Medical Plan Comparison

 

BCBSKC Health Saving Account

BCBSKC Traditional PPO

BCBSKC Buy-Up PPO

In-Network
Non-Network
In-Network
Non-Network
In-Network
Non-Network
ANNUAL MAXIMUM BENEFITSUnlimitedUnlimitedUnlimitedUnlimitedUnlimitedUnlimited
EmployerHealth Savings Account (HSA) Match Contribution 1/1/20 Prorated for New Hires
    Single

$500

Not Applicable

Not Applicable

    Family

Not Applicable

Not Applicable

DEDUCTIBLES
    Single

$2,700

$2,500

$1,500

    Family

$5,400

$5,000

$3,000

OUT-OF-POCKET MAXIMUMS (includes deductible)
    Single
$2,700 $13,000 $6,350 $12,700 $5,000 $10,000
    Family
$5,400 $26,000$12,700 $25,400$10,000 $20,000
PLAN CO-PAYMENTS
    Office Visit
0% after deductible40% after deductible$35 copay60% after deductible$35 copay50% after deductible
    Specialist Office Visit
0% after deductible40% after deductible$70 copay60% after deductible$70 copay50% after deductible
    Preventive Care
Covered at 100%40% after deductibleCovered at 100%60% after deductibleCovered at 100%50% after deductible
    Urgent Care Visit
0% after deductible40% after deductible$70 copay60% after deductible$70 copay50% after deductible
    Emergency Room

0% after deductible

$200 copay, plus 30% after deductible

$200 copay, plus 20% after deductible

    Hospitalization
0% after deductible40% after deductible30% after deductible60% after deductible20% after deductible50% after deductible
    Outpatient Surgery
0% after deductible40% after deductible30% after deductible60% after deductible20% after deductible50% after deductible
PRESCRIPTION DRUG COPAY
    Retail Generic

Preventative Generic: covered at 100%
Generic, Preferred, and Non-Preferred: 0% after deductible

Deductible, then 50% after applicable copays
Generic:$10
Preferred Brand: $40
Non-Preferred:50%

$10 copay

50% after applicable copay

$10 copay

50% after applicable copay

    Retail Preferred Brand
$40 copay$40 copay
    Retail Non-Preferred
50%50%
    Mail Order
102 days for 3 copays102 days for 3 copays