BlueCare℠ DeluxeSG Choice
When you choose a health insurance plan, you want to get the most out of your health care dollars – today, more than ever. Blue Cross and Blue Shield of Kansas developed BlueCare plans with you in mind. BlueCare helps put you in control of your health care.
|Deductible||$0||$2,500 per person / $5,000 family|
(percentage paid by member)
|Coinsurance maximum||Same as the annual out-of-pocket maximum||$7,000 per person / $14,000 family|
|Annual out-of-pocket maximum||$3,250 per person / $6,500 family||Includes the deductible and coinsurance maximum for health benefits only|
|Doctor's Office Visits|
|Home and office visits - Primary||Subject to coinsurance||Subject to deductible and coinsurance|
|Home and office visits - Specialists|
|Preventive care||These services are paid at 100%
of the allowable charge.
Some of the services include:
|Prescription drugs||Subject to coinsurance||Subject to deductible and coinsurance|
|Mail order drugs|
|Emergency medical transportation||Subject to coinsurance||Subject to deductible and coinsurance|
|Inpatient surgery physician/surgical|
|Inpatient facility fee|
|Outpatient surgery physician/surgical|
|Outpatient lab and radiology|
|Advanced imaging (CT/PET scans, MRIs)|
|Emergency Room||Subject to in-network ER benefits|
|Injections||Subject to deductible and coinsurance|
|Dental and Vision|
|Pediatric dental (for ages 0-19)||Subject to coinsurance||Subject to deductible and coinsurance|
|Pediatric vision (for ages 0-19)|
|Outpatient rehabilitation||Subject to coinsurance||Subject to deductible and coinsurance|
|Home health care|
|Mental Illness/Substance Use Disorders|
|Mental illness/substance use disorders - inpatient services
Requires pre-admission certification from New Directions Behavioral Health at 1-800-952-5906
|Provided at the same payment level that is applicable to the service provided for a condition other than the mental health disorders|
|Mental illness/substance use disorders - outpatient services|
|Lifetime maximum||Unlimited for each covered person|
|Eligible dependents||Covered to age 26|
Exclusions: Following is a list of common non-covered services. For a complete list of limitations and exclusions, refer to your certificate.
Duplicate benefits provided under federal, state or local laws, regulations or programs except Medicaid; services involving cosmetic or reconstructive surgery (except as state in the contract); charges for personal items; convalescent or custodial care or rest cure; routine adult eye exams (vision benefits are provided for insureds up to age 19); all keratotomy procedures; blood or payments to donors of blood; any service or supply related to the medical management of obesity, except services covered as preventive health benefits; services or supplies related to sex transformations; services related to the reversal of sterilization procedures; any medically-aided insemination procedure; charges for services by immediate relatives or by members of the household; acupuncture and admission for acupuncture; medically unnecessary services and admissions; services covered and payable under any medical expense payment provision of any automobile insurance policy; mental illness or substance use disorder services provided by a non-eligible provider; services, supplies or treatments not specifically listed as covered in the member’s contract.
Drug coverage limitation: Generic drugs are mandatory if available unless physician prescribes a brand drug.
- Dental Program
- Hospital Indemnity Plan
- Life Insurance
- Long-term Care Insurance
- Plan 150 (Cancer Policy)
Additional Program Information
- Inpatient Admissions - Pre-admission certification is required for all planned inpatient admissions.
- Benefit Period - The 12-month period based on the group anniversary month.
- Waiting Period - Businesses select a waiting period option.
Dual Option Plan
The Dual Option Plan is available to groups of 2 to 50 employees with this product. The plan offers employees one of two out-of-pocket choices annually. This provides employees the option to "buy up" to a better level of coverage, based on their personal insurance needs.
Contact us to learn more about the features of DeluxeSG Choice.