- Home
- Patients and Visitors
- Billing, Insurance and Financial Support
- Insurance Coverage
Billing, Insurance and Financial Assistance
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
The University of Kansas Health System is in-network for the following major managed care plans. If your plan is not listed here, please refer to your coverage or contact your insurance carrier for guidance on where to locate in-network providers.
-
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 -
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 -
Healthy Blue
Missouri Medicaid managed care plan -
Home State Health
Missouri Medicaid managed care plan -
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) -
MO HealthNet
Missouri Medicaid -
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 -
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 Community Plan - MO HealthNet Managed Care
Missouri Medicaid managed care plan -
UnitedHealthcare Medicare Advantage
Medicare Advantage HMO and PPO products
If you are considering a plan other than those listed here, we encourage you to visit the plan’s website or call to ensure your healthcare team members are in network for the plan you choose.
Please note that our Great Bend locations may appear differently on insurance plans compared to how The University of Kansas Health System is listed in the Kansas City area. On insurance plans, our Great Bend entities may be listed under any of the following names:
• UKHS GB LLC
• UKHS Great Bend Medical Pavilion
• UKHS Great Bend St. Rose Medical Pavilion
• UKHS Great Bend Family Medicine
• University of Kansas Great Bend
Original Medicare vs. Medicare Advantage
Questions are common regarding the differences between original Medicare plans and Medicare Advantage plans. These comparisons from the Kansas Hospital Association may be helpful:
| Original Medicare | Medicare Advantage |
| See any provider that accepts original Medicare. No referrals needed. | Designated primary care physician directs your care. Referrals needed to see other medical professionals. |
| Most medical services are covered. Routine dental, vision and hearing care are not. | Receive all medical services covered by original Medicare. Some plans may also include dental, vision, hearing and gym memberships. |
| Only about 1% of physicians do not participate in the original Medicare network. You can choose to see almost any physician and access care across the US. | Based on limited networks that are usually self-contained. |
| You may pay a premium, deductible and coinsurance, but there are usually no other cost surprises. | There is a risk of surprise out-of-pocket costs that can quickly build up if you get sick. |
| Rarely requires authorizations and approvals for any medical care. | Requires approvals before physicians can provide services, including inpatient admissions, skilled care stays, home health, outpatient surgery, ambulance transport, medical equipment, laboratory and radiology services, dental care and vision care. |