Designed for employees who want cost certainty when they need commonly used services, along with coverage for unexpected accidents or illness.

Eliminates uncertainty on the cost of office visits and other frequently accessed services.

Deductible and coinsurance reserved for less commonly used services.

Available only on the Preferred-Care Blue Network.

Classic Plan Variations

Classic PCB Gold5
Preferred-Care Blue with BlueCard
(Available for purchase directly from Blue KC)1
Classic PCB Silver5
Preferred-Care Blue with BlueCard
(Available for purchase directly from Blue KC)1
Classic2 PCB Silver5
Preferred-Care Blue with BlueCard
(Available for purchase directly from Blue KC)1
Network IN OUT IN OUT IN OUT
DEDUCTIBLE
SINGLE $750 $750 $3,500 $3,500 $5,000 $5,000
FAMILY $1,500 $1,500 $7,000 $7,000 $10,000 $10,000
OUT OF POCKET MAX
SINGLE $6,500 $13,000 $7,000 $14,000 $7,000 $14,000
FAMILY $13,000 $26,000 $14,000 $28,000 $14,000 $28,000
COST SHARING
COINSURANCE 0% 30% 40% 60% 0 20%
PCP1 $20/$40 COPAY Ded then 30% Coins $40/$60 COPAY Ded then 60% Coins $40/$60 COPAY Ded then 20% Coins
SPECIALIST $80 COPAY Ded then 30% Coins $100 COPAY Ded then 60% Coins $100 COPAY Ded then 20% Coins
URGENT CARE $60 COPAY Ded then 30% Coins $80 COPAY Ded then 60% Coins $80 COPAY Ded then 20% Coins
ER $500 COPAY $600 COPAY $600 COPAY
PHARMACY2 Tier 1: $10
Tier 2: $55
Tier 3: 20% (MAX $250)
Tier 43: DED THEN 30%
Tier 1: $10
Tier 2: $55
Tier 3: 20% (MAX $250)
Tier 43: DED THEN 30%
Tier 1: $10
Tier 2: $55
Tier 3: 20% (MAX $250)
Tier 43: DED THEN 30%
DEDUCTIBLE TYPE4 EMBEDDED EMBEDDED EMBEDDED

Summary of Benefits and Coverage

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

  • 1 Primary Care Physicians include General Practice, Family Practice, Internal medicine and Pediatrics.
  • 2 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. Cost-sharing for out-of-network pharmacy claims in all PPO products is 50% coinsurance after deductible.
  • 3 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 2018 Missouri Prescription Drug List and for Kansas members in the 2018 Kansas Prescription Drug List.
  • 4 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.
  • 5 These Preferred-Care Blue plans use the lower PCP copayment for Patient-Centered Medical Home (PCMH) visits

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Good health starts with good support. That's why every Blue KC member has access to the resources they need to live healthy. From Health Risk Assessments to health and wellness programs. From prenatal programs to preventive care. We're committed to improving the health of our members and our community.

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We'll help you, and your employees, understand the lay of the healthcare landscape. Navigate through all the twists and turns. And make decisions that benefit the bottomline. After all, the smarter we are, the healthier we can be.

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