance plan at work or on your own, you may want to check the networks. Most plans offer the best coverage for doctors and hospitals that are in their networks.

That means you'll want to find each health plan's network list and search for your doctors, other providers and The University of Kansas Health System.

Networks change from year to year, so be sure to check, even if you plan to stay in the same plan you had last year.

Note: Medicare annual wellness visits can be scheduled once every 12 months. Check with your insurance carrier to determine when you are next eligible for these visits before scheduling. Well-child checks are also covered according to specific schedules. Check with your insurance carrier to determine when your child is next eligible for these visits before you schedule.

Enroll 365 can help you choose a plan.

Major managed care plans

• Aetna
  Commercial HMP/POS and PPO products; commercial behavioral health product
• Aetna Better Health of Kansas
  KanCare HMO (Kansas Medicaid); KanCare HMO behavioral health (Kansas Medicaid)
• Aetna CareLink
  Coverage for members in Missouri only
• Aetna Medicare
  Medicare Advantage HMO and PPO products (includes legacy Coventry Medicare Advantage products)
• Ambetter from Sunflower Health Plan (KS)
  Health Insurance Marketplace HMO product
• Ambetter from Home State Health (MO)
  Health Insurance Marketplace HMO product
• Blue Cross Blue Shield of Kansas
  Commercial HMO/POS and PPO products including: Premier Blue; Blue Choice; Solutions (not available for residents of Wyandotte and Johnson counties in Kansas). Services provided at our ambulatory surgery center at KU MedWest are not covered.
• Blue Cross Blue Shield of Kansas City
  Commercial HMO/POS and PPO products including: Blue Access (PPO); Blue Advantage (HMO); Blue Care (HMO); Blue Select Plus (PPO); Preferred Care (PPO); Preferred Care Blue (PPO); traditional/indemnity and commercial behavioral health product
• Blue Cross Blue Shield of Kansas City Medicare Advantage
  Medicare Advantage HMO and PPO product
• Cenpatico Behavioral Health
  KanCare – Sunflower State Health Plan (Kansas Medicaid); MO HealthNet – Home State Health Plan (Missouri Medicaid)
• CIGNA-Health Springs
  Medicare Advantage HMO product
• CIGNA Healthcare
  Commercial HMO/POS and PPO products
• Coventry Health Care
  Commercial HMO/POS and PPO products; commercial behavioral health product
• First Health (a Coventry Health Care company)
  Commercial PPO leased network
• Freedom Network
  Commercial PPO leased network by preferred health professionals (PHP)
• Freedom Network Select
  Commercial PPO leased network by preferred health professionals (PHP)
• Great West Healthcare (a CIGNA Healthcare company)
  Commercial HMO/POS and PPO products
• Humana
  Commercial HMO/POS and PPO products
• Humana Behavioral Health
  Commercial HMO/POS and PPO products; commercial HMOx/POSx and PPOx products; Medicare Advantage HMO/POS and PPO products
• Humana Medicare Advantage
  Medicare Advantage HMO and PPO products

• Humana Medicare Community Health Plan
• Medicaid Kansas Traditional
  Medicaid traditional
• Medicare
  Medicare traditional
• Medicare Advantage PFFS products
  Medicare PFFS
• Medicare Supplemental (offered by payers under different names)
  Medicare supplement plans
• Mental Health Associates (MHNet)
  Commercial behavioral health product; MO Health Net – Healthcare USA (Missouri Medicaid)
• MultiPlan
  Commercial PPO product (complementary network)
• New Directions Behavioral Health
  Commercial behavioral health HMO product
• OptumHealth Behavioral Health
  KanCare – UnitedHealthcare community plan (Kansas Medicaid); commercial behavioral health products
• Oscar
  Commercial product for Kansas residents who live in Wyandotte or Johnson counties and Missouri residents who live in Clay, Jackson or Platte counties
• Preferred Health Professionals (PHP)
  Commercial PPO product
• Preferred Health Systems (a Coventry Health Care company)
  Commercial HMO/POS and PPO products including: Preferred Health Care Network and Preferred Plus of Kansas
• Private Healthcare Systems (PHCS) (a MultiPlan Company)
  Commercial PPO product (complementary network)
• Sunflower State Health Plan
  KanCare HMO (Kansas Medicaid)
• Sunflower wellcare
  HMO and PPO products
• TriCare (Healthnet)
  HMO and PPO products
• UHC (United Healthcare) Exchange Plan
  An ACA marketplace plan
• UnitedHealthcare
  Commercial HMO/POS and PPO products
• UnitedHealthcare Community Plan
  KanCare HMO (Kansas Medicaid)
• UnitedHealthcare Medicare Advantage
  Medicare Advantage HMO and PPO products