Medical Benefits

Your employer offers medical insurance that covers expenses such as visits to the doctor’s office, emergency care, and prescription drugs. 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 a doctor in the Preferred Care Blue Network please visit www.member.bluekc.com.

	In-Network	Out-of-Network
Deductible (Individual/Family)	$1,000/$2,000	$1,000/$2,000
Member Coinsurance	20%	40%
Out-of-Pocket Max (Individual/Family)	$2,500/$5,000	$5,000/$10,000
Preventive Care	No Charge	Not Covered
Primary Care	$25 Copay	Deductible + 40%
Virtual Care	$10 Copay	Not Applicable
Specialist	$25 Copay	Deductible + 40%
Urgent Care	$25 Copay	Deductible + 40%
Emergency Care	$100 Copay, then Deductible + 20%	$100 Copay, then Deductible + 20%

Retail Prescriptions (up to a 34-day supply)	In-Network	Out-of-Network
Tier 1	$15 Copay	Retail Copay + 50%
Tier 2	$70 Copay	Retail Copay + 50%
Tier 3	$110 Copay	Retail Copay + 50%
Tier 4	$200 Copay	Retail Copay + 50%
Mail Order Prescriptions (up to a 102-day supply)
	2.5 Retail Copay	Retail Copay + 50%

	Rate	Employer Share	Employee Share	Bi-Weekly Rate (26 Pay Periods)
Employee Only	$872.26	$436.13	$436.13	$201.29
Employee + Spouse	$2,198.50	$436.13	$1,762.37	$813.40
Employee + Child(ren)	$1,683.07	$436.13	$1,246.94	$575.51
Employee + Family	$2,494.87	$436.13	$2,058.74	$950.19

Downloads

Summary of Benefits

Summary of Benefits-Spanish

BlueKC Member Guide

Virtual Care Flyer

Blue KC Mindful Flyer

	In-Network	Out-of-Network
Deductible (Individual/Family)	$3,300/$6,600	$3,300/$6,600
Member Coinsurance	0%	20%
Out-of-Pocket Max (Individual/Family)	$3,300/$6,600	$6,600/$13,200
Preventive Care	No Charge	Deductible + 20%
Primary Care	Deductible	Deductible + 20%
Virtual Care	Deductible ($60 Charge)	Not Applicable
Specialist	Deductible	Deductible + 20%
Urgent Care	Deductible	Deductible + 20%
Emergency Care	Deductible	Deductible

Retail Prescriptions (up to a 34-day supply)	In-Network	Out-of-Network
Tier 1	Deductible	Deductible + 50%
Tier 2	Deductible	Deductible + 50%
Tier 3	Deductible	Deductible + 50%
Mail Order Prescriptions (up to a 102-day supply)
	Deductible	Deductible + 50%

	Rate	Employer Share	Employee Share	Bi-Weekly Rate (26 Pay Periods)
Employee Only	$792.97	$396.49	$396.48	$182.99
Employee + Spouse	$1,998.28	$396.49	$1,601.79	$739.29
Employee + Child(ren)	$1,530.43	$396.49	$1,133.94	$523.36
Employee + Family	$2,267.89	$396.49	$1,871.40	$863.72