Lowest cost Blue KC plan offered to small group employees.

Provides two visits to a Primary Care Physician (PCP) at a low copayment before deductible or coinsurance applies.

Available only in the BlueSelect network service area (Johnson and Wyandotte counties in Kansas and Clay, Jackson and Platte counties in Missouri)

Basic Plan Variations

Basic Silver
BlueSelect7 with BlueCard
(Available for purchase directly from Blue KC)1
Basic Bronze
BlueSelect7 with BlueCard
(Available for purchase directly from Blue KC)1
Network IN OUT IN OUT
DEDUCTIBLE
SINGLE $2,750 not covered $6,000 not covered
FAMILY $5,500 not covered $12,000 not covered
OUT OF POCKET MAX
SINGLE $5,000 not covered $7,000 not covered
FAMILY $10,000 not covered $14,000 not covered
COST SHARING
COINSURANCE 40% not covered 40% not covered
PCP2 $10 Copay first 2 visits, Ded/Coins 3+ visits $25 Copay first 2 visits, Ded/Coins 3+ visits
SPECIALIST Ded then 40% Ded then 40%
URGENT CARE Ded then 40% Ded then 40%
ER Ded then 40% Ded then 40%
PHARMACY3 Tiers 2-4: $1,000 Deductible
Tier 1: $10/$20
Tier 2: Ded then $55 / Ded then $80
Tier 3: Ded then 20% (Max $250) / Ded then 20%
Tier 44: Ded then 30% / Ded then 30%
Tiers 2-4: $1,000 Deductible
Tier 1: $20/$30
Tier 2: Ded then $80 / Ded then $100
Tier 3: Ded then 20% (Max $250) / Ded then 20%
Tier 44: Ded then 30% / Ded then 30%
DEDUCTIBLE TYPE5 EMBEDDED EMBEDDED

Summary of Benefits and Coverage

View a complete list of Summary of Benefits and Coverage Documents.

  • The Basic product is an Exclusive Provider Organization (EPO), which means out-of-network benefits are not covered, with the exception of Emergency Services and certain mental health benefits.
  • Benefits under Basic products are limited for Missouri residents to services provided by BlueSelect providers. Services provided by Non-Preferred (i.e., out-of-network) providers are not covered except for Emergency Services and certain Mental Health office visits. If you choose to offer Basic products to your employees, you must also offer a non-Basic product.
  • 1 Blue KC is a Qualified Health Plan issuer on the Individual Health Insurance Marketplace. With the exception of Short-Term Security plans, all Blue KC products qualify as Minimum Essential Coverage under the Affordable Care Act (ACA), meaning you will not be subject to the individual mandate penalty for any months you are enrolled in the product.
  • 2 Primary Care Physicians include General Practice, Family Practice, Internal Medicine, and Pediatrics.
  • 3 Maintenance medications must be filled through the mail-order pharmacy to receive the lowest copay. Individuals will be charged two times the applicable copay for a maintenance medication at retail pharmacies after the second prescription is filled.
  • 4 Tier 4 specialty medications should be filled through the mail-order pharmacy to receive the lowest copay. Members will be charged up to two times the applicable copay for a specialty medication at retail pharmacies. Some specialty medications are only available through the mail order pharmacy. A list of those medications for Missouri members is available in the 2017 Missouri Prescription Drug List and for Kansas members in the 2017 Kansas Prescription Drug List.
  • 5 Embedded—An individual deductible you must satisfy each calendar year before benefits will be paid. Aggregate – The entire family deductible must be satisfied each calendar year before benefits for any covered person will be paid.

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