Increasing the quality of care while containing costs When health insurance picks up most of the cost of medical care, there is a perception that “someone else” is paying. But really, it’s your money. When you, your family, and your co-workers use more and more medical services, the cost is passed on in the form of higher premiums, copayments, coinsurance, and deductibles. That’s why medical … Continue reading How we make medical policy and member benefit decisions

Why a doctor-prescribed service or device isn’t always covered by health insurance Medical necessity and covered benefits are two entirely different things. A medical necessity is something that your doctor has decided is necessary. A covered benefit is something that your health plan or policy has agreed to cover. The fact that a doctor may prescribe, order, recommend, or approve a service does not always … Continue reading What’s the difference between medical necessity and a covered benefit?

When it comes to your health plan, knowledge is power As a Blue Cross and Blue Shield of Kansas member, you are entitled to certain rights and responsibilities. Some are guaranteed by federal law, such as the right to get a copy of your medical records, and the right to keep them private. The health care law also offers rights and protections that make coverage fairer … Continue reading What are my rights as a member?