Plan Overview

Blue Secure has a $0 monthly premium, $0 deductibles and an in-network maximum out-of-pocket limit of $3,650. With this HMO product, you get freedom of choice (no referrals) and a focus on helping you navigate your health care choices so that you get the right care, at the right time. Blue Secure plan members have access to Spira Care providers for their PCP Coordinated Care.

Blue KC makes it flexible for you to use your plan as you decide. Blue Benefit Bucks works like a debit card so it’s simple to use. It’s loaded with the benefits and you have the power to spend it based on your personal needs.

The Blue Secure plan comes loaded with a $500 per year benefit allowance to use for eyewear and transportation. Plus, we’ll load your $100 per quarter over-the-counter (OTC) allowance and healthy activity rewards1 on the same card. Your OTC allowance accumulates throughout the year, but must be spent by the end of the year.

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Advantages Include

  • $0 monthly premium
  • $0 medical and prescription drug deductibles
  • $0 Primary care physician copay
  • $0 Tier 1 and Tier 2 Prescription Drugs, up to 100-day supply
  • $1,000 dental benefit, each year.
  • $0 hearing aids, and services for Level 1 devices, a $500 benefit per ear, annually
  • $100 over-the-counter items allowance, every 3 months
  • $500 Blue Benefit Bucks, flexible benefits for eyewear and transportation combined
  • 40 hours per year for Member and Caregiver support for help to appointments or around the house
  • Meals support for chronic conditions
  • Low $3,650 annual out-of-pocket maximum
  • SilverSneakers® fitness membership at no additional cost

You'll be required to get most of your care from an in-network provider. You'll also be asked to choose a primary care physician who will provide your basic healthcare services. You are still protected when you travel with worldwide emergency and urgent care coverage.

To join, you must be entitled to Medicare Part A, be enrolled in Medicare Part B, and live in these counties in Kansas: Johnson and Wyandotte, and these counties in Missouri: Cass, Clay, Clinton, Jackson, Lafayette, Platte and Ray.

1Rewards for healthy activities may not be used for any benefit cost sharing.

Plan Benefits
At-A-Glance

You must continue to pay Part B premium

Total Premium

$0

Blue National Network

N/A

Plan Deductible

$0

Maximum Out of Pocket (MOOP)

$3,650

Inpatient Services
Inpatient Hospital - Acute
In-Network

$285/day, Days 1-5
$0, Days 6-90*

Skilled Nursing Facility
In-Network

$0, Days 1-20
$184/day, Days 21-100

Emergency Care/Urgent Care
Emergency Care (Worldwide)
In-Network

$90

Urgently Needed Care (Worldwide)
In-Network

$50

Ambulance Services (Worldwide)
In-Network

$285

Professional Services
PCP Visit
In-Network

$0

Specialist Visit
In-Network

$40

Telehealth
In-Network

$0

Diagnostic Testing Services
Diagnostic Procedures/Tests
In-Network

$0

Lab Services
In-Network

$0

X-Ray Services
In-Network

$0

MRI/CT at physicians office or free standing
In-Network

$100

MRI/CT at other facility
In-Network

$285

Outpatient Services
Observation
In-Network

$285

Outpatient Hospital & ASC (Minor surgical; other services)
In-Network

20%

Surgery (Ambulatory Surgical Center)
In-Network

$285

Surgery (Outpatient Hospital)
In-Network

$285

Supplemental Services
Dental
In-Network

100% coverage for preventive
50% coverage for comprehensive

$1,000 benefit maximum

Eyewear and Transportation

$500 allowance for transportation and eyewear combined

Hearing and Hearing Aids

$0 hearing exam; up to $500 per ear per year for hearing aids

Over-the-counter allowance

$100 per quarter

*After 90 days, our plan covers an unlimited number of additional days for an inpatient hospital stay at $0 copay.

Prescription Drug Benefits

Annual Deductible

$0

Preferred Generics (Tier 1)
30-day Supply

$0 copay

100-day Supply

$0 copay

Generics (Tier 2)
30-day Supply

$5 copay

100-day Supply

$0 copay

Preferred Brands (Tier 3)
30-day Supply

$47 copay

90-day Supply

$141 copay

Non-Preferred Drugs (Tier 4)
30-day Supply

$100 copay

90-day Supply

$300 copay

Specialty Drugs (Tier 5)
30-day Supply

33%

90-day Supply

N/A

Gap Coverage

Tier 1 and Tier 2

$35 Insulin Program

Yes

We offer a 100-day mail order and retail drug benefit with a $0 copay for all Tier 1 and Tier 2 prescription drugs.

This information is not a complete description of benefits.

Sheri Blue KC Medicare Expert

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