Know your medical plan network

Flexibility and choice are important, so our medical plan includes an in-network option that still helps you save money. You may be wondering how in-network is different from the health system network. These are providers and facilities outside of our health system that have agreed to accept an approved amount for their services from the health insurance company.

So, if an in-network doctor charges $150 for a service and the approved amount with the medical plan is $90 – you save $60. You’ll also pay a lower annual deductible, coinsurance and copays compared to using out-of-network care. Your out-of-pocket maximum is also significantly lower compared to using out-of-network care.

Both medical plans offer access to a variety of in-network providers and facilities for covered services through the Blue Cross Blue Shield network.

• Kansas City metro area: Through the Blue Select Plus network, both medical plans give you access to more than 4,100 providers at facilities including:
  • Advent Health (3 locations)
  • Cameron Regional Medical Center
  • Children’s Mercy (Hospital Hill and South)
  • Liberty Hospital
  • North Kansas City Hospital
  • St. Joseph Medical Center
  • St. Mary’s Medical Center
  • Providence Medical Center
  • University Health (Truman and Lakewood)
  • Western Missouri Medical Center
• Greater Kansas and nationwide: Both medical plans offer in-network coverage via the BlueCard PPO network in greater Kansas and nationwide (excluding a designated 20-county area in Missouri, east of Kansas City designated in the light blue on the map).

While not as low-cost as the health system network, you’ll still save compared to out-of-network care.

Simply put, it’s the opposite of in-network. Out-of-network healthcare providers and facilities (such as HCA and Saint Luke’s) have not agreed to accept an approved amount for services from the health insurance company. So, you pay more for getting care because the rates are likely higher than the discounted health system and in-network rates. You’ll also pay significantly more toward your deductible, copays, coinsurance and out-of-pocket maximum. Plus, any money you spend on health system and in-network care does not count toward the out-of-network out-of-pocket deductible or out-of-pocket maximum – making it even more costly. One caveat: Insurance plans can’t make you pay more in copayments or coinsurance if you get emergency care from an out-of-network hospital.

Given the big impact on your bottom line, it’s important to make sure your provider is in-network – or better yet – in the health system network for the absolute lowest cost to you.

Find a health system or in-network provider or check which network your provider is in by using Blue Cross Blue Shield’s find a doctor tool. Here’s how:

1. Click on the “Enter Card ID” button in the pop-up (you do not need your credentials)

2. Narrow your results without logging in by entering “USK”

3. The providers will be sorted by “tier” and health system tier providers will be listed first. In the upper right corner, select the network and zip code for your search.

All other providers listed that do not say “health system tier” in the right column are in-network providers. Out-of-network providers will not appear in the list.