Kansas Health Advantage

Kansas Health Advantage Provider Directory

This directory provides a list of Kansas Health Advantage HMO-SNP participating network providers and pharmacies (Network Providers). To get detailed information about your health care coverage, please see your Evidence of Coverage.

You will have to choose one of our Network Providers who are listed in this directory to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care services from your PCP. Kansas Health Advantage HMO-SNP is an Institutional-eligible Health Maintenance Organization (HMO) Special Needs Plan (SNP). Since we are an HMO, it is necessary for you to select a PCP to utilize while on the plan. We do not guarantee that each provider is still accepting new members.

The “Network Providers” listed in this directory have agreed to provide you with your health care. You may go to any of our Network Providers listed in this directory. However, some services may require a referral. If you have been going to one Network Provider, you are not required to continue to go to that same Network Provider. In some cases, you may get covered services from non-network providers. If you get a bill from a non-network provider, please submit it to Kansas Health Advantage HMO-SNP for processing. We can help determine how much you are responsible for paying, if any.

Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you must use Network Providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any Medicare certified dialysis provider. You must use Kansas Health Advantage Network Providers except in emergency or urgent care situations. If you obtain routine care from non-network providers neither Medicare nor Kansas Health Advantage HMO-SNP will be responsible for the costs.

What is the service area for Kansas Health Advantage?

The counties in our Kansas service area are Allen, Atchison, Bourbon, Butler, Chautauqua, Cherokee, Clay, Cowley, Crawford, Doniphan, Douglas, Edwards, Finney, Franklin, Geary, Grant, Greenwood, Harvey, Jackson, Jefferson, Johnson, Kearny, Kingman, Kiowa, Labette, Leavenworth, Lyon, Miami, Montgomery, Nemaha, Neosho, Osage,
Pottawatomie, Reno, Riley, Russell, Sedgwick, Shawnee, Sumner, Wabaunsee, Wilson, and Wyandotte.

How do you find Kansas Health Advantage Network Providers in your area?

This is a searchable online document and is updated at least monthly. You can enter areas in the fields to narrow down your search. For example, if you enter “Kansas” in the state field, and “Sedgwick” in the county field, the search engine will generate a list of all providers, hospitals and pharmacies in Sedgwick County, Kansas. You can also search by provider name, city, or specialty.

If you have questions about Kansas Health Advantage HMO-SNP or require assistance in selecting a PCP, please call our Member Service Department at 1-800-399-7524, from 8 a.m. to 8 p.m. sevent (7) days a week. TTY users should call 711 or visit www.kansashealthadvantage.com.

Kansas Health Advantage HMO-SNP is a Health Plan with a Medicare contract, Enrollment in Kansas Health Advantage HMO-SNP depends on contract renewal. This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.

The formulary, pharmacy network, or provider network may change at any time. You will receive notice when necessary.