In-network care
There are also important considerations when receiving care throughout the plan year to help you save money.
We are proud of the care we provide at The University of Kansas Health System, which is why the health system
network has the lowest cost to you. The second lowest cost is for in-network providers. The health system network
deductible and out-of-pocket maximum will accumulate with the in-network deductible and out-of-pocket maximum.
Out-of-network care
If you choose an out-of-network provider, your costs will be significantly higher. Here are some factors that impact
your share of the cost:
- Higher out-of-pocket costs: The deductible, coinsurance and out-of-pocket maximum are highest for out-of-network care.
- Independent deductible and out-of-pocket maximum: The amount you pay for out-of-network care does not accumulate with expenses incurred when you use health system or in-network providers for the purpose of meeting your deductible or your out-of-pocket maximum.
- Balance billing: This happens when you visit providers who are out-of-network and are not in the Blue Cross and Blue Shield network. These providers may charge you for the amount your medical plan does not cover – the difference between the billed amount and the allowed amount (the maximum your plan will pay for the service). For example, if the provider’s charge is $100 and the allowed amount is $70, you may be responsible for the $30 difference (after you meet your deductible and pay your coinsurance or copay).
