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
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Apply for MHIP Coverage

Applications accepted until 11-15-13.

It's easy to apply for MHIP coverage. We've put together a simple checklist to help you get all your information in order.

Go to the Apply Now Checklist Page for information and helpful links.

Download the MHIP Application.

Need help with your application?
Call us at 800-821-2231.

Appeals and Grievances

Appeals and Grievances should be filed in accordance with State Pool Certificate of Coverage (page 45).

State Pool Certificate of Coverage

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