Under 65    Over 65    Groups 1-9    Groups 10-99    Groups 100+    Other Plans

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
• Nervous & mental (limited)
• 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

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 option.

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.