Medical 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 bcbsks.com.
In-Network |
Out-of-Network |
|
---|---|---|
Deductible |
$2,500/$5,000 |
$2,500/$5,000 |
Out-of-Pocket Max |
$6,350/$12,700 |
$6,350/$12,700 |
Member Coinsurance |
20% |
20% |
Preventive Care |
100% |
Deductible, then Coinsurance |
Primary Care Visit |
$35 Copay |
$35 Copay |
Telemedicine |
$35 Copay |
$35 Copay |
Specialist Visit |
$70 Copay |
$70 Copay |
Inpatient Surgery |
Deductible, then Coinsurance |
Deductible, then Coinsurance |
Outpatient Surgery |
Deductible, then Coinsurance |
Deductible, then Coinsurance |
Urgent Care |
$35 Copay |
$35 Copay |
Emergency Room |
$250 Copay, then Deductible & Coinsurance |
$250 Copay, then Deductible & Coinsurance |
Retail Prescriptions
|
In-Network |
Out-of-Network |
---|---|---|
Tier 1 |
$15 Copay |
$15 Copay |
Tier 2 |
$50 Copay |
$50 Copay |
Tier 3 |
$75 Copay |
$75 Copay |
Tier 4 |
$150 Copay |
Not Covered |
Specialty |
20% up to $250 |
Not Covered |
Mail Order Prescriptions |
||
90 Day Supply |
2.5 x Retail Copay |
2.5 x Retail Copay |
Monthly Cost |
|
---|---|
Employee Only |
$86.98 |
Employee + Spouse |
$380.00 |
Employee + Child(ren) |
$380.00 |
Employee + Family |
$525.00 |
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 bcbsks.com.
In-Network |
Out-of-Network |
|
---|---|---|
Deductible |
$1,000/$2,000 |
$1,000/$2,000 |
Out-of-Pocket Max |
$5,000/$10,000 |
$5,000/$10,000 |
Member Coinsurance |
20% |
20% |
Preventive Care |
100% |
Deductible, then Coinsurance |
Primary Care Visit |
$35 Copay |
$35 Copay |
Telemedicine |
$35 Copay |
$35 Copay |
Specialist Visit |
$35 Copay |
$35 Copay |
Inpatient Surgery |
Deductible, then Coinsurance |
Deductible, then Coinsurance |
Outpatient Surgery |
Deductible, then Coinsurance |
Deductible, then Coinsurance |
Urgent Care |
$35 Copay |
$35 Copay |
Emergency Room |
$250 Copay, then Deductible & Coinsurance |
$250 Copay, then Deductible & Coinsurance |
Retail Prescriptions |
In-Network |
Out-of-Network |
---|---|---|
Tier 1 |
$15 Copay |
$15 Copay |
Tier 2 |
$50 Copay |
$50 Copay |
Tier 3 |
$75 Copay |
$75 Copay |
Tier 4 |
$150 Copay |
Not Covered |
Speciality |
20% up to $250 |
Not Covered |
Mail Order Prescriptions |
||
90 Day Supply |
2.5 x Retail Copay |
2.5 x Retail Copay |
Monthly Cost |
|
---|---|
Employee Only |
$199.28 |
Employee + Spouse |
$510.00 |
Employee + Child(ren) |
$510.00 |
Employee + Family |
$700.00 |
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 bcbsks.com.
In-Network |
Out-of-Network |
|
---|---|---|
Deductible |
$5,000/$10,000 |
$5,000/$10,000 |
Out-of-Pocket Max |
$6,350/$12,700 |
$6,350/$12,700 |
Member Coinsurance |
0% |
0% |
Preventive Care |
100% |
Deductible |
Primary Care Visit |
Deductible |
Deductible |
Telemedicine |
Deductible |
Deductible |
Specialist Visit |
Deductible |
Deductible |
Inpatient Hospital |
Deductible |
Deductible |
Outpatient Hospital |
Deductible |
Deductible |
Urgent Care |
Deductible |
Deductible |
Emergency Room |
Deductible |
Deductible |
Retail Prescriptions |
In-Network |
Out-of-Network |
---|---|---|
Tier 1 |
$15 Copay |
$15 Copay |
Tier 2 |
$50 Copay |
$50 Copay |
Tier 3 |
$75 Copay |
$75 Copay |
Tier 4 |
$150 Copay |
Not Covered |
Speciality |
20% up to $250 |
Not Covered |
* Integrated Drugs (Pharmacy Submitted) until deductible is met, then the tier co-pay coverage begins. |
||
Mail Order Prescriptions* |
||
90 Day Supply |
2.5 x Retail Copay |
2.5 x Retail Copay |
* Medical deductible must be met in full before copay amounts shown will apply. |
Monthly Cost |
|
---|---|
Employee Only |
$0.00 |
Employee + Spouse |
$260.00 |
Employee + Child(ren) |
$260.00 |
Employee + Family |
$400.00 |
Provided By
Blue Cross Blue Shield of Kansas
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