State Pool Plan Options

Printer-friendly State Pool Plans and Premiums - This will open in a new window.

All five MHIP state pool plans are comprehensive major medical plans that use a preferred provider organization (PPO). Enrollees must receive care from a PPO network provider to receive maximum benefits.

Download the State Pool Certificate of Coverage.

Plan Options Overview

	Plan I		Plan II		Plan III		Plan IV		Plan V
	Network	Non-Network	Network	Non-Network	Network	Non-Network	Network	Non-Network	Network	Non-Network
Description	You pay the deductible and coinsurance amounts until you meet the out-of-pocket maximum. You have a separate deductible, coinsurance and out-of-pocket maximum for prescription drugs.								This plan is designed to be used with a Health Savings Account. Contact the carrier serving your area for more information.
Deductible	$500	$1,000	$1,000	$2,000	$2,500	$5,000	$5,000	$10,000	$2,500 combined medical/pharmacy deductible, network and non-network
Coinsurance	20% after deductible	50% after deductible	20% after deductible	50% after deductible	20% after deductible	50% after deductible	20% after deductible	50% after deductible	20% after deductible	50% after deductible
Out-of-Pocket Maximum	$3,000	No Limit	$6,000	No Limit	$7,500	No Limit	$10,000	No Limit	$5,000	$10,000
Prescription Deductible	$100		$100		$250		$500		$2,500 combined medical/pharmacy deductible, network and non-network
Prescription Coinsurance	30% of drug's cost after pharmacy deductible	You pay drug's cost and are reimbursed up to 70%	30% of drug's cost after pharmacy deductible	You pay drug's cost and are reimbursed up to 70%	30% of drug's cost after pharmacy deductible	You pay drug's cost and are reimbursed up to 70%	30% of drug's cost after pharmacy deductible	You pay drug's cost and are reimbursed up to 70%	30% of drug's cost after deductible (BCBSKC) / 20% of drug's cost after deductible (Anthem)	30% of drug's cost after deductible (BCBSKC) / 50% of drug's cost after deductible (Anthem)
Prescription Out-of-Pocket Maximum	$3,000		$3,000		$3,150		$3,400		$5,000, combined with medical plan