Blue Cross Blue Shield Blue & U First Select Silver MO

Plan Information
Company Blue Cross and Blue Shield of Kansas City
State MO
Metal Tier Silver
Plan Type PPO

Cost Sharing Benefits

These details are for the standard Silver plan. For reduced Cost Sharing versions scroll down below

Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $4,750 Data Not Available
Deductible (Family) $9,500 Data Not Available
Coinsurance Data Not Available Data Not Available
Out of Pocket Maximum (Individual) $4,750 $9,500
Out of Pocket Maximum (Family) $9,500 $19,000
Services In Network Out of Network
Primary Care Visit No Charge Data Not Available
Specialist Visit No Charge Data Not Available
In Patient Hospital Services No Charge Data Not Available
Emergency Room Services No Charge $0
Mental / Behavioral Health $0 Data Not Available
Imaging (CT/PET Scans, MRIs) $0 Data Not Available
Rehabilitative Speech Therapy $0 Data Not Available
Rehabilitative Occupational & Physical Therapy $0 Data Not Available
Preventative Care Data Not Available Data Not Available
Laboratory Outpatient and Professional Services $0 Data Not Available
X-ray and Diagnostic Imaging $0 Data Not Available
Prescription Drugs In Network Out of Network
Generic Rx $4 Copay before deductible
Preferred Brand Rx $50 Copay before deductible
Non Preferred Brand Rx $80 Copay before deductible
Specialty Drugs No Charge

73% Cost Sharing Benefits

Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $3,750.00
Deductible (Family) $7,500.00
Out of Pocket Maximum (Individual) $3,750.00
Out of Pocket Maximum (Family) $7,500.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists No Charge
Emergency Room No Charge
Inpatient Facility No Charge
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $4 Copay before deductible
Preferred Brand Rx $50 Copay before deductible
Non Preferred Brand Rx $80 Copay before deductible
Specialty Drugs No Charge

87% Cost Sharing Benefits

Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $1,500.00
Deductible (Family) $3,000.00
Out of Pocket Maximum (Individual) $1,500.00
Out of Pocket Maximum (Family) $3,000.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists No Charge
Emergency Room No Charge
Inpatient Facility No Charge
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $4 Copay before deductible
Preferred Brand Rx $30 Copay before deductible
Non Preferred Brand Rx $60 Copay before deductible
Specialty Drugs No Charge

94% Cost Sharing Benefits

Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.

Deductibles and Cost Sharing In Network Out of Network
Deductible (Individual) $600.00
Deductible (Family) $1,200.0
Out of Pocket Maximum (Individual) $600.00
Out of Pocket Maximum (Family) $1,200.00
Services In Network Out of Network
Primary Care Physician No Charge
Specialists No Charge
Emergency Room No Charge
Inpatient Facility No Charge
Inpatient Physician No Charge
Prescription Drugs In Network Out of Network
Generic Rx $4 Copay before deductible
Preferred Brand Rx $20 Copay before deductible
Non Preferred Brand Rx $40 Copay before deductible
Specialty Drugs No Charge

Other Plans

Other plans that are available in the state.

Plan Name
Blue & U Classic PCB Gold
Blue & U Classic PCB Silver
Blue & U Classic Select Gold
Blue & U Classic Select Silver
Blue & U First PCB Bronze
Blue & U First PCB Gold
Blue & U First PCB Silver
Blue & U First Select Bronze
Blue & U First Select Gold
Blue & U First Select Silver
Blue & U Saver PCB Silver
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This tool is for research purposes only. The numbers shown are estimates based on the information you have provided and our best efforts to provide accurate data. We try to keep the information up to date however we cannot make warranties about the accuracy of our information. We advise that users confirm any research with the respective health insurance companies and health exchanges.