info@mokansheetmetal.org

(816) 531-0334

Download SBC (Summary of Benefits Coverage).

Locating an In-Network provider for Preferred Care Blue, Blue Card and Dental Network of America.

  1. Go to the Blue Cross and Blue Shield of Kansas City website at www.bluekc.com. Click on Find a Doctor in the upper right hand corner.
  2. Select your current insurance plan from the drop-down box. For medical services this will be the Preferred Care Blue Network option, for dental it will the Dental-Preferred Care Network option.
  3. Under Location, type in your City & State or Zip Code. Select drop down box for the radius you are willing to travel within the City & State or Zip Code you input.
  4. Refer to chart below.
  5. A list of providers matching your search criteria will appear on the next page.
If then
you know the provider’s name
  • enter the last and first name;
  • click Go.
you don’t know the provider name
  • select the Search By Specialty option under Find a Doctor or Hospital;
  • Click the letter that starts with the Specialty you are searching for (such as “F” for Family Practice);
  • click the name of the Specialty you want under that letter;
  • click Go.

Medical Providers outside the Kansas City Area (BlueCard):

  1. Go to the Blue Cross and Blue Shield of Kansas City website at www.bluekc.com. Click on Find a Doctor in the upper right hand corner.
  2. Click on Find a Doctor in the upper right-hand corner of the homepage.
  3. Under Location, type in your City & State or Zip Code. Select drop down box for the radius you are willing to travel within the City & State or Zip Code you input.
  4. Under Already a Member, type KDL (the first three letters on your BCBS card). Under Choose Your Network, select BlueCard PPO/EPO.
  5. Refer to chart below.
If then
you know the provider’s name
  • enter the last and first name;
  • click Go.
you are searching for an out of area provider
  • select Bluecard Provider Directory;
  • click continue;
  • enter the alpha prefix in the box provided;
  • use the search options provided to locate provider.

Register for a Blue Cross and Blue Shield of Kansas City Log-in and be able to access claims information, benefits, and copies of your Explanation of Benefits. For a step-by-step guide on how to create your Log-in, Click here.

Benefit Summary

Benefits Summary – Download the benefits summary.

The following notice is required each year under the Women’s Health and Cancer Rights Act (WHCRA).

Under the Women’s Health and Cancer Rights Act, group health plans that provide medical and surgical benefits in connection with mastectomy, like this Plan, must provide benefits for certain reconstructive surgery. This benefit covers reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction on the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications of all states of mastectomy, including lymphedemas. This coverage is subject to the plan’s deductible and coinsurance provisions which are described in Your Summary Plan Description (SPD).

View Map of Counties Covered

 

 

**When obtaining services from a provider not contracted with Mo-Kan Sheet Metal Workers Welfare Fund, you may be responsible for charges in excess of Allowable Charges, as determined by Mo-Kan Sheet Metal Workers Welfare Fund. Additional service area restrictions may apply.

Prescription Drug Plan

Mo-Kan Sheet Metal Workers Welfare Fund has added a new benefit for over-the-counter medications under the prescription drug program. Members are now able to purchase certain over-the-counter medications at $10.00 retail co-pay and $20.00 mail order copay. In order to receive the appropriate generic co-pay, you must present a prescription from your physician, for the over-the-counter product, to your pharmacist to process the claim.

We provide benefits for smoking cessation. Benefits are payable for one treatment cycle per calendar year and are subject to the lifetime max shown in the Benefit Summary. The one course of treatment must be prior authorized with Medtrak PA at 1-800-771-4648.

Please note our mailing address:
P.O. Box 300019 Kansas City , MO 64130-0019
Your new drug plan through Medtrak is as follows:

Retail Pharmacy (30 day supply):
Generic- $10 copayment
Brand Name- You pay 50% of the cost of the prescription drug up to a maximum of $50. This means the maximum amount you’ll pay out of your pocket per prescription for Brand name drugs is $50.

NEW! You can now get a 90 day supply at Participating Retail Pharmacies. Call Medtrak at 1-800-771-4648 and ask for a Performance 90 Network Pharmacy near you. You must present a 90 day supply prescription from your doctor in order for the pharmacist to process the claim. Same benefits as the Mail Order.

Mail Order (90 day supply): (with Orchard Pharmaceutical)
Generic- $20 copayment
Brand Name- You pay 50% of the cost of the prescription drug up to a maximum of $100. This means the maximum amount you’ll pay out of your pocket per prescription for Brand name drugs is $100.

Out-of-Pocket Maximum:
The maximum amount you’ll pay out-of-pocket for prescription drugs in a calendar year is $1,000 per member or $2,000 per member for family coverage.

Summary Plan

Summary Plan Description – Download the the complete Summary Plan Description.

Working Spouse Incentive Summary – View the Working Spouse Incentive Program Summary. Please also download the Member letter with FAQ.

For more information about MO-KAN Sheet Metal Workers Welfare Fund, please contact the Fund Office at (816) 531-0334 or toll free outside the Kansas City Metropolitan area at (866) 531-5488.