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 member.bluekc.com.

	Network	Non-Network
Member Coinsurance	20%	40%
Deductible (Individual/Family)	$2,000/$6,000	$2,000/$6,000
Out-of-Pocket Max (Individual/Family)	$5,000/$10,000	$10,000/$20,000
Physician Visits
Primary Care	$35 Copay	Deductible+40%
Preventive Care	Fully Covered	Deductible+40%
BlueKC Telehealth	Fully Covered	Deductible+40%
Specialist	$70 Copay	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%
Urgent Care	$70 Copay	Deductible+40%
Emergency Room	$100 Copay per visit, then Ded. + 20%	$100 Copay per visit, then Ded. + 20%
Prescription Drugs
Retail	$15 / $70/ $110/ $200 Copay	$15 / $70/ $110/ $200 Copay+50%
Mail Order	$37.50 / $175/ $275 Copay	$37.50 / $175/ $275 Copay+50%

	Total Rate	Employer Share	Employee Share	Per Pay Period
Employee Only	$597.49	$403.94	$193.55	$89.33
Employee + Spouse	$1,194.99	$807.88	$387.11	$178.67
Employee + Child(ren)	$1,135.24	$767.48	$367.76	$169.74
Employee + Family	$1,911.98	$1,292.60	$619.38	$285.87

Downloads

Summary of Benefits

Summary of Benefits-Spanish

Member Guide

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 member.bluekc.com.

	In-Network	Non-Network
Member Coinsurance	20%	40%
Deductible (Individual/Family)	$5,000/$10,000	$5,000/$10,000
Out-of-Pocket Max (Individual/Family)	$6,500/$13,000	$13,000/$26,000
Physician Visits
Primary Care	$35 Copay	Deductible + 40%
Preventive Care	Fully Covered	Deductible + 40%
BlueKC Telehealth	Fully Covered	Not Applicable
Specialist	$70 Copay	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%
Urgent Care	$70 Copay	Deductible + 40%
Emergency Room	$100 Copay per visit, then Ded. + 20%	$100 Copay per visit, then Ded. + 20%
Prescription Drugs
Retail	$15 / $70/ $110/ $200 Copay	$15 / $70/ $110/ $200 Copay+50%
Mail Order	$37.50 / $175/ $275 Copay	$37.50 / $175/ $275 Copay+50%

	Total Premium	Employer Share	Employee Share	Per Pay Period
Employee Only	$545.86	$434.27	$111.59	$51.50
Employee + Spouse	$1,091.71	$868.53	$223.18	$103.01
Employee + Child(ren)	$1,037.13	$825.11	$212.02	$97.86
Employee + Family	$1,746.74	$1,389.65	$357.09	$164.81

Downloads

Summary of Benefits

Summary of Benefits-Spanish

Member Guide

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 member.bluekc.com.

	Spira Center	BSP Network
Member Coinsurance	0%	0%
Deductible (Individual/Family)	None	$5,000/$10,000
Out-of-Pocket Max (Individual/Family)	$5,000/$10,000	$5,000/$10,000
Physician Visits
Primary Care	No Charge (includes Mental Health)	Deductible
Preventive Care	No Charge	Fully Covered
BlueKC Telehealth	No Charge	Fully Covered
Specialist	Not Applicable $60 Copay	Deductible
Hospital Services
Inpatient Hospitalization	Not Applicable	Deductible
Physician Services	Not Applicable	Deductible
Outpatient Surgery	Not Applicable	Deductible
Outpatient Diagnostics	No charge for basic labs & x-rays	Deductible
Urgent Care	No Charge	Deductible
Emergency Room	Not Applicable	Deductible
Prescription Drugs
Retail	$15 / $70/ $110/ $200 Copay	$15 / $70/ $110/ $200 Copay
Mail Order	Not Applicable	$37.50 / $175/ $275 Copay

	Total Rate	Employer Share	Employee Share	Per Pay Period
Employee Only	$479.47	$380.59	$98.88	$45.64
Employee + Spouse	$958.94	$761.18	$197.76	$91.27
Employee + Child(ren)	$910.99	$723.12	$187.87	$86.71
Employee + Family	$1,534.30	$1,217.89	$316.41	$146.04