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Mo-Kan Sheet Metal Workers Welfare Fund Benefits

Locating an In-Network provider for Preferred Care Blue, Blue Card and Dental Network of America.
Providers in the Kansas City (local) Area Medical and Dental:

  1. Click on Find Blue KC Doctors, Hospitals and Pharmacies in the upper or lower right-hand corner of the homepage.
  2. On the next page, select the Provider Directory for your search.
  3. Select your current insurance plan from the drop-down box. For medical services this will be the Preferred Care Blue option, for dental it will the Dental-Preferred Care option.
  4. Select a Provider Type by clicking the appropriate radio button.
  5. Click the Continue button.

If

then

you know the provider’s name
  • enter the last and first name;
  • click Find Providers.

you don’t know the provider name
  • select the appropriate Provider Specialty;
  • zip code for the state of resident (required field);
  • select the number of miles you are willing to travel to see the provider (required field);
  • click Find Providers.
  1. A list of providers matching your search criteria will appear on the next page.

 Medical Providers outside the Kansas City Area (BlueCard):

  1. Click on Find Blue KC Doctors, Hospitals and Pharmacies in the upper or lower right-hand corner of the homepage.
  2. On the next page, select the Provider Directory for your search.

If

then

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.

Dental Providers outside the Kansas City Area – Dental Network of America (DNoA) 

  1. Click on Find Blue KC Doctors, Hospitals and Pharmacies in the upper or lower right-hand corner of the homepage.
  2. On the next page, select the Provider Directory for your search.

If

then

you are searching for an out of area provider
  • select Dental Network of America;
  • click continue;
  • use the search options provided to locate provider.
  • choose a specialty from the drop down box

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). 

**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. 

Please note our mailing address:
P.O. Box 300019 Kansas City , MO 64130-0019

Your new drug plan 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.

Mail Order (90 day supply):
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.

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Summary Plan

Summary Plan Description - Download the the complete Summary Plan Description.

Working Spouse Summary - View the Working Spouse Incentive Program Summary.

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.

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Mo-Kan Sheet Metal Workers Welfare Fund
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