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High Deductible Health Plan (HSA-Qualified)
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
| In-Network | Out-of-Network | |
|---|---|---|
|
CALENDAR YEAR DEDUCTIBLE1 (CYD) |
$2,250 for individual $3,750 for individual $4,500 for family $7,500 for 2-person/3-person/family |
|
|
OUT-OF-POCKET MAXIMUM2 (OOP) |
$4,500 for $2,250 deductible $5,625 for $3,750 deductible $9,000 for $4,500 deductible $11,250 for $7,500 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 |
Plan pays: 80% Your responsibility: 20% |
Plan pays: 60% Your responsibility: 40% |
|
TELADOC & TELADOC Expert Medical Services |
Member must pay 100% of the current Teladoc consultation fee until CYD is met. No charge after CYD is met. All Teladoc Expert Medical Services are at no charge. |
|
|
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 |
||
|---|---|---|
|
Plan pays: 80% Your responsibility: 20% |
Plan pays 60% Your responsibility: 40% |
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 10 years for members age 45 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 enrolled as dependents on a family plan.
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.