A wrap network is designed to provide in-network coverage when outside the primary coverage area.

A wrap network is a valuable component of your health plan, designed to offer in-network coverage when you require care outside of the primary coverage area. Also known as a “gap network,” it serves as an extended network of contracted providers, ensuring that employees covered under the University’s Medical insurance can access care and receive the benefits of in-network coverage, even when outside the primary service area.

While employees have the freedom to choose any healthcare provider, those participating in the University’s Medical insurance can benefit from a higher level of coverage by opting for network participating providers. Should you reside or travel outside of the service area, accessing providers within the University’s out-of-area network becomes possible through the wrap around networks listed on the back of your insurance card.

Current Health plan wrap networks include:

• Healthlink 800-624-5356, healthlink.com
• Freedom Network Select: phpkc.com
• FirstHealth: 800-226-5116, firsthealth.com

Each website will allow you to search for participating providers either by specific facility or provider name, or a general zip code search. You may also refine your search criteria by specialty.

Dos and Don’ts

Do:

• If you do not live outside of the service area:  Call Med-pay for prior authorization.
  • If a Covered person is seeking services by a Wrap or Non-Network provider when services are available in the network area by a Network provider, prior to seeking services, the Network provider in that specialty must submit a referral to the Utilization Review Coordinator to determine if the services will be considered under the Network Provider Benefit & the time period for which the services will be approved under this exception.
  • If a Covered person is seeking Mercy Tertiary Network Provider in the Mercy extended PPO coverage area outside Southwest Missouri, a referral is required and must be submitted to the Utilization Review coordinator for approval. If approved, the Network provider benefit will apply.
  • See the plan document for further plan information, limitations, and exceptions.

Don’t:

• Ask the provider if they “take your insurance” or “accepts Med-pay”.
  • Med-pay is a third-party administrator, processing the University’s health plan.
  • Providers often will “accept” any insurance payment; that affirmation does not indicate that they are a contracted or participating provider.
    • Instead, it’s more appropriate to inquire if the provider participates in the network; giving the provider the network name (Healthlink/ Freedom Network Select/ FirstHealth)

Understanding your health plan and the available wrap networks can significantly enhance your healthcare experience. By leveraging these networks effectively, you can ensure access to quality care wherever you may be.

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