Blue Cross Blue Shield of Kansas

Blue Cross Blue Shield of Kansas

More than 900,000 Kansans have chosen Blue Cross and Blue Shield of Kansas for their health insurance needs. That number represents nearly one-third of the population in the 103 Kansas counties served by BCBSKS. BCBSKS offers Greenbush Health members a choice of four fully insured health coverage options, one of them being a QHDP with an optional HSA.

If you don't see the form you are looking for listed below, please click here to go to the BCBSKS forms page.

***In order to print brochures and / or forms please download them first.***

(BCBSKS plans are now Option A - B - C - D / These are the same as our Option 1 - 2 - 3 - 4) Example: Option 1 is now called Option A and so on....

2021-2022 BCBSKS Benefits Summary

2020-2021 BCBSKS Benefits Summary


Telemedicine Information

Telemedicine "How to Use"

2021 BCBSKS Employee Enrollment Form

2021 BCBSKS Employee Change Form

2021 BCBSKS Non-Grandfathered Quad Option Change Form

2021 BCBSKS Waiver Form

2021 BCBSKS Preventive Services

2021 BCBSKS Medication Covered Under The ACA With No Cost Sharing

2021 Understanding The Coverage You Need - MC17

2021 Uniform Glossary of Health Coverage and Medical Terms

2021 - 2022 Summary of Benefits and Coverage (SBC)

BCBSKS Option A

BCBSKS Option B

BCBSKS Option C

BCBSKS Option D (QHDP/ with Optional HSA)

2020 - 2021 Summary of Benefits and Coverage (SBC)

BCBSKS Option A

BCBSKS Option B

BCBSKS Option C

BCBSKS Option D (QHDP/ with Optional HSA)

Spanish

Uniform Glossary of Health Coverage and Medical Terms

Important Information about Comprehensive Major Medical

Coverage is limited to those charges that are medically necessary, as described in the plan document. Exclusions: The following procedures and all related services and supplies are not covered under this program. Services provided directly for or relative to diseases or injuries caused by or arising out of acts of war, insurrection, rebellion, armed invasion, or aggression; duplicate benefits provided under federal, state of local laws, regulation or programs, except Medicaid; cosmetic or reconstructive surgery (except as stated in the certificate); any keratotomy procedures; charges for personal items; convalescent or custodial / maintenance care of rest cures; blood or payments to donors of blood, any service or supply related to the medical management of obesity; charges for services by immediate relatives or by members of your household; acupuncture and admissions for acupuncture; services related to temporomandibular joint dysfunction syndrome over the amount specified in the certificate; dental implants; services or supplies related to sex changes, sexual dysfunctions or inadequacies; any medically aided insemination procedure; services related to the reversal of sterilization procedures; treatment of nervous or mental conditions over the amount specified in the certificate; hearing aids; eyeglasses or contact lenses (except after the removal of cataracts); unnecessary services and admissions; services or supplies which are experimental or investigative in nature; services not specifically listed as benefits in the certificate; services covered and payable by any medical expense payment provision of any automobile insurance policy.



The above Benefit Summaries are brief summaries of the coverage available under this program. They are not legal documents and the exact provisions of the benefits and exclusion are contained in the actual policy certificates.