Provided By
Blue Cross Blue Shield of Kansas City
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Customer Service
Resources
Frequently Asked QuestionsMedical Benefits
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit https://mybluekc.com.
Preferred Care Blue Network |
In-Network |
Out-of-Network |
|---|---|---|
Deductible |
$750/$2,250 |
$1,500/$4,500 |
Coinsurance (Plan pays/Member pays) |
80% / 20% |
40% |
Out-of-Pocket Max |
$3,000/$6,000 |
$8,000/$16,000 |
Physician Visits |
||
Primary Care |
$20 Copay |
40% Coinsurance after Deductible |
Specialist |
$20 Copay |
40% Coinsurance after Deductible |
Routine Preventive |
Covered at 100% |
40% Coinsurance after Deductible |
Telehealth |
$20 Copay |
N/A |
Hospital Services |
||
Inpatient Hospitalization |
$250 Copay + Deductible + 20% |
Deductible + 40% |
Physician Services |
Deductible + 20% |
|
Outpatient Surgery |
Deductible + 20% |
Deductible + 40% |
Outpatient Diagnostics |
Deductible + 20% |
40% Coinsurance after Deductible |
Chiropractic Services |
$20 Copay |
Deductible + 40% |
Urgent Care Visit |
$20 Copay |
Deductible + 40% |
Emergency Room Visit |
$100 Copay per visit + Deductible + 20% Coinsurance |
$100 Copay per visit + Deductible + 20% Coinsurance |
Prescription Card |
||
Retail |
||
Tier 1 |
$10 Copay |
$10 Copay |
Tier 2 |
$20 Copay |
$20 Copay |
Tier 3 |
$40 Copay |
$40 Copay |
Tier 4 |
30% Coinsurance |
30% Coinsurance |
Mail Order |
||
Tier 1 |
$25 Copay |
$25 Copay |
Tier 2 |
$60 Copay |
$60 Copay |
Tier 3 |
$120 Copay |
$120 Copay |
Tier |
Per Pay Day Employee Cost |
|---|---|
Employee Only |
$37.25 |
Employee + 1 or more |
$388.80 |
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit https://mybluekc.com.
Preferred Care Blue Network |
In-Network |
Out-of-Network |
|---|---|---|
Deductible (Employee/Family) |
$1,500 / $3,000 |
$3,000 / $6,000 |
Coinsurance (Plan pays/Member pays) |
80% / 20% |
60% / 40% |
Out-of-Pocket Maximum (Employee/Family) |
$5,000 / $10,000 |
$8,000 / $16,000 |
Physician Visits |
||
Primary Care |
$20 Copay |
Deductible + 40% |
Specialist |
$20 Copay |
Deductible + 40% |
Routine Preventive |
Covered at 100% |
Deductible + 40% |
Telehealth |
$20 Copay |
N/A |
Hospital Services |
||
Inpatient Hospitalization |
$250 Copay + Deductible + 20% |
Deductible + 40% |
Physician Services |
Deductible + 20% |
Deductible + 40% |
Outpatient Surgery |
Deductible + 20% |
Deductible + 40% |
Outpatient Diagnostics |
Deductible + 20% |
Deductible + 40% |
Chiropractic Services |
$20 Copay |
Deductible + 40% |
Urgent Care Visit |
$20 Copay |
Deductible + 40% |
Emergency Room Visit |
$100 Copay per visit + Deductible + 20% Coinsurance |
$100 Copay per visit + Deductible + 20% Coinsurance |
Prescription Card |
||
Retail |
||
Tier 1 |
$10 Copay |
$10 Copay |
Tier 2 |
$20 Copay |
$20 Copay |
Tier 3 |
$40 Copay |
$40 Copay |
Tier 4 |
30% Coinsurance |
30% Coinsurance |
Mail Order |
||
Tier 1 |
$25 Copay |
$25 Copay |
Tier 2 |
$60 Copay |
$60 Copay |
Tier 3 |
$120 Copay |
$120 Copay |
Tier |
Per Pay Day Employee Cost |
|---|---|
Employee |
$0.00 |
Employee + 1 or more |
$288.24 |
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs and the needs of your family.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit https://mybluekc.com.
Preferred Care Blue |
In-Network |
Out-of-Network |
|---|---|---|
Deductible (Employee/Family) |
$3,500 / $5,000 |
$5,000 / $10,000 |
Coinsurance (Plan pays/Member pays) |
0% / 100% |
0% / 100% |
Out-of-Pocket Maximum (Employee/Family) |
$6,000 / $12,000 |
$10,000 / $20,000 |
Physician Visits |
||
Primary Care |
Deductible + 20% |
Deductible + 40% |
Specialist |
Deductible + 20% |
Deductible + 40% |
Routine Preventive |
Covered at 100% |
Deductible + 40% |
Telehealth |
Deductible + 20% |
Deductible + 40% |
Hospital Services |
||
Inpatient Hospitalization |
Deductible + 20% |
Deductible + 40% |
Physician Services |
Deductible + 20% |
Deductible + 40% |
Outpatient Surgery |
Deductible + 20% |
Deductible + 40% |
Outpatient Diagnostics |
Deductible + 20% |
Deductible + 40% |
Chiropractic Services |
Deductible + 20% |
Deductible + 40% |
Urgent Care Visit |
Deductible + 20% |
Deductible + 40% |
Emergency Room Visit |
Deductible + 20% |
Deductible + 20% |
Prescription Card |
||
Retail |
||
Tier 1 |
Deductible, then $10 Copay |
Deductible, then $10 Copay |
Tier 2 |
Deductible, then $20 Copay |
Deductible, then $20 Copay |
Tier 3 |
Deductible, then $40 Copay |
Deductible, then $40 Copay |
Tier 4 |
Deductible, then 30% Coinsurance |
Deductible, then 30% Coinsurance |
Mail Order |
||
Tier 1 |
Deductible, then $25 Copay |
Deductible, then $25 Copay |
Tier 2 |
Deductible, then $60 Copay |
Deductible, then $60 Copay |
Tier 3 |
Deductible, then $120 Copay |
Deductible, then $120 Copay |
Tier |
Per Pay Day Employee Cost |
|---|---|
Employee |
$0.00 |
Employee + 1 or more |
$158.57 |
Provided By
Blue Cross Blue Shield of Kansas City
Provider Website
Customer Service
Resources
Frequently Asked Questions