Comprehensive Major Medical
This program combines basic hospital, medical and surgical coverage with major medical coverage to offer you a complete range of health care services. A choice of deductible and coinsurance options is available. You'll enjoy the freedom to choose any health care provider. Payment will be made at the maximum allowance when eligible services are received from BCBSKS contracting providers.
With Comprehensive Major Medical, you pay a predetermined deductible for covered services. After that deductible has been met, you pay 20 percent of allowed charges to a predetermined maximum. After that maximum has been met, Blue Cross and Blue Shield of Kansas pays 100 percent of allowed charges for the balance of the benefit period. Accident care may or may not be subject to a deductible and coinsurance.
Learn how the Blue Choice network enhances your Comprehensive Major Medical coverage
Benefit Summary (Benefits include but are not limited to:)
- In-hospital care
- Surgery & anesthesia
- Maternity & newborn services (husband and wife must be enrolled in same plan)
- Radiology & lab services
- Immunizations
- Outpatient prescription drugs
- Ambulance
- Hearing tests
- Eye exams
- Allergy tests
- Physical medicine
- Medical equipment
- Routine physicals
- Private duty nursing (limited)
- Dental (limited to covered services)
- Outpatient surgery
- Second surgical opinion
- Emergency services
- Mental illness & substance use disorders
Deductible
A choice of deductibles is available:
- $500 per person/$1,000 family
- $1,000 per person/$2,000 family
Coinsurance
Expenses are covered at 80 percent up to $1,000 per person/$2,000 family, then BCBSKS pays 100 percent of allowed charges for the remainder of the benefit period.
Optional Benefits:
- Dental Program
- Hospital Indemnity Program
- Life Insurance
- Long-term Care Insurance
- Plan 150 (Cancer Policy)
Exclusions
See the Exclusions page for details.
Additional Program Information
- Lifetime Maximum - Up to $5 million in lifetime benefits for each covered person.
- Inpatient Admissions - Pre-admission certification is required for all planned inpatient admissions.
- Dependent Coverage - Unmarried dependent children are covered to age 23.
- Benefit Period - A 12-month period beginning on the date your health insurance coverage starts.
- Waiting Period - A 240-day waiting period on new contracts applies to obstetrical services; operations for removal of tonsils and/or adenoids; treatment for tumors or growths; treatment for hernia; and treatment for conditions of gallbladder, rectum and genito-urinary tract.
More Information
- Phone: Learn more about the features of Comprehensive Major Medical by calling 785-291-4303 in Topeka or toll-free at 1-800-874-1823, 8 a.m. to 4:30 p.m., Monday through Friday.
- E-mail: Send a note to our Comprehensive Major Medical representative. Please provide a daytime phone number in your message indicating where and when you can be reached. All requests will be responded to via phone within two business days.
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