Limit: 3000.0 Dollars per Episode

Treatment must begin within 12 months of the injury.

Chiropractic visits beyond 26 per benefit period require Prior Authorization.

Covered Services include dialysis treatments in an outpatient dialysis, or home dialysis and training for you and the person who will help you with home self-dialysis.

Limit: 1.0 Item(s) per Year

Covered lenses and frames each available at limit of one per year.

See the Prescription Drug formulary for more information on drug costs.

Limit: 20.0 Visit(s) per Benefit Period

Habilitative services definition: 'help you keep, learn or improve skills and functioning for daily living.'

Benefits include hearing aids provided to a newborn for initial amplification following a newborn hearing screening.

Limit: 100.0 Visit(s) per Benefit Period

To be eligible for benefits, you must essentially be confined to the home, as an alternative to a Hospital stay, and be physically unable to get needed medical services on an outpatient basis.

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

You have a $0 copay for telehealth visits with your doctor, saving you money and time. This Plan offers first dollar coverage for the first four (4) office visits. Eligible services include primary care, specialist, urgent care, mental health, and/or substance abuse services received in an office. Deductible and coinsurance apply after you have received four (4) visits in the calendar year. Office visits are subject to the applicable copayment, see Plan Documents for more information.

Limit: 20.0 Visit(s) per Benefit Period

To be Covered Services, rehabilitation services must involve goals you can reach in a reasonable period of time. Benefits will end when treatment is no longer Medically Necessary and you stop progressing toward those goals.

You have a $0 copay for telehealth visits with your doctor, saving you money and time. This Plan offers first dollar coverage for the first four (4) office visits. Eligible services include primary care, specialist, urgent care, mental health, and/or substance abuse services received in an office. Deductible and coinsurance apply after you have received four (4) visits in the calendar year. Office visits are subject to the applicable copayment, see Plan Documents for more information.

Limit: 82.0 Visit(s) per Benefit Period

Private duty nursing services are a Covered Service only when given as part of the 'Home Care Services' benefit. Private Duty Lifetime Maximum: 164 visits In- and Out-of-Network combined.

Benefits include the purchase, fitting, adjustments, repairs and replacements.

Benefits include reconstructive surgery to correct significant deformities caused by congenital or developmental abnormalities, illness, injury or an earlier treatment in order to create a more normal appearance.

Limit: 20.0 Visit(s) per Benefit Period

20 visit limit each for PT and OT.

Unlimited visits for speech therapy.

Limit: 1.0 Exam(s) per Benefit Period

Coverage is available if Medically Necessary.

Limit: 150.0 Days per Benefit Period

Limit is for in-and out-of-network combined and includes rehab and outpatient day rehab.

You have a $0 copay for telehealth visits with your doctor, saving you money and time. This Plan offers first dollar coverage for the first four (4) office visits. Eligible services include primary care, specialist, urgent care, mental health, and/or substance abuse services received in an office. Deductible and coinsurance apply after you have received four (4) visits in the calendar year. Office visits are subject to the applicable copayment, see Plan Documents for more information.

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

Covered Services include removable appliances for TMJ repositioning and related surgery, medical care, and diagnostic services.

Save money and time with Blue KC Virtual Care. You may access virtual care for a $0 copay, 24/7. This Plan offers first dollar coverage for the first four (4) office visits. Eligible services include primary care, specialist, urgent care, mental health, and/or substance abuse services received in an office. Deductible and coinsurance apply after you have received four (4) visits in the calendar year. Office visits are subject to the applicable copayment, see Plan Documents for more information.