Choosing a plan that's right for you
You may get a headache pondering the small print of a policy, but the basic idea behind health insurance is simple: It helps cover your costs if you need medical care.
So why does it have to be so complicated? All the terminology associated with health insurance can be confusing when you're trying to choose a plan. Learning about the general types of available coverage can help.
Traditional plans - In this system, the doctor or hospital charges a fee for medical care. In most cases, a Blue Cross and Blue Shield of Kansas contracting provider will send the claim to us for payment.
Most traditional plans require you to share in the cost in some way, in addition to your premium responsibility. This out-of-pocket amount is what you incur before insurance benefits begin to pay. Under most plans of this type, you can see any doctor you choose, including specialists. At BCBSKS, traditional benefit plans include:
- AffordaBlue - Designed to fit both a family's budget and health care needs, AffordaBlue offers preventive and catastrophic benefits everyone wants, with premiums as much as 25 percent lower than our two most popular major medical plans.
- Comprehensive Major Medical - This program combines basic hospital, medical and surgical coverage with basic or routine services plus more. A variety of cost-saving deductible and coinsurance options are available.
- Shared Pay Comprehensive - This program offers comprehensive coverage without a deductible. The costs of services are shared on a 50/50 basis, beginning with the member's first dollar of expense, until the out-of-pocket amount reaches a predetermined maximum.
- Blue Choice - This preferred provider organization (PPO) is designed to provide the same comprehensive benefits available under our traditional benefit plans. The Blue Choice network has been created through special contracts with hospitals, medical professionals, medical equipment suppliers and ambulatory surgical centers. By using Blue Choice contracting providers and obtaining pre-admission certification before any planned admission, maximum benefits are available.
- Basic Blue - This program offers basic hospital-medical-surgical coverage as the foundation of the program. Premium dollars are saved as a result of the cost-sharing features of the program and limiting or eliminating coverage for other features.
What's the difference
With a wide variety of benefit options available - from the most basic to a very comprehensive plan - you will want to select a plan that will meet your most crucial needs.
BCBSKS listens when our customers tell us what they want included in their health care coverage. The following are standard benefits we offer:
- Maternity care
- Outpatient prescription drugs
- Inpatient hospital room, incidentals and treatment
- ICU and CCU care
- Outpatient surgery and treatment
- Doctor's office visits
- Medical, surgical, therapeutic, exploratory and emergency care
- Dental (accident or injury)
- Accidental injury care
- Vision and hearing exams
- Radiology services, lab work and anesthesia
- Diagnostic blood tests
- Durable medical equipment
- Coverage for mental health and substance abuse care
- Back -