Blue Cross and Blue Shield of Kansas (BCBSKS) has member contract changes effective 7/1/2011 resulting in the following:

Preventive Service Benefits

• Member cost sharing will not apply when Preventive Services are received by an in network provider. Members will be responsible for deductible and coinsurance amounts when Preventive Services are received from a non-contracting provider.
• Prostate Specific Antigen – Prostate Specific Antigen (PSA) is no longer a preventive service for non-grandfathered plans. Effective July 1, 2011, PSAs will be processed according to the member benefits. Plans which included PSA as a preventive benefit prior to the March 23, 2010, Affordable Care Act (ACA) ruling, that renewed their plan coverage after March 23, 2010 to include the ACA preventive benefit services are now non-grandfathered plans. The PSA remains a covered service subject to member benefits.

New Oral Chemotherapy Benefit

• Oral Chemotherapy – Due to a state mandate Oral Chemotherapy will be covered at 100 percent of allowed charge under the grandfathered and non-grandfathered plans BlueRx Card, BlueRx Rider, and BlueRx Direct prescription drug programs. This benefit is effective for group renewals beginning July 1, 2011.

For a quick reference guide when submitting claims for preventative services, click here.

Additional information on Preventive Services covered under the Affordable Care Act is available on the bcbsks.com website.

A complete list of Preventive Services Covered under the Affordable Care Act can be viewed at www.healthcare.gov.

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