QHDHP KC Care

Qualified High Deductible Health Plan

This Qualified High Deductible Health Plan (QHDHP) allows you to contribute pre-tax dollars a Health Savings Account (HSA) to use for eligible medical expenses. Each time you visit the doctor or receive health care services, you can use your pre-tax dollars towards the expenses. The HSA covers incurred expenses by paying them from this allocation until the contribution dollars are exhausted.

  • Kansas City Orthopaedic Institute
  • University of Kansas Hospital
  • Children’s Mercy Hospital
  • University Health Truman Medical Center
  • Research Medical Center
  • AdventHealth Shawnee Mission
  • North Kansas City Hospital
  • Olathe Medical Center
  • Jackson
  • Platte
  • Clay
  • Douglas
  • Wyandotte
  • Johnson
  • Well Child or Well Baby exams
  • Annual school or sports physicals
  • Regular vaccines
  • Nutrition and weight management consultation
  • Support with chronic conditions such as asthma or diabetes
  • Annual Well Woman exams, including birth control or pregnancy tests as appropriate
  • Lab work
  • Well-woman exams
  • Testing & screening
  • Access to specialty care
  • Seasonal vaccines
  • Hepatitis C treatment
  • PrEP HIV prevention
  • Chiropractic care
  • Cardiac care
  • Colds
  • Flu
  • Skin infections / Rashes
  • Ear aches
  • Fevers
  • Headaches
  • Upper respiratory
  • infections
  • Urinary tract infections
  • Diabetes
  • Asthma
  • High blood pressure
  • High cholesterol
  • Arthritis
  • Obesity

KCOI is continuing a Domestic Tier, which allows employees to take advantage of services done at KCOI.

Per Pay Period Premium
QHDHP Plan KC Care
Employee $28.00
Employee + Spouse $206.00
Employee + Child(ren) $159.50
Employee + Family $245.50
QHDHP KC Care
Network KC Care Network
Domestic Tier: benefits when using KCOI or KCOA physicians & services
Annual Deductible (Individual/Family) $4,000 / $8,000
Out-of-Pocket Maximum (Individual/Family) $4,000 / $8,000
Co-Insurance (Member's Responsibility) 0%
Covered Services (Outpatient Specialis N/A
General Services (In-Network)
Annual Deductible Individual $4,000
Annual Deductible Family $8,000
Annual Out-of-Pocket Limit Individual $4,000
Annual Out-of-Pocket Limit Family $8,000
Co-Insurance (Member’s Responsibility) 0%
Office Services (In-Network)
Office Visits/Exam Deductible
Specialist Visit Deductible
Urgent Care Deductible
Preventive Care No charge
Outpatient Diagnostic (lab / X-ray) Deductible
Complex Imaging (MRI, CT / PET scans) Deductible
Hospital Services (In-Network)
Ambulance Deductible
Emergency Room Deductible
Inpatient Hospital Stay Deductible
Outpatient Surgery Deductible
Prescription Drugs (through Payer Matrix & Magellen - Tiers 1 / 2 / 3 / 4)
Retail Pharmacy (30-day supply) Deductible
Mail Order (90-day supply) Deductible
Preferred Specialty Deductible
Non-Preferred Specialty Deductible

Health Savings Account (HSA)

You contribute pretax dollars to the HSA. Interest accumulates tax-free, and funds are withdrawn tax-free to pay for medical expenses.

You can use the money in your HSA to pay for eligible medical expenses and prescriptions. The HSA funds you use can help you meet your plan’s annual deductible.

THE OPPORTUNITY FOR LONG-TERM SAVINGS: Save unused HSA funds from year to year — you can use this money to reduce future out-of-pocket health expenses. You can even save HSA dollars to use after you retire.

You are eligible to open and fund an HSA if:

  • You are enrolled in an HSA-eligible high-deductible health plan, such as Kansas City Orthopaedic Institute’s medical plans.
  • You are not covered by your spouse’s health plan (unless it is a qualified HDHP), flexible spending account (FSA) or health reimbursement account (HRA).
  • You are not eligible to be claimed as a dependent on someone else’s tax return.
  • You are not enrolled in Medicare, TRICARE or TRICARE For Life.
  • You have not received Veterans Administration

Once your account is open, you can access it via www.healthequity.com. You’ll set up your payroll contributions during open enrollment. You can make contribution changes at any time during the year through WEX. Note that it may take between one and two payroll periods for an HSA change to be processed.

The HSA is administered by Health Equity. Kansas City Orthpaedic pays the monthly administrative fee for your HSA. If your coverage status or employment status changes, you will be responsible for all HSA account holder fees.

You’ll notice two separate line items on your paycheck when you participate in the HDHP with HSA option — one

Employee Only – $4,300

Family – $8,550

Catch-up (age 55+) – $1,000

Our four medical plan options are offered through Meritain Health an Aetna Company. Need to connect?

Healthy Merits

Meritain Aetna Network

get connected!

Technical support: 800-925-2272

Meritain portal support: servicehelp@meritain.com 

Prescription Benefits Manager - Prime Therapeutics