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Your 2012 Benefit Plans Offer: • Comprehensive medical coverage • Choice of Traditional PPO and HMO Plans • Routine/Preventive Care covered at 100% • Full coverage prescription benefits • One of the nation’s largest PPO networks (wide selection of providers)
National Network • Access through • BlueCard® • 1,177,194 Physicians • 6,776 Hospitals • Access in ALL 50 States Welcomed in over 200countries Worldwide BlueCard PPO Network • Worldwide Network of PPO Healthcare Providers
Finding a Provider is Easy… • Kansas City Metro Area www.BlueKC.com Find Blue KC Doctors, Hospitals, Pharmacies SELECT A PROVIDER DIRECTORY • Local BlueKC Provider Directory MY INSURANCE PLAN • Select Your Plan Blue-Care HMO Preferred-Care Blue PPO SELECT A PROVIDER TYPE • Doctors • Hospitals • Pharmacies, Facilities, Labs • Dental • Urgent Care and Retail Health Centers • Mental Health • Other Providers Click CONTINUE • All Other Areas • www.BlueKC.com • Find Blue KC Doctors, Hospitals, Pharmacies • SELECT A PROVIDER DIRECTORY • BlueCard Provider Directory CONTINUE • Select Guest Tab • Choose Product PPO/EPO • FIND PROVIDERS • Physicians • Hospitals • Behavioral Health • All Types
Traditional Plans Blue-Care HMO Preferred-Care Blue PPO
*PCP: GP, FP, IM, PED **Specialist: Allergist, ENT, Dermatologist, OB/GYN
*Copays do not apply to deductible or OOP maximum *Lab services performed in a Hospital or Outpatient setting and all Radiology Services subject to Deductible and Coinsurance
Preventive Care All Plans
Prescription Drugs Retail and Mail-Order Prescription Drug copaysDO NOT go towards Deductible or Out-of-Pocket Maximum To get started on EXPRESS SCRIPTS get a NEW Prescription from your Doctor!
Categories In the Step Therapy Program For some medication classes, multiple generic medication alternatives now exist. Members will be required to try a generic medication before initiating therapy with a brand name medication. This will apply to the following medication classes: • NSAIDs:(Anti-Inflammatory medications for Arthritis and pain) • Calcium Channel Blockers: (CCB for hypertension) • ACE Inhibitors/ARBs: (Medications for hypertension) • Statins:(Medications for cholesterol) • SSRIs/NDRIs: (Medications for Depression) • Nasal Steroids:(Medications for Allergies) • Sedative Hypnotics:(Medications for Sleep) • Proton Pump Inhibitors (PPIs): (Medications for gastroesophageal reflux disease [GERD] or stomach acid) • Antibotics:(Medications for Acne)
The Points to Blue Incentive Program: Designed to engage employees for participation in health and wellness activities as well as reward behavior change. Members can earn points for taking HRA, screenings, classes, calling health coach, using the ePHIT tools, etc. Earn up to 250,000 points per year or cash equivalent of $250. Minimum redemption of $25. Redeem points for gift cards for charities or from more than 350 merchants including retailers, sports and fitness goods, restaurants, travel, arts and entertainment providers, or debit card. Online Health ResourcesRewards
24-Hour Nurse Line • Available 24 hours a day, 7 days a week, 365 days a year • Care Advisors help you with symptoms or answer a health-related question • Registered nurses available • 24-hour access to an Audio Health Library containing more than 1,500 topics in English and Spanish. Health topics include adult, pediatric, and women’s health.
Thank you! Questions?