We offer three levels of plans
We keep things clear and simple with three plan levels: Bronze, Silver and Gold. Each level balances what you pay monthly with what you pay when you need care. Think of it like this—Bronze plans have lower monthly costs, but higher out-of-pocket expenses when you visit the doctor. Gold plans cost more each month, but typically cover more of your care costs. Our team can help you find the sweet spot that works for your health needs and budget.
To help guide you through shopping, use our consumer guides based on if you are a Metro or Rural county resident:
Gold Plans
On average Blue KC pays 80% of covered, in-network costs and you pay the remaining 20%
| High monthly premiums Lower deductible and out-of-pocket costs for care Ideal for individuals and families needing frequent medical services |
| In-network costs (Individual / Family) | Standard Gold |
|---|---|
| Key Feature | N/A |
| Deductible | $2,500/$5,000 |
| Coinsurance | 25% |
| Out-of-pocket max | $8,600/$17,200 |
| PCP network visit | $30 |
| Generic prescriptions | $15 |
| In-network costs (Individual / Family) | Simply Blue Gold |
|---|---|
| Key Feature | Low deductible & access to Spira Care |
| Deductible | $2,100/$4,200 |
| Coinsurance | 25% |
| Out-of-pocket max | $8,400/$16,800 |
| PCP network visit | $0 Spira Care $50 In-Network |
| Generic prescriptions | $10 |
Silver Plans
On average, Blue KC pays 70% of covered, in-network costs and you pay the remaining 30%
| These plans offer a balance of a monthly premium and out-of-pocket costs for care Moderate monthly premiums Cost-sharing reductions based on family size and household income Popular choice for many individuals and families who anticipate some medical services throughout the year, outside of preventive care services |
| In-network costs (Individual / Family) | First Silver |
|---|---|
| Key Feature | N/A |
| Deductible | $5,500 / $11,000 |
| Coinsurance | 40% |
| Out-of-pocket max | $8,800 / $17,600 |
| PCP network visit | $30 |
| Generic prescriptions | $20 |
| In-network costs (Individual / Family) | Standard Silver |
|---|---|
| Key Feature | N/A |
| Deductible | $6,400 / $12,800 |
| Coinsurance | 40% |
| Out-of-pocket max | $10,300 / $20,600 |
| PCP network visit | $40 |
| Generic prescriptions | $20 |
| In-network costs (Individual / Family) | First Choice Silver |
|---|---|
| Key Feature | Low deductible & access to Spira Care |
| Deductible | $4,900 / $9,800 |
| Coinsurance | 40% |
| Out-of-pocket max | $8,500 / $17,000 |
| PCP network visit | $0 Spira Care $50 In-Network |
| Generic prescriptions | $20 |
| In-network costs (Individual / Family) | Community Silver |
|---|---|
| Key Feature | N/A |
| Deductible | $6,900 / $13,800 |
| Coinsurance | 40% |
| Out-of-pocket max | $8,550/$17,100 |
| PCP network visit | $40 |
| Generic prescriptions | $20 |
| In-network costs (Individual / Family) | Simply Blue First Silver |
|---|---|
| Key Feature | Access to Spira Care |
| Deductible | $5,400/$10,800 |
| Coinsurance | 40% |
| Out-of-pocket max | $8,300/$16,600 |
| PCP network visit | $0 Spira Care $50 In-Network |
| Generic prescriptions | $20 |
Bronze Plans
On average, Blue KC pays 60% of costs and you pay 40% of costs
| Typically have the lowest monthly premiums Highest deductibles and out-of-pocket costs Ideal for individuals and families who generally do not need medical services often throughout the year |
| In-network costs (Individual / Family) | Basic Bronze |
|---|---|
| Key Feature | N/A |
| Deductible | $12,000 / $24,000 |
| Coinsurance | 0% |
| Out-of-pocket max | $12,000 / $24,000 |
| PCP network visit | $0 Spira Care $0 after Ded In-Network |
| Generic prescriptions | Deductible |
| In-network costs (Individual / Family) | Standard Bronze |
|---|---|
| Key Feature | N/A |
| Deductible | $7,500 / $15,000 |
| Coinsurance | 50% |
| Out-of-pocket max | $12,000/$24,000 |
| PCP network visit | $50 |
| Generic prescriptions | $25 |
| In-network costs (Individual / Family) | First Bronze |
|---|---|
| Key Feature | N/A |
| Deductible | $9,900 / $19,800 |
| Coinsurance | 50% |
| Out-of-pocket max | $12,000/$24,000 |
| PCP network visit | $50 |
| Generic prescriptions | $30 |
| In-network costs (Individual / Family) | First Choice Bronze |
|---|---|
| Key Feature | Access to Spira Care |
| Deductible | $9,900 / $19,800 |
| Coinsurance | 50% |
| Out-of-pocket max | $12,000/$24,000 |
| PCP network visit | $0 Spira Care Ded & Coins In-Network |
| Generic prescriptions | $30 |
| In-network costs (Individual / Family) | Simply Blue First Bronze |
|---|---|
| Key Feature | Access to Spira Care |
| Deductible | $9,900 / $19,800 |
| Coinsurance | 50% |
| Out-of-pocket max | $12,000/$24,000 |
| PCP network visit | $0 Spira Care $75 In-Network |
| Generic prescriptions | $30 |
Advanced primary care with Spira Care
Great healthcare should be easy to access, easy to understand, and designed around you. That’s why Blue KC offers several health plans with exclusive access to Spira Care Centers—offering advanced primary care services, behavioral health support, and more, all under one roof. What you get with Spira Care:
With nine Spira Care Centers across Kansas City, you’ll have convenient, high-quality care designed to keep you and your family feeling your best.
Understanding health insurance and the Affordable Care Act
Buying health insurance on your own (rather than through an employer) can feel like a lot, but we’ve got you covered.
Care that’s always close to home
Whether you live in the city, out in the country or somewhere in between, we’ve built strong relationships with local doctors and hospitals to give you convenient access to care. Before you choose a plan, let’s make sure your favorites are covered.
Our local experts are ready to help with all your questions
Costs vary based on plan selected. Deductibles, exclusions, reductions, and limitations apply. For costs and further details of the coverage, including exclusions, any reductions or limitations and the terms under which the policy may be continued in force, see your insurance producer, or contact Blue KC.
Blue KC members enrolled in plans (without a Health Savings Account) with exclusive access to Spira Care will have no additional cost for any appointment or service provided at a Spira Care Center.
Spira Care appointment availability varies based on demand and capacity at each Care Center location on any given day. Saturday appointments are only available between 8 a.m. and noon at select locations.