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844-655-0355First Bronze 7000
First Bronze 7000
Plan Overview
A good fit for those who use preventive care plus a few office visits, with a higher deductible and lower premium.
Key benefit
- 4 copays at $40 (PCP, Specialist & Urgent Care); subsequent visits go toward deductible & coinsurance
- Higher deductible and lower premium
- Affordable generic prescription drug coverage
- Large provider network with $0 copay for Blue KC Virtual Care App
Benefits
| Benefit Item | Value | |
|---|---|---|
| Single Deductible | $7,000 | |
| Family Deductible | $14,000 | |
| Coinsurance | 50% | |
| Single Out-of-Pocket Max | $8,550 | |
| Family Out-of-Pocket Max | $17,100 | |
| Access to Spira Care | No | |
| Spira Visits | N/A | |
| Virtual Care2,5 | $0 | |
| PCP Network Visits1 | 4 @ $404 | |
| Urgent Care | 4 @ $404 | |
| Specialist Visits | 4 @ $404 | |
| Hospital | Ded/Coins | |
| Emergency Room | Ded/Coins | |
| Prescription Drugs3 RxSelect Network | ||
| Generic Drug | $30 | |
| Preferred Drug | $150 | |
| Non-Preferred Drug | $250 | |
| Generic Specialty Drug and Preferred Specialty Drug | $400 | |
| Non-Preferred Specialty Drug | Ded & 50% | |
1 Primary Care Physicians include General Practice, Family Practice, Internal Medicine and Pediatrics.
2 First plans telehealth visits do not accrue toward limited copay visits.
3 Specialty medications should be filled at an Optum Specialty Pharmacy to receive the lowest member cost-sharing. You may pay more if filling a specialty prescription at a retail location.
4 Copay for the first four visits combined for PCP, Specialist, and Urgent Care. Deductible and coinsurance apply after that.
5 Copay is $0 via Blue KC Virtual Care app; $10 copay with an in-network eligible provider.
