Medical

PPO Plan BCBS

You have the flexibility to seek care from an in-network or out-of-network provider. It is important to note that you receive the maximum benefits from the plan when you seek services from in-network providers.

The Blue Cross Blue Shield network offers the best national access to providers. To find out if your physician is in network, please visit their website at: https://member.myhealthtoolkitkc.com/. Click on Find a Provider and use KDC as our Member ID. You may also direct your questions to the Customer Service number located on the back of your identification card.

Below is a brief summary of the medical plans available to you and your family. For more detailed information, please refer to the Summary of Benefits and Coverage (SBC) provided by Blue Cross Blue Shield.

Natural Family Planning – For Members Covered by the Health Plan
This benefit includes office visits and materials (such as the Clear Blue Easy Fertility Monitor and test strips) and is available through programs approved by the archdiocese. The following programs are considered to be approved: Billings Method, Creighton Model, Couple to Couple League, and Marquette Method. The Archdiocese will cover 100% of costs up to a maximum of $400 per calendar year for the insured employee or their spouse. The benefit is limited to $400 total per family. Please submit copies of receipts to the archdiocese Human Resources office by January 31 of the following year.

Gianna Family Care – For Members Covered by the Health Plan
The Archdiocese Health Plan provides coverage at Gianna Family Care, which is a membership and faith-based medical practice located in Shawnee, Kansas. Charges from the Gianna Family Care medical practice
will be treated as follows:

  • Membership and other physician fees will be reimbursed at 90% of billed amount for the PPO plan.
  • The HDHP will be subject to the deductible then covered at 90%.
  • Any other fees, such as labs or medications, if billed by Gianna, will be covered as out of network.

For more information on this practice, visit: www.giannafamilycare.com.

PCB or BSP Network

PCB or BSP NetworkIn-Network
Calendar Year Deductible
(Individual/Family)
$750/$1,500
Combined with Prescription Drug Benefits
Calendar Year Out-of-Pocket Max
(Individual/Family)
$6,500/$13,000
Combined with Prescription Drug Benefits
Coinsurance80%
Routine Preventive Care100% Covered
Physician Office Visit$25 Copay
Urgent Care$50 Copay
Emergency Room$100, then Deductible + Coinsurance
Inpatient Hospital CareDeductible + Coinsurance
Outpatient Hospital CareDeductible + Coinsurance
Chiropractic Care (20 visit limit per year)$25 Copay + Deductible+ Coinsurance
Lab Services100%

Prescription Drugs

Prescription DrugsPPO Plan BCBS
Calendar Year Deductible (30 day Supply)Not Applicable
Retail (30 day Supply)
GenericLesser of $10 or actual cost
Brand Formulary25% or minimum of $25
Brand Non-Formulary40% or minimum of $40
Mail Order Drugs (90 day Supply)
Generic$25 Copay
Brand Formulary25% or minimum of $62.50
Brand Non-Formulary40% or minimum of $100
Specialty (30 day Supply)
Generic25% of discounted cost
Brand Formulary25% of discounted cost
Brand Non-Formulary25% of discounted cost

Downloads

Summary of Benefits PCB Network

Summary of Benefits BSP Network

Claim Form

Tria Health Benefit Guide

Provider Lookup and My Health Toolkit

Online Tools Flyer

Medicare Creditable Coverage-Important Notice

ABCD's of Understanding Medicare

Continuation of Medical PPO

BlueSelect Plus

BlueSelect Plus Spanish

My Catholic Doctor Flyer

HDHP Plan BCBS

You have the flexibility to seek care from an in-network or out-of-network provider. It is important to note that you receive the maximum benefits from the plan when you seek services from in-network providers.

The Blue Cross Blue Shield network offers the best national access to providers. To find out if your physician is in network, please visit their website at: https://member.myhealthtoolkitkc.com/. Click on Find a Provider and use KDC as our Member ID. You may also direct your questions to the Customer Service number located on the back of your identification card.

Below is a brief summary of the medical plans available to you and your family. For more detailed information, please refer to the Summary of Benefits and Coverage (SBC) provided by Blue Cross Blue Shield.

Natural Family Planning – For Members Covered by the Health Plan
This benefit includes office visits and materials (such as the Clear Blue Easy Fertility Monitor and test strips) and is available through programs approved by the archdiocese. The following programs are considered to be approved: Billings Method, Creighton Model, Couple to Couple League, and Marquette Method. The Archdiocese will cover 100% of costs up to a maximum of $400 per calendar year for the insured employee or their spouse. The benefit is limited to $400 total per family. Please submit copies of receipts to the Archdiocese Human Resources office by January 31 of the following year.

Gianna Family Care – For Members Covered by the Health Plan
The Archdiocese Health Plan provides coverage at Gianna Family Care, which is a membership and faith-based medical practice located in Shawnee, Kansas. Charges from the Gianna Family Care medical practice
will be treated as follows:

  • Membership and other physician fees will be reimbursed at 90% of the billed amount for the PPO plan.
  • The HDHP will be subject to the deductible then covered at 90%
  • Any other fees, such as labs or medications, if billed by Gianna, will be covered as out-of-network.

For more information on this practice, visit: www.giannafamilycare.com.

PCB or BSP Network

PCB or BSP NetworkIn-Network
Calendar Year Deductible
(Individual/Family)
$3,200/$6,400
Combined with Prescription Drug Benefits
Calendar Year Out-of-Pocket Max
(Individual/Family)
$6,500/$13,000
Combined with Prescription Drug Benefits
Coinsurance90%
Routine Preventive CareDeductible + Coinsurance
Physician Office VisitDeductible + Coinsurance
Urgent CareDeductible + Coinsurance
Emergency RoomDeductible + Coinsurance
Inpatient Hospital CareDeductible + Coinsurance
Outpatient Hospital CareDeductible + Coinsurance
Chiropractic Care (20 visit limit per year)Deductible + Coinsurance
Lab ServicesDeductible + Coinsurance

Prescription Drugs

Prescription DrugsHDHP Plan BCBS
Calendar Year Deductible (30 day Supply)$3,200/$6,400
Combined with medical benefits
Retail (30 day Supply)After Plan Deductible
Generic
Brand Formulary25% or minimum of $25
Brand Non-Formulary40% or minimum of $40
Mail Order Drugs (90 day Supply)Lesser of $10 or actual cost
Generic25% of minimum of $25
Brand Formulary40% or minimum of $100
Brand Non-Formulary40% or minimum of $100
Specialty (30 day Supply)After Plan Deductible
Generic25% of discounted cost
Brand Formulary25% of discounted cost
Brand Non-Formulary25% of discounted cost

with PCB Network Group #71-5954M-00

with PCB Network Group #71-5954M-00Employee
per Pay Period
Employer
per Pay Period
Employee Only$50.52$190.06
Employee + Spouse$262.43$487.37
Employee + Child(ren)$222.18$412.62
Employee + Family$286.58$532.22

 

with BSP Network Group #71-5954M-06

with BSP Network
Group #71-5954M-06
Employee
per Pay Period
Employer
per Pay Period
Employee Only$45.00$180.00
Employee + Spouse$245.70$456.30
Employee + Child(ren)$207.90$386.10
Employee + Family$270.90$503.10

Downloads

Summary of Benefits PCB Network

Summary of Benefits BSP Network

Claim Form

Tria Health Benefit Guide

Provider Lookup and My Health Toolkit

Online Tools Flyer

Medicare Creditable Coverage-Important Notice

ABCD's of Understanding Medicare

Continuation of Medical HDHP

BlueSelect Plus

BlueSelect Plus Spanish

My Catholic Doctor Flyer

Medication Management Program

Helping You Manage Your Medications and Reduce Your Health Care Costs!
Pharmacy Advocate Program
Tria Health is a free and confidential benefit available through your insurance plan with the Archdiocese of Kansas City in Kansas. If you have a chronic condition or take multiple medications, Tria Health’s pharmacists are ready to support you in managing your health.

Not only will Tria Health’s pharmacists make sure your medications are working as intended and that you’re on the right medications, but they can support you by creating a care plan that is specific to your needs and
share it with your doctor. Talk to a Tria pharmacist over the phone and receive the personalized care you deserve.

Who Should Participate?
Tria Health’s Pharmacy Advocate Program is available for employees and/or dependents on the Archdiocese of Kansas City in KS’s health insurance. Tria Health is recommended for members who have any of the
following conditions:

  • Diabetes
  • Heart Disease
  • High Cholesterol
  • High Blood Pressure
  • Mental Health
  • Asthma/COPD
  • Osteoporosis
  • Migraines

Active Participants Can Save Money on Their Medications
Active participants will receive discounted copays on select medications used to treat targeted chronic conditions. You are not required to change your medications, pharmacy, or doctor to receive this benefit.

  • Free generics
  • Reduced cost on select brand medications
    *Chronic pain medications are excluded

Free Diabetes Meter & Testing Supplies
Active participants with diabetes will have access to a FREE blood glucose meter, testing strips, and a digital dashboard designed to help you better understand your diabetes & share readings with your care team. Your dashboard will auto-populate with your data and is available online and through Tria Health’s mobile app.

Tria Health – Personalized Health Care
Tria Health is a free and confidential benefit available through your health plan. If you have a chronic condition or take multiple medications, Tria Health’s pharmacists are ready to support you in managing your health. Not only will Tria Health’s pharmacists make sure your medications are working as intended and that you’re on the right medications, but they can support you by creating a care plan that is specific to your needs and sharing it with your doctor. Talk to a pharmacist over the phone and receive the personalized care you deserve. Active participants will receive free generics and reduced select brand medications used to treat targeted chronic conditions. Participants with diabetes will also have free access to a blood glucose meter and testing supplies.

Why Participate?
Did you know that approximately 50% of patients do not take their medications as prescribed? Tria Health provides pharmacist-led consultations. Using their knowledge of medications, pharmacists understand how to achieve maximum benefit, minimal side effects and to avoid drug interactions.

Your Tria Health pharmacist can help:

  • Make sure your medications are working as intended.
  • Help you save money – Tria saves patients an average $250 per year!
  • Answer any questions you have about your health.
  • Coordinate care with your doctor(s) – Over 95% of recommendations made by Tria Health were accepted by an individual’s physician.

Tria Help Desk
The Tria Help Desk is a toll-free resource where all members can speak directly with a Tria Health clinical pharmacist to receive information ranging from less expensive drug therapies to learning more about potential drug-to-drug interactions. Members can access the Tria Help Desk at 1-888-799-TRIA(8742) Monday-Friday from 8am to 9pm and Saturday from 9am to 8pm.

Does my doctor know about Tria Health?
Tria Health’s pharmacist will inform your doctor about Tria Health and our services. All necessary information and recommendations are provided to the member’s doctor as part of our coordination of care.

Am I required to change my medications or pharmacy?
After speaking with your pharmacist, Tria Health may provide recommendations to you AND your doctor(s) to improve the outcomes you receive from your medications and/or lower your out-of-pocket cost. Any changes are left up to you and your doctor for approval.

How often do members speak with a Tria Health clinical pharmacist?
Pharmacists will keep in touch with each member approximately 2 or 3 times throughout the year, depending on each member’s personal care plan, which is discussed during their initial consultation. All members, however, have unlimited access to the Tria Help Desk, where they can speak with a Tria Health Clinical Pharmacist regarding any medication issue.

How to Sign Up?
To schedule your first appointment, visit www.triahealth.com/schedule or call 1-888-799-8742 to speak with a Tria Health member advocate.

You can enroll by…
Calling
1-888-799-8742
Online
You may enroll online by visiting the website:
www.triahealth.com/schedule 

Telehealth

MyCatholicDoctor is a nationwide organization that brings a network of faithful medical professionals to you through video appointment (telehealth). We offer rapid access urgent care 24/7/365, as well as appointment-based visits. Appointment-based visits will generally have a lower co-pay and include both primary care and specialty care.

We can initiate your medical care virtually, order any necessary labs or imaging, and send prescriptions to
any pharmacy of your choice. We practice evidence-based scientific medicine from a Catholic perspective
and integrate Catholic spirituality into our care as appropriate to the situation.

When can I use MyCatholicDoctor?
Choose our rapid access urgent care when:

  • You need care now
  • If you are considering the ER or urgent care center for a non-emergency issue
  • You are traveling
  • You need care during non-business hours
  • PPO co-pay $25, no deductible. HDHP $55 which is applied to the deductible

Smartphone access appointments by video or phone.
Confidential visits are available during evenings, weekends, and holidays.

To Get Started Visit
https://mycatholicdoctor.com/archkck/
No Password Required
No Special App

Downloads

My Catholic Doctor Flyer