Advanced primary care is right around the corner

To be eligible to use Spira Care for your primary care needs you must be enrolled in either an employer sponsored health plan or an Individual and Family plan that includes access to Spira Care Centers. Spira Care is exclusive to Blue KC and many, but not all, plans include Spira Care. When enrollment time comes around take into consideration which plans do or do not include Spira Care. To see if your plan includes Spira Care, review your Summary of Coverage and Benefits by logging into your member account or see your member ID card.

Spira Care is designed for individuals looking to simplify and personalize their healthcare experience. If you think you and your family’s health needs in the next year will mostly fall within primary care—including routine labs, digital X-rays*, and routine behavioral health consultations—you can enjoy the peace of mind that comes with having the support of a Care Team and help with any services you need outside the Care Center that are in your plan’s network.

*X-rays are available at select locations only, must be ordered by a Spira Care provider, and are at no additional cost to members.

Eligible members enrolled in a Blue KC health plan without a Health Savings Account with exclusive access to Spira Care Centers will have no additional cost* for any appointment or service provided at Spira Care Centers.

Eligible members enrolled in a Blue KC health plan with a Health Savings Account or HSA eligible with exclusive access to Spira Care Centers will incur a $60 charge* for appointments or services at Spira Care Centers. Once you meet your deductible, any future primary care needs at a Spira Care Center are at no additional cost*. You will receive a bill from Spira Care after receiving service. Preventive services are covered at no additional cost**.

*Blue KC members enrolled in plans (without a Health Savings Account) with exclusive access to Spira Care Centers will have no additional cost for any appointment or service provided at a Spira Care Center. Blue KC members enrolled in a plan with a Health Savings Account or HSA eligible with exclusive access to Spira Care Centers will incur a charge for an office visit at a Spira Care Center. Once a member has met their deductible, any future primary care needs at a Spira Care Center are at no additional cost. Preventive services are covered at 100 percent.

**For costs and further details of the coverage, including exclusions, any reductions or limitations and the terms under which the policy may be continued in force, see your insurance producer or write Blue KC.

For Individual & Family plans that include access to Spira Care, Blue KC Choice Plans give members exclusive access to nine Spira Care Centers across the Kansas City metropolitan area. Members enrolled in a Blue KC Choice Plan will have no additional cost* for any appointment or service provided at a Spira Care Center. Spira Care offers advanced primary care for newborns, infants, children, adolescents, and adults that gives you easy, convenient access to advanced primary care services, behavioral health support, lab draws, preventive care, immunizations, sick care and more.

*Blue KC members enrolled in plans with exclusive access to Spira Care Centers and no Health Savings Account (HSA) will have no costs. For costs and further details of the coverage, including exclusions, any reductions or limitations and the terms under which the policy may be continued in force, see your insurance producer or write Blue KC.

There are currently nine Care Centers – Crossroads, Lee’s Summit, Overland Park, Liberty, Olathe, Shawnee, Independence, Tiffany Springs, and Wyandotte. Each of these Care Centers offers a variety of primary care services under one roof, including multidisciplinary Care Teams working together to take exceptional care of you. Spira Care was designed with you and your family at the heart of everything they do. Their goal is to eliminate stress, confusion and the feeling of being rushed in and out of your doctor’s office.

Spira Care Centers offer advanced primary care services for the whole family including:

• Treatment of common medical conditions and minor injuries
• Wellness appointments, also known as annual physicals or checkups, for infants, children, teens, and adults.
• Health screenings to help identify potential health problems early or prevent them all together
• Sick care
• Behavioral health support
• Routine labs, x-rays* and more!

*X-rays are available at select locations only, must be ordered by a Spira Care provider, and are at no additional cost to members.

While plans with Spira Care are ideal for members who utilize the Care Centers, members still have access to all providers in their plan’s network (depending on your plan costs may be subject to your deductible or applicable copay). Many patients enjoy the convenient benefits and advanced primary care services offered at Spira Care including care for newborns, infants, children, teens, and adults. Patients also have access to a team of Care Guides for care and coverage questions. Find out more about the providers at Spira Care Centers.

Yes, Spira Care offers behavioral health support for children, teens, and adults that is integrated with your primary care. In partnership with your medical provider and a behavioral health consultant, members have access to brief and focused interventions. If you have an ongoing or long-term behavioral health need (such as therapy), Spira Care can work with you to identify a provider in your plan’s network.

You have access to your plan’s network within the Kansas City metro area. For emergency situations, you are covered both in and out of your plan’s network. Services beyond Spira Care (for example, a visit to a specialist or an emergency room) are subject to a person’s plan deductible.

To ensure the best member experience, always schedule an appointment for wellness check-ups, physicals, sick care, chronic medical condition management, immunizations, chronic medical condition management, and refills. If a Care Center is at capacity, we’ll work with you on an alternative solution such as availability at another Care Center, virtual care, or finding an option in your plan’s network (subject to your deductible). Convenient telehealth visits are also available with an affordable copay. Schedules vary by Care Center.