Missouri health plan · 2026

Blue KC Catastrophic BlueSelect EPO · 34762MO0590023

Blue Cross and Blue Shield of Kansas City offers this marketplace health insurance plan (Plan ID 34762MO0590023) so you can compare premiums, coverage levels, and provider access against other health plan insurance options. Use the modules below to decide whether this is the best health insurance plan for your household or if another insurance health plan fits better.

Metal level: Catastrophic Plan type: EPO CSR: Standard Catastrophic On Exchange Plan Issuer: Blue Cross and Blue Shield of Kansas City
Telehealth Data pending HSA eligible Yes Dental Not listed Vision Child
Pay / Manage Plan View issuer site

2026 cost summary

Key premiums & cost sharing

Rates mirror the latest CMS import (Tue, 02 Dec 2025 06:13 GMT). Personalize costs with your ZIP, age, and subsidies in the plan finder.

Monthly premium

$290 – $1138

Before subsidies

Estimate after subsidies

Deductible

$10,600

$21200 per group

See deductible details

Max out-of-pocket

$10,600

$21200 per group

Review MOOP rules

Office visits

Primary care $100.00, No Charge after deductible
Specialist No Charge after deductible
HSA Eligible

Drug tiers

Generic No Charge after deductible
Preferred brand No Charge after deductible

View formulary tiers

$398 / mo before subsidies

≈ $4770 per year before tax credits.

Start with this unsubsidized premium, then apply marketplace tax credits to see your final monthly payment.

  • Ideal for shoppers comparing Bronze vs. Silver budgets.
  • Update your Marketplace application to apply premium tax credits.

$1260 / mo before subsidies

≈ $15116 per year before tax credits.

Pre-subsidy rate for a couple with one dependent. Switch to Silver CSR plans if you qualify to reduce these numbers.

  • Compares well against PPO vs HMO networks when planning for childcare and telehealth needs.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$1526 / mo before subsidies

≈ $18307 per year before tax credits.

Pairs with cost-sharing reductions (CSR) when you select a Silver tier and qualify based on income.

  • Use this estimate before adding childcare, dental, or vision extras.
  • CSR Silver variants can lower deductibles dramatically for eligible incomes.
  • CSR savings require a Silver variant. Use the plan finder to load Silver options if you need lower deductibles.

$970 / mo before subsidies

≈ $11634 per year before tax credits.

Shows the combined pre-subsidy rate for two adults. Add dependents or subsidies in your application to refine it.

  • Great for households deciding between PPO and HMO networks.
  • Telehealth and HSA perks (when offered) apply to both members.
Issuer profile See benefits

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

No Charge after deductible

Durable Medical Equipment

No Charge after deductible

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Enrollment guidance

Stay on top of 2026 ACA deadlines

Open Enrollment window

Marketplace enrollment for 2026 coverage typically runs Nov 1 – Jan 15 (dates may vary slightly in Missouri). Submit changes before the deadline to avoid a coverage gap.

  • Enroll by Dec 15 for Jan 1 starts.
  • Finalize plan switches before the window closes.

Special Enrollment Periods

You can change plans mid-year if you experience a qualifying life event (move, childbirth, marriage, loss of other coverage).

  • Report the event within 60 days.
  • Keep documentation handy for Healthcare.gov or your state exchange.

CSR & subsidy reminders

Premium tax credits and cost-sharing reductions (CSR) update annually when you re-submit your marketplace application.

  • Enter accurate income to maximize Advanced Premium Tax Credits.
  • Standard Catastrophic On Exchange Plan plans like this one keep deductibles and copays lower if you qualify.

Thinking about switching?

Before you leave your current plan, compare networks, drug coverage, and total cost using the cards on this page.

  • Match provider networks so ongoing care isn’t disrupted.
  • Confirm prescriptions stay on-formulary or budget for tier changes.

Top covered benefits

How this plan handles key care scenarios

Preventive Care/Screening/Immunization

No Charge

Emergency Room Services

No Charge after deductible

Durable Medical Equipment

No Charge after deductible

Premium snapshot

Plan identifiers & filings

Track the official identifiers, documents, and filing dates tied to this plan. Open the marketing or formulary links whenever you need the latest PDF from the issuer.

Plan ID 34762MO0590023
Coverage year 2026
State Missouri
Issuer Blue Cross and Blue Shield of Kansas City
Formulary document Download formulary
Marketing materials View marketing kit
Variant ID 34762MO0590023-01
Available variants

Standard Off Exchange Plan · 34762MO0590023-00

Standard On Exchange Plan · 34762MO0590023-01
Last plan update Wed, 15 Oct 2025 00:00 GMT
Last HealthPorta import Tue, 02 Dec 2025 06:13 GMT

Network stats

Provider access snapshot

Review the network branding plus the number of in-network clinicians we track from issuer filings. Counts update with each CMS import (Tue, 02 Dec 2025 06:13 GMT).

All providers in Missouri 7913
PCPs in Missouri 1134
Telehealth support Data pending
Nationwide providers 12307
7,913 doctors statewide 1,134 PCPs 31 OB/GYN

Provider network(s)

Providers Missouri All US states
All 7913 12307
PCP 1134 1733
Allergy N/A 1
OB/GYN 31 72
Dentists 8 13

Drug coverage overview

3,830 drugs tracked

Inspect tier distribution plus authorization, step therapy, and quantity-limit counts sourced from HealthPorta’s formulary import.

Tier Covered drugs
GENERIC 1,613
INFERTILITY 1,250
PREFERRED-BRAND 376
NON-PREFERRED-BRAND-SPECIALTY 337
GENERIC-SPECIALTY 254
Prior authorization Drugs
Required 737
Not Required 3,093
Step therapy Drugs
Required 68
Not Required 3,762
Quantity limits Drugs
Has Limit 885
No Limit 2,945

Customer highlights

What stands out for members

  • Issuer: Blue Cross and Blue Shield of Kansas City · Plan ID 34762MO0590023 · 2026 filing.
  • Disease management programs available: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy.
  • Download the latest formulary directly from the issuer here.
  • Review marketing brochures and SBC PDFs via the issuer marketing repository.
  • Variant 34762MO0590023-01 (Standard On Exchange Plan) currently displayed.
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Benefits

Covered services & limitations

Everyday care

Office visits, preventive care, labs, imaging, and home health.

Chiropractic Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Chiropractic visits beyond 26 per benefit period require Prior Authorization.

Diabetes Education

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Home Health Care Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 100.0 Visit(s) per Benefit Period

To be eligible for benefits, you must essentially be confined to the home, as an alternative to a Hospital stay, and be physically unable to get needed medical services on an outpatient basis.

Laboratory Outpatient and Professional Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Other Practitioner Office Visit (Nurse, Physician Assistant)

$100.00, No Charge after deductible
Tier 1 in-network $100.00, No Charge after deductible
Out-of-network 100.00%

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

Preventive Care/Screening/Immunization

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Primary Care Visit to Treat an Injury or Illness

$100.00, No Charge after deductible
Tier 1 in-network $100.00, No Charge after deductible
Out-of-network 100.00%

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

Rehabilitative Occupational and Rehabilitative Physical Therapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Benefit Period

20 visit limit each for PT and OT.

Rehabilitative Speech Therapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Unlimited visits for speech therapy.

Specialist Visit

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

Urgent Care Centers or Facilities

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Save money and time with Blue KC Virtual Care. You may access virtual care for a $0 copay, 24/7.

X-rays and Diagnostic Imaging

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Hospital & urgent

Emergency room, inpatient stays, ambulance, and surgeries.

Chemotherapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Delivery and All Inpatient Services for Maternity Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Dialysis

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Covered Services include dialysis treatments in an outpatient dialysis, or home dialysis and training for you and the person who will help you with home self-dialysis.

Durable Medical Equipment

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Emergency Room Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Emergency Transportation/Ambulance

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network No Charge after deductible

Hospice Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Inpatient Hospital Services (e.g., Hospital Stay)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Inpatient Physician and Surgical Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Mental/Behavioral Health Inpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Mental/Behavioral Health Outpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

Outpatient Facility Fee (e.g., Ambulatory Surgery Center)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Outpatient Rehabilitation Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Benefit Period

To be Covered Services, rehabilitation services must involve goals you can reach in a reasonable period of time. Benefits will end when treatment is no longer Medically Necessary and you stop progressing toward those goals.

Outpatient Surgery Physician/Surgical Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Radiation

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Skilled Nursing Facility

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 150.0 Days per Benefit Period

Limit is for in-and out-of-network combined and includes rehab and outpatient day rehab.

Substance Abuse Disorder Inpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Substance Abuse Disorder Outpatient Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

You have a $0 copay for telehealth visits with your doctor, saving you money and time.

Transplant

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Pregnancy & family

Maternity, newborn, pediatric dental and vision extras.

Basic Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Hearing Aids

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Benefits include hearing aids provided to a newborn for initial amplification following a newborn hearing screening.

Major Dental Care - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prenatal and Postnatal Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Routine Eye Exam for Children

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 1.0 Exam(s) per Benefit Period

Well Baby Visits and Care

No Charge
Tier 1 in-network No Charge
Out-of-network 100.00%

Pharmacy & drugs

Generic, brand, specialty, and mail order tiers.

Generic Drugs

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Non-Preferred Brand Drugs

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Preferred Brand Drugs

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Specialty Drugs

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Wellness & extras

Vision, dental, therapies, prosthetics, weight management.

Accidental Dental

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 3000.0 Dollars per Episode

Treatment must begin within 12 months of the injury.

Basic Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Dental Check-Up for Children

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Infusion Therapy

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Major Dental Care - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Nutritional Counseling

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Orthodontia - Adult

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Orthodontia - Child

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Prosthetic Devices

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Benefits include the purchase, fitting, adjustments, repairs and replacements.

Routine Dental Services (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Weight Loss Programs

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Additional benefits

Other plan-specific services and limitations.

Abortion for Which Public Funding is Prohibited

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Acupuncture

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Allergy Testing

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Bariatric Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Cosmetic Surgery

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Eye Glasses for Children

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 1.0 Item(s) per Year

Covered lenses and frames each available at limit of one per year.

Habilitation Services

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 20.0 Visit(s) per Benefit Period

Habilitative services definition: 'help you keep, learn or improve skills and functioning for daily living.'

Imaging (CT/PET Scans, MRIs)

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Infertility Treatment

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Long-Term/Custodial Nursing Home Care

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Private-Duty Nursing

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Limit: 82.0 Visit(s) per Benefit Period

Private duty nursing services are a Covered Service only when given as part of the 'Home Care Services' benefit. Private Duty Lifetime Maximum: 164 visits In- and Out-of-Network combined.

Reconstructive Surgery

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Benefits include reconstructive surgery to correct significant deformities caused by congenital or developmental abnormalities, illness, injury or an earlier treatment in order to create a more normal appearance.

Routine Eye Exam (Adult)

Coverage details pending

Issuer did not share extra notes for this benefit beyond the summary above.

Routine Foot Care

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Coverage is available if Medically Necessary.

Treatment for Temporomandibular Joint Disorders

No Charge after deductible
Tier 1 in-network No Charge after deductible
Out-of-network 100.00%

Covered Services include removable appliances for TMJ repositioning and related surgery, medical care, and diagnostic services.

Variant attributes

Blue KC Catastrophic BlueSelect EPO · Variant 34762MO0590023-01

Plan identifiers & tier

Issuer-provided metadata for this variant.

Business Year

2026

CSR Variation Type

Standard Catastrophic On Exchange Plan

HIOS Product ID

34762MO059

Metal Level

Catastrophic

Plan ID (Standard Component ID with Variant)

34762MO0590023-01

Plan Marketing Name

Blue KC Catastrophic BlueSelect EPO

Plan Variant Marketing Name

Blue KC Catastrophic BlueSelect EPO

Issuer & service area

Issuer-provided metadata for this variant.

Issuer ID

34762

Issuer Marketplace Marketing Name

Blue Cross and Blue Shield of Kansas City

Market Coverage

Individual

Multiple In Network Tiers

No

National Network

No

Network ID

MON002

Out of Country Coverage

No

Out of Country Coverage Description

We provide limited services outside the United States through Global Core. Such services are limited to emergency services.

Out of Service Area Coverage

No

Out of Service Area Coverage Description

Services are not provided out-of-network, except in an Emergency or other limited situations. If an out-of-network service is covered and provided outside of Our Service Area, such services will be provided at the in-network benefit level. Non-emergency services that are covered out-of-network will not apply to your in-network out-of-pocket maximum.

Service Area ID

MOS001

State Code

MO

URL for Summary of Benefits & Coverage

Open link

Cost sharing & actuarial values

Issuer-provided metadata for this variant.

Begin Primary Care Deductible Coinsurance After Number Of Copays

3

Inpatient Copayment Maximum Days

0

Medical Drug Deductibles Integrated

Yes

Medical Drug Maximum Out of Pocket Integrated

Yes

SBC Scenario, Having a Baby, Coinsurance

$0

SBC Scenario, Having a Baby, Copayment

$0

SBC Scenario, Having a Baby, Deductible

$10,600

SBC Scenario, Having Diabetes, Coinsurance

$0

SBC Scenario, Having Diabetes, Copayment

$300

SBC Scenario, Having Diabetes, Deductible

$4,800

SBC Scenario, Treatment of a Simple Fracture, Coinsurance

$0

SBC Scenario, Treatment of a Simple Fracture, Copayment

$0

SBC Scenario, Treatment of a Simple Fracture, Deductible

$2,800

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance

0.00%

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Group

$21200 per group

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family Per Person

$10600 per person

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual

$10,600

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Group

per group not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family Per Person

per person not applicable

Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual

Not Applicable

Enrollment & documents

Issuer-provided metadata for this variant.

Formulary ID

MOF003

Formulary URL

Open link

Plan Brochure

Open link

SBC Scenario, Having a Baby, Limit

$60

SBC Scenario, Having Diabetes, Limit

$0

SBC Scenario, Treatment of a Simple Fracture, Limit

$0

URL for Enrollment Payment

Open link

Additional attributes

Issuer-provided metadata for this variant.

Begin Primary Care Cost-Sharing After Number Of Visits

0

Child-Only Offering

Allows Adult and Child-Only

Composite Rating Offered

No

Dental Only Plan

No

Design Type

Not Applicable

Disease Management Programs Offered

Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy

EHB Percent of Total Premium

1

First Tier Utilization

100%

Import Date

10/15/2025

Limited Cost Sharing Plan Variation - Estimated Advanced Payment

$0.00

HSA Eligible

Yes

New/Existing Plan

Existing

Notice Required for Pregnancy

No

Is a Referral Required for Specialist?

No

Plan Effective Date

1/1/2026

Plan Expiration Date

12/31/2026

Plan Level Exclusions

All services must be rendered under the provisions of the Contract and comply with the Medical policies of the Plan. Please refer to the Member's Plan Document for more information.

Plan Type

EPO

QHP/Non QHP

Both

Source Name

HIOS

Plan ID

34762MO0590023

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual

Not Applicable

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Group

$21200 per group

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family Per Person

$10600 per person

Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual

$10,600

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Group

per group not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Family Per Person

per person not applicable

Combined Medical and Drug EHB Deductible, Out of Network, Individual

Not Applicable

Unique Plan Design

No

Wellness Program Offered

No

Copay & coinsurance

Pharmacy cost sharing by tier

Drug tier Pharmacy type Copay amount Copay option Coinsurance rate Coinsurance option Mail order

Questions & answers

Frequently asked questions

How do I choose the right ACA plan in Missouri?

Blue KC Catastrophic BlueSelect EPO (34762MO0590023) is a Catastrophic EPO from Blue Cross and Blue Shield of Kansas City in Missouri for the 2026 coverage year.

Compare it against other options with the HealthPorta plan finder to confirm premiums, deductibles, and network access fit your household.

Does Blue KC Catastrophic BlueSelect EPO support telehealth or virtual urgent care?

The issuer has not published telehealth details yet. Review the Summary of Benefits and Coverage to confirm if virtual visits are included.

Is Blue KC Catastrophic BlueSelect EPO HSA-eligible and does it include dental or vision coverage?

It is HSA-eligible, so you can pair it with a Health Savings Account to lower taxes.

Dental coverage is not listed for this plan.

Vision add-ons: Child.

Does Blue KC Catastrophic BlueSelect EPO support mail-order prescriptions?

Mail order coverage is not listed for this plan, so confirm with the issuer before relying on home delivery.

Which disease management programs come with Blue KC Catastrophic BlueSelect EPO?

The issuer lists disease management resources for: Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Pregnancy.

Is there out-of-country coverage for Blue KC Catastrophic BlueSelect EPO?

No, out-of-country services are not covered for this plan. Details: We provide limited services outside the United States through Global Core. Such services are limited to emergency services.

Does Blue KC Catastrophic BlueSelect EPO cover care outside the service area?

No, the issuer indicates out-of-service-area care is not covered except for emergencies. Details: Services are not provided out-of-network, except in an Emergency or other limited situations. If an out-of-network service is covered and provided outside of Our Service Area, such services will be provided at the in-network benefit level. Non-emergency services that are covered out-of-network will not apply to your in-network out-of-pocket maximum.

Disclaimer: Based on the Tue, 02 Dec 2025 06:13 GMT HealthPorta import from CMS issuer filings. Data is best-effort and should be validated with the issuer directly. Sources: CMS.gov and the HealthPorta Healthcare MRF API.
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