Kansas is home to large, flat masses of farm land, producing a majority of the nation’s wheat supply. Though it has been dubbed the “Breadbasket of the World” due to the amount of wheat, the state also provides a significant quantity of corn, oats, and hay. Kansas isn’t all farm – the state also contains several growing cities, including Lawrence, a trendy college town, and Kansas City, location of the Kansas City Speedway, and host to many large music and entertainment events. Residents can also enjoy a variety of parks as a result of the state’s access to open land. This provides the opportunity to walk, bike, hike, run and enjoy the rivers in state parks spread throughout Kansas.
Kansans have ample options when choosing a health insurance plan, with some of the best insurers in the nation offering their products. Companies in Kansas include Aetna, Blue Cross Blue Shield of Kansas, Coventry, Humana and UnitedHealth Care. There are multiple plan options through each company, which will vary in price depending on your age, health, and family size. To compare all of your options, enter your zip code in the quote engine below to get the process started.
Health in Kansas seems to be on a steady decline, despite access to freshly grown foods and moderately good air quality. Many factors affected the state’s ranking in overall health, including an increase in the number of obese and diabetic adults, as well as low public health funding. There are currently 640,000 adults who can be considered obese by health care standards in Kansas, which has gone up in the past ten years. Diabetes affects 8.4% of the adult population, which is reasonably higher than it was only five years ago at 6.9%. Smoking also affects a large number of Kansans, though the number has decreased over time.
Some positive attributes include a decent amount of individuals with health insurance, leaving almost 13% uninsured, which is lower than many states. There is also a good amount of prenatal care being used in the health care system in Kansas. As for the rest of the statistics, Kansas has proven its need for a great improvement. By getting a health plan and using preventive and wellness services, the population could take a good first step in making health important. Adopting healthier eating habits and regular exercise will also contribute to a better, longer life for Kansas residents.
Health Insurance Plans
- Open Access Managed Choice plans are PPOs that offer a great amount of care to individuals who want options and flexibility in choosing providers. In Kansas, PPO plans come in High Deductible (see below), Value 5000, and PPO 2500 and 5000 options. Value plans have a more limited set of benefits, and both Value and PPO types cover 80% of major medical costs after deductible. There is a predictable copayment for in-network doctor’s office visits as soon as your plan starts, and preventive care for no cost. These plans also offer non-network services for 50% coinsurance after deductible.
- Open Access Managed Choice High Deductible plans have the option of opening a health savings account (HSA) for optimum control over money spent on medical care. The funds from an HSA are tax-advantaged, giving you the ability to withdraw funds without tax and receive deductions on income taxes. These plans cover all types of in-network medical care (minus maternity) at 100% once you meet the deductible, which can be $2,500 or $5,500. Preventive care is also covered in full when using network doctors, and is available immediately when benefits start.
- Preventive and Hospital Care plans cover a limited number of benefits for those who do not need a large amount to choose from right away. For a deductible of $2,750 for individuals and $5,500 for families, you can receive in-network preventive services as soon as your plan starts for no cost. After the deductible is met, you have access to a handful of major medical services, such as inpatient hospitalization, outpatient surgery, home health care and skilled nursing for 20% coinsurance.
Blue Cross Blue Shield of Kansas
- Comprehensive Major Medical plans come in three types, one with 20% coinsurance up to $1,000, one with 40% coinsurance up to $2,000, and a High Deductible plan with 20% coinsurance up to $2,500. These plans cover doctor’s office visits with specialists and primary care physicians, hospital care and surgery after you meet the deductible. The first five office visits are a $30 copay with the 40% coinsurance plans only. These are PPO plans which allow you to use in-network or out-of-network care, without any referrals. Preventive care is available for no cost from the day your plan begins.
- AffordaBlue plans offer low out-of-pocket costs and either 20% coinsurance with a $1,000 deductible or 50% coinsurance with a $5,000 deductible. After you meet the deductible, you can receive in-network hospital services for your chosen amount of coinsurance. As soon as your plan starts, your first five doctor’s office visits are a $25 copay for network primary care physicians and specialists. More immediate benefits include preventive care, which is covered at 100% when using the PPO network.
- Basic Blue plans are also PPOs, with deductibles of either $500 or $1,000 for individuals or twice as much for families. These plans cover 50% of select medical services such as emergency room visits, outpatient care and inpatient hospitalization after deductible. Preventive care is always covered at 100% as soon as you get a plan with a network provider. Physician services for non-preventive care such as illness or injury are not covered with Basic Blue Plans, nor are prescription drugs.
- Blue Copay plans offer benefits for a predictable copay as soon as your plan starts on services like physician office visits for $30 and specialist visits for $80. These plans have no deductible, and are part of the PPO network. Preventive services such as immunizations, screenings for various diseases, and annual health exams are free of charge and offered as soon as your plan becomes effective. Prescription drugs and emergency care are also covered, as well as maternity care.
- Healthy Blue plans give members the first three non-preventive physician office visits for no cost, and 50% coverage after you meet the deductible. The deductible is $2,000 for individuals and $6,000 for families. Once it has been reached, you can receive hospital care and prescriptions for 50% coinsurance. Prescriptions have their own deductible, which is $100 for individuals and $300 for families. Healthy Blue plans also have the largest provider network in the state to use for discounted services.
- Shared Pay Comprehensive plans are also part of the PPO network, and have no deductible so your benefits start as soon as you purchase your plan. All covered services, including doctor’s office visits, emergency care, outpatient and inpatient hospital services, and prescription drugs are covered at 50%. There is an out-of-pocket maximum of $1,500 for individuals and $3,000 for families. When using in-network providers for preventive care, services are covered at 100% by your plan. You also have the option of using out-of-network providers depending on your preference.
- PPO plans come in a variety of deductibles, ranging from $500 to $7,500 for individuals in Kansas. All of these plans come with the immediate benefit of preventive care at no cost, and non-preventive doctor’s office visits for a copay. Once your deductible is met, you pay 20% coinsurance for major medical care such as outpatient surgery, hospitalization and emergency care. Urgent care and prescription drugs are also available for a copay, which varies depending on your deductible.
- GO plans stand for “Generics Only” and offer better rates on health care coverage by only providing generic prescriptions instead of every tier. These have the same range of deductibles as the traditional PPO plans, but have generic prescription drugs for a $12 copay. After you have reached the deductible, your plan covers 80% of hospital care, emergency room visits, and outpatient services. As soon as your plan starts, physician office visits and urgent care are available for a copay, and preventive care is no cost.
- SJ (Super Joe) plans are designed for greater savings, and have deductible options of $1,500, $2,500, $3,000 or $5,000 for individuals. As soon as your plan starts, you can see a primary care physician for a $35 copay, and use preventive services at no charge in-network. After meeting the deductible, hospital services, emergency room visits, home health care and more are covered at 90% by your plan. Certain services have an additional copayment after deductible, such as urgent care and emergency room facility services. You can also use non-network providers for 40% coinsurance after deductible.
- Copay plans in Kansas come in two types: Portrait Share 80 and Autograph Share 80 Plus Rx/Copay. Both plans offer preventive care covered at 100% as soon as your plan starts for no cost. All copay plans have prescription drug coverage, as well as 80% coverage on inpatient and outpatient hospital care. Portrait share plans have unlimited doctor’s office visits for a predictable copayment per visit, and Autograph limits you to six office visits. Urgent care is also available for a copay with both of these plans.
- 100% After Deductible plans have a wide range of deductible and cover in-network medical costs in full after you meet the deductible. Three types of plans from Humana cover 100% of your costs: Monogram, Autograph Total Plus Rx/HSA and Autograph Total HSA. These plans offer a comprehensive set of benefits, including physician services, hospital stays, surgery, prescriptions and emergency care for no cost after deductible. Once your plan starts, you can use any in-network provider for preventive care and it will be covered in full. HSA plans give you the option of opening a health savings account for greater control over your health care spending with tax advantages.
- Copay plans have deductibles ranging from $1,000 to $10,000 for individuals, and double for families. Available in Select or Select Value, you can receive physician services, prescription drugs and urgent care for a copay as soon as your plan begins, as well as preventive care for no cost in-network. Value plans have limited prescription benefits and doctor’s office visits, while Select plans have unlimited doctor’s visits and all tiers of prescription drugs. After you meet the deductible, Value plans cover 70% of in-network hospital services and other medical costs, and Select plans cover either 70%, 80% or 100%.
- High Deductible plans offer a comprehensive level of coverage, with many physician and hospital services after deductible for either 20% coinsurance or no charge. These plans come in three types: Plan 100, Plan 80 and Saver 80. Plan 100 has the most benefits for higher premiums and deductibles and no cost sharing once you have met the deductible, while Plan 80 has lower premiums and higher coinsurance. Saver 80 plans are more limited for a lower premium, excluding prescription drug coverage.
- Health Savings Account plans give you financial control over your health care expenses with an HSA and a large number of covered services. These plans cover 70% or 100% of your medical costs after deductible, including inpatient and outpatient hospital care, and doctor’s office visits when using in-network providers. HSA 70 plans have individual deductibles ranging from $1,250 to $5,000, and HSA 100 plans range from $2,500 to $5,000. HSA 70 plans do not have prescription coverage, and HSA 100 plans come with a preferred price card for all tiers of prescription drugs.
Public Health Options
In Kansas, there are several programs funded by the state to offer assistance to various groups of uninsured individuals. Medical Assistance (Medicaid) is the primary source of all health care coverage for low-income residents of Kansas, including families, children, persons over 65, pregnant women and more. Other services are provided by the state for disease prevention and control, disabilities and injuries, and assistance with leading a healthy lifestyle. For a full list of programs offered throughout the state, visit the Kansas Department of Health and environment Public Health site.
- Kansas Medical Assistance Program (KMAP): health insurance for low-income, uninsured Kansans who qualify. For a list of eligibility criteria, visit our Medicaid Eligibility by State page.
- HealthWave: medical coverage for children under 19 living in Kansas without insurance.
- Kansas Immunization Program: gives residents of the state access to vaccinations for preventable diseases.
- Physical Activity and Nutrition Program: education and assistance on health, nutrition and wellness for Kansas residents, including access to fresh produce with farmer’s markets.
Health Insurance Laws
Kansas health insurance laws are changing with the rest of the country as we see new legislation constantly taking shape. While many of the new laws have yet to be set in stone, the ones that currently exist are important to be aware of. Firstly, individuals with pre-existing conditions in Kansas are determined by the insurer’s definition. This usually mean a condition for which someone could have used treatment for or did have medical care for in the past before applying for a health plan. If an insurance company decides you have a pre-existing condition, you can either be rejected as an expensive prospect or accepted with higher premiums.
Health insurance companies can also give individuals with pre-existing conditions an exclusion period of up to 24 months in Kansas. This makes it possible for the insurer to provide you with other covered services, but not cover care related to your pre-existing condition. Kansas insurance companies can also use elimination riders to permanently decide to not pay for that certain type of care. Kansas residents with pre-existing conditions do have an alternative for health care coverage called the Pre-Existing Condition Insurance Plan.
Pre-Existing Condition Insurance Plans are operated by the state of Kansas, and offer an affordable option for people who qualify. These plans will expire in 2014 when all health insurance companies and state-run health exchanges will be required to accept all adults regardless of their health status and medical history. According to the ACA, elimination riders and exclusion periods will no longer be permitted.
Guaranteed renewal is part of the HIPAA laws that ensures individuals with health insurance get to keep their coverage by getting it renewed at the end of a term. Insurers are required to abide by this law and offer the same health plan to their clients when theirs ends to avoid any gaps in coverage. This law also prevents insurance companies from terminating benefits on the grounds of illness acquired after enrolling in the plan. Guaranteed renewability helps the individual stay insured if they are paying their premiums regularly and following the rules of their plan.