Plan Types
True or False - Spira Care plans are only available as an EPO Plan Type
False - Spira Care plans can be offered as an EPO or PPO Plan Type
The first of Oprah’s offspring, he’s a Kansas City native and Shawnee Mission North grad. He now has his own show.
Who is Dr. Phil?
What is the name of the Blue KC HMO network?
What is Blue Care
Convenient online and mobile access to several wellness tools that allow you to get healthy and chances to win great prizes.
What is A Healthier You program?
This is an amount you pay for major medical services before BlueKC begins to pay
What is a deductible?
HMO members are required to have a referral to see a specialist?
FALSE - No referral is needed but all providers must be in the Blue Care network
This rockin’ 80’s tune suggests he’s called this to make you feel alright
Who is Dr. Feelgood? (Motley Crew)
The number of counties that make up Blue KCs service area?
What is 32
This program allows you to save money on health and wellness products and services
What is Blue 365?
This type of plan has no medical or RX copays and allows you to open a Health Savings Account.
What is a Qualified High Deductible Health Plan?
PPO stands for?
Preferred Provider Organization
You'll see this young surgeon with autism and savant syndrome work his wonders every Monday night.
Who is the Good Doctor? ( Shawn Murphy)
EPO members can find network providers in TX?
Correct, EPO members have access to the BlueCard National network of providers
This program helps you save money on your out of pocket prescription drug costs.
What is RX savings solutions?
These are the shared expenses between you and BlueKC after you have satisfied your deductible.
What is coinsurance?
Leslie is on an HMO plan and is traveling to CA for the holidays. She has coverage through our BlueCard national network in CA. TRUE or FALSE?
This professor of surgery from Columbia University was a regular on Oprah and now has his own daily show.
Who is Dr. Oz?
Shane is on a BlueSelect plan and needs to see a cardiologist. He found a cardiologist who comes highly recommended at St Lukes. Will his plan cover?
Only if he is on a PPO with out of network benefits. If an EPO, no out of network benefits unless an emergency.
What is the Diabetes management program, Livongo?
It offers retail or home delivery service for prescription medications.
What is Optum RX?
Which plan types offer coverage for out of network providers?
BONUS: How are claims processed and paid differently?
PPO
BONUS: Members can be balanced billed when using OON providers.
This doctor and Holocaust survivor became a media sensation with a radio show that made us blush!
Who is Dr. Ruth?
Which two hospital systems make up the Blue High Performance network?
What is St Luke's and Children's Mercy
What is Solera or Diabetes Prevention Program?
This is your deductible, plus coinsurance, plus medical and RX copays.
What is your Out of Pocket Maximum