Providernetworks

PHARMACY
PROVIDER NETWORK

ProCare:  KYHC's pharmacy benefits are administered for KYHC by an organization known as ProCare. The ProCare logo on the back of your KYHC Member Identification Card signifies to pharmacists and other health care providers that KYHC uses the ProCare National Pharmacy Network.  In order to be considered "in-network" for covered pharmacy services, a provider must participate in ProCare's National Pharmacy Network.

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PEDIATRIC VISION
PROVIDER NETWORK

Avesis:  KYHC's pediatric vision benefit is administered for KYHC by an organization known as Avesis. Avesis issues separate (standalone) Identification Cards to KYHC members who are eligible for pediatric vision services. The Avesis logo on the standalone Identification Card signifies to health care providers that KYHC uses the Avesis provider network. In order to be considered "in-network" for covered pediatric vision services, a provider must participate in the Avesis provider network.

The KYHC Care Network and the First Health Network also have ophthalmologists, optometrists, and other kinds of vision services providers.  These vision services providers are not considered "in-network" for the pediatric vision benefit unless they participate in the Avesis provider network. However, such providers may qualify as "in-network" for other covered vision services which are not a part of the pediatric vision benefit. 

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BEHAVIORAL HEALTH & SUBSTANCE ABUSE
PROVIDER NETWORK

MHNet:  KYHC's behavioral health and substance abuse benefits are administered for KYHC by an organization known as MHNet. The MHNet logo on the back of your KYHC Member Identification Card signifies to health care providers that KYHC uses the MHNet Network.  In order to be considered "in-network" for covered behavioral health and substance abuse services, a provider must participate in the MHNet Network.

First Health Network: KYHC currently uses the First Health Network of health care providers for all types of Covered Services except pharmacy services; behavioral health and substance abuse services; and services associated with KYHC’s pediatric vision benefit. The First Health logo on the back of your KYHC Member Identification Card signifies to hospitals, physicians and other health care providers that KYHC uses the First Health Network for medical, surgical and other types of Covered Services. Please note that:

• Effective January 1, 2015, health care providers in the First Health Network who are located outside KYHC’s Network Service Area, will be considered “in-network” solely for emergency care and urgent care services.

KYHC’s Network Service Area is described in a later section.

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KYHC Care Network: KYHC has entered into direct agreements with a number of health care providers who may (or may not) also participate in the First Health Network. These providers with direct provider agreements are a part of the “KYHC Care Network.” The KYHC Care Network logo on the back of your KYHC Member Identification Card signifies to hospitals, physicians and other health care providers that KYHC uses the KYHC Care Network for medical, surgical and other types of Covered Services. As a general rule, providers in the KYHC Care Network will only be found inside KYHC’s Network Service Area. (KYHC’s Network Service Area is described in the next section).