High Deductible Health Plan (HSA-Qualified)

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CLICK HERE to get a better understanding of HSAs from Health Equity and how they can complement your KFBHP health plan.

About the Plan

Looking for Health Savings Account (HSA) qualified plan? Kansas Farm Bureau Health Plans offers a range of High Deductible Health Plans (HDHP) which meet all federal requirements necessary to open a HSA.

Kansas Farm Bureau Health Plans uses UnitedHealthcare ChoicePlus Network. Please keep in mind that in-network payments are based on negotiated fees. If an out-of-network provider is used, the member’s liability will increase significantly.

Not everyone is eligible for an HSA. For more information about HSA's contact Health Equity at 866-346-5800.

Resources

Provider Network 

Schedule of Benefits

  In-Network Out-of-Network

CALENDAR YEAR DEDUCTIBLE1 (CYD)
Unless otherwise indicated, all benefits are subject to CYD.

$1,500 for individual

$2,500 for individual

$3,000 for family

$5,000 for 2-person/3-person/family

OUT-OF-POCKET MAXIMUM2 (OOP)
Once the OOP maximum is met, benefits are provided at 100% for a member for the remainder of the calendar year. This applies to in-network provider services only. Copayments do not apply to OOP and must still be paid after OOP is met.

$3,000 for $1,500 deductible

$3,750 for $2,500 deductible

$6,000 for $3,000 deductible

$7,500 for $5,000 deductible

 

Unlimited

LIFETIME BENEFIT MAXIMUM

Unlimited

FOOTNOTES

1 Deductible – the dollar amount of covered services that must be incurred and paid first by a member each calendar year before plan benefits begin.

2 Once the OOP maximum is met, benefits are provided at 100% for a member(s) for the remainder of the calendar year. This applies to in-network provider services only. There is no Out of Pocket Maximum when out of network providers are used.

 

  In-Network Out-of-Network

COINSURANCE
Based on the maximum allowable charges for eligible benefits. Family deductible can be satisfied by one or more covered members during a calendar year.

Plan pays: 80%

Your responsibility: 20%

Plan pays: 60%

Your responsibility: 40%

TELADOC

Your responsibility: $45 consultation fee until CYD deductible is met. No charge after deductible is met.

PREVENTATIVE CARE BENEFITS

Well Child Services3

20%

Not Covered

Annual OB/GYN Exam4

20%

Not Covered

Routine Colonoscopy5

20%

40%

Annual Routine PSA6

20%

40%

Annual Routine Pap Smear7

20%

40%

Mammogram8

20%

40%

PRESCRIPTION DRUG COVERAGE

Unlimited calendar year maximum per member.

Generic and Brand Prescriptions: Kansas Farm Bureau Health Plans will reimburse 80% of the maximum allowable charge, after deductible, when purchased at an in-network pharmacy.

Home delivery service is available.

FOOTNOTES

3 Benefits are available, subject to deductible and coinsurance, for a member under the age of seven (on plan deductibles $3,000 and $5,000) for physical examinations and appropriate immunizations/vaccinations when services are rendered by an in-network provider. Exams not used during the time periods below do not carry over to the next time period.

Age Number of Exams
Under age one four exams from birth to the child's first birthday
Age one two exams from the child's first birthday to the child's scond birthday
Age two through six one exam per year (determined by the child's birthday)

4 Benefits will be provided for one routine colonoscopy every four years for members age 50 and over when provided by an in-network or out-of-network provider, subject to the deductible and coinsurance.

5 Benefits will be provided, subject to deductible and coinsurance, for one routine PSA per calendar year when services are rendered by an independent laboratory or other outpatient setting.

6 Benefits will be available for one routine OB/GYN exam per calendar year, subject to deductible and coinsurance. Services must be rendered by an in-network physician’s office and billed by the in-network provider. Related pathology, including pap smear, which is provided as a part of the routine OB/GYN exam, will be covered when the services are rendered by an in-network physician’s office and billed by the in-network provider. Related pathology that the physician sends to an independent laboratory will be subject to deductible and coinsurance. No benefit is available for routine OB/GYN exams provided by an out-of-network provider.

7 Benefits will be provided for the interpretation of one routine pap smear per calendar year when services are rendered by an independent laboratory or other outpatient setting, subject to deductible and coinsurance.

8 For routine mammography screening provided such examinations are conducted upon the recommendation of the member’s physician. One baseline routine mammogram will be allowed for members between the ages of 35-39. One routine mammogram will be allowed annually for members age 40 and above. All routine mammography screens are subject to deductible and coinsurance.

9 Benefits will be provided, subject to deductible and coinsurance.

 

Benefits will not be provided for any pre-existing condition until a member has completed a waiting period of at least 12 months. A pre-existing condition is defined in the contract as “An illness, injury, pregnancy or any other medical condition which existed at any time preceding the effective date of coverage under this contract for which: Medical advice or treatment was recommended by, or received from, a provider of health care services; or symptoms existed which would cause an ordinarily prudent person to seek diagnosis, care or treatment.” The pre-existing condition waiting period does not apply to members under the age of 19.

Maternity Benefits will be available after a member’s coverage on a 2-person, 3-person or family contract has been in effect for nine consecutive months. Individual coverage has NO maternity benefits.