Blue cross blue shield of kansas benefits plan options
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Blue Cross Blue Shield of Kansas Benefits Plan Options. USD 336 Holton. Current Triple Option Plan. Deductible Option 1: $500/$1000 Option 2: $1000/$2000 Option 3: $1500/$3000 Coinsurance - $1000/$2000 (80/20%) Office Visit Copay - $20 no limits

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Blue cross blue shield of kansas benefits plan options

Blue Cross Blue Shield of Kansas

Benefits Plan Options

USD 336 Holton


Current Triple Option Plan

  • Deductible

    • Option 1: $500/$1000

    • Option 2: $1000/$2000

    • Option 3: $1500/$3000

  • Coinsurance - $1000/$2000 (80/20%)

  • Office Visit Copay- $20 no limits

  • Accident Coverage – Subject to deductible / coinsurance

  • Prescription Drugs - $15/30/45 copay, Mail order $37.50/75/112.50


High Deductible Health Plan 1 (HDHP)

  • Deductible - $2500/$5000

  • Coinsurance - $0

  • Office Visit Copay– Subject to deductible / coinsurance

  • Accident Coverage – Subject to deductible / coinsurance

  • Prescription Drugs – Subject to deductible/coinsurance, then

    • $15/50/75 copay, Mail order $37.50/125/187.50


AffordaBlue Triple Option

  • Deductible

    • Option 1: $500/$1500

    • Option 2: $1000/$3000

    • Option 3: $2000/$6000

  • Coinsurance - $1000/$3000 (80/20%)

  • Office Visit Copay- $25, limited to 5 visits per person, 15 per family

  • Accident Coverage – $50 copay for initial visit

  • Prescription Drugs - $100 / $300 deductible, then 50%


High Deductible Health Plan 2 (HDHP)

  • Deductible - $3000/$6000

  • Coinsurance - $0

  • Office Visit Copay– Subject to deductible / coinsurance

  • Accident Coverage – Subject to deductible / coinsurance

  • Prescription Drugs – Subject to deductible/coinsurance, then

    • $15/50/75 copay, Mail order $37.50/125/187.50


Comprehensive Major Medical

  • Deductible - $1500/3000

  • Coinsurance - $2000/$4000 (60/40%)

  • Office Visit Copay- $30 Primary Care (PCP) or $60 Specialist,

  • limited to 5 visit per person / 15 family

  • Accident Coverage – Pays 100% up to $1000 per person, then

  • subject to deductible/coinsurance

  • Prescription Drugs - $15/50/75/150 copay, Mail order

  • $37.50/125/187.50/375


High Deductible Health Plan 3 (HDHP)

  • Deductible - $5000/$10,000

  • Coinsurance - $0

  • Office Visit Copay– Subject to deductible / coinsurance

  • Accident Coverage – Subject to deductible / coinsurance

  • Prescription Drugs – Subject to deductible/coinsurance, then

    • $15/50/75 copay, Mail order $37.50/125/187.50



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