Shared Pay Comprehensive
This program is complete, affordable coverage. Benefits begin immediately — there is no deductible to satisfy before coverage begins. With this program, you pay a 50 percent shared payment amount up to a selected out-of-pocket maximum. Then the program takes over and pays 100 percent of allowed charges for covered services for the remainder of the 12-month benefit period. The program offers up to $5 million in lifetime benefits.
Learn how the Blue Choice network enhances your Shared Pay Comprehensive coverage
Benefit Summary (Benefits include but are not limited to:)
Hospital Services:
- In-hospital care
- Radiology & lab services
- Ambulance services
- $100 Emergency Room copay
- Surgery & anesthesia
- Outpatient surgery
- Accident coverage – 100% up to $1,000
Medical Services:
- Vision & hearing tests
- Maternity & newborn services
- Eye examinations
- Mental illness & substance use disorders
- Prescription drugs – $15/$30/$45 BlueRx Card with mail order
- Home Health Care/Hospice
Out-of-pocket Maximum Choices:
- $750 per person/$1,500 two or more persons
- $1,500 per person/$3,000 two or more persons
- $3,000 per person/$6,000 two or more persons
Optional Benefits:
- Dental Program
- Life Insurance
- Hospital Indemnity Program
- 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 - The 12-month period based on the group anniversary month.
- Waiting Period - Businesses select a waiting period for new hires.
Triple Option Plan
The Triple Option Plan is available to groups of 2 to 50 employees with this product. The plan offers employees one of three out-of-pocket choices annually within the Shared Pay Comprehensive benefit program. The employer must contribute at least 25 percent of the employee-only premium amount for the highest out-of-pocket option. This stabilizes the group's base and gives the employees the option to "buy up" to a better level of coverage, based on their personal insurance needs.
More Information
- Phone: Learn more about the features of Shared Pay Comprehensive by calling 785-291-4303 in Topeka or toll-free at 1-800-874-1823.
- Tell Us About Your Business and a representative will contact you about your options.