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Blue
Cross® Blue Shield® of Arizona
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Blue
Cross® Blue Shield® of Arizona HSA Plans
The most
popular plan offered by Blue Cross® Blue Shield® of
Arizona is their Blue Preferred Saver;
an HSA qualified high deductible health plan. Blue Cross
Blue Shield is an association of independent licensees, each
representing the Blue Cross and Blue Shield Association in
their own region. High deductible plans have always
been a smart way for consumers to better manage their health
care dollars.
With a
high deductible health insurance plan, you will save on the
cost of insurance by sharing more of the smaller expenses
such as physician office visits. While these plans are
designed to be affordable, you will enjoy the satisfaction
of knowing they will help you protect against the catastrophic
cost of a major illness or injury. Blue Cross® Blue
Shield® of Arizona offers one of the most popular High
Deductible Health Insurance plans in the state of Arizona.
Families
especially like the single deductible because its easy,
simple, and affordable. |
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- In
a recent study of individual under-65 customers who pay
for their health insurance directly and do not receive it
through an employer, a whopping 94 percent said they were
satisfied with the service provided by Blue Cross® Blue
Shield® of Arizona. The most frequently mentioned
reasons for satisfaction included excellent customer service,
easy access to medical care (including easy access to physicians,
specialists, hospitals, and pharmacies), and prompt and
accurate claims processing.
Ninety-five
percent of those surveyed said they were likely to renew their
membership with Blue Cross® Blue Shield® of Arizona.
See more information on the Customer
Satifaction Survey. |
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Plan
at a Glance: View
the Outline
of Coverage brochure 
Features |
Preferred
Provider |
Preferred
Provider |
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Calendar-Year
Deductibles |
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Coinsurance
Based on the BCBS AZ allowed amount for
covered services. The BCBS AZ allowed amount
is generally calculated using the lesser of
billed charges or the applicable BCBS AZ fee
schedule, including any contractual arrangements. |
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After you pay your Preferred calendar-year
deductible, BCBS AZ pays 80% or 100%,
depending on your plan, of the BCBS
AZ allowed amount for most covered
services.
The $1,500 deductible plan is available
as a 100% plan.
The $2,600 per person/$5,100 family plan option is available with either
80% or 100% coinsurance coverage
after meeting the Preferred deductible.
The $5,000 per person/$10,000 family
plan option is available with 100%
coinsurance.
Please
note: On the $1,500 and $2,600
deductible options, some services
are covered at 50% coinsurance (outpatient
mental health, inpatient rehabilitation,
and skilled nursing facility) and
continue to accumulate toward the
out-of-pocket maximum, even after
the deductible is met. |
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After you pay your nonPreferred calendar-year
deductible, BCBS AZ pays 50% of the BCBS
AZ allowed amount for covered services.
You pay the remaining 50% of the BCBS AZ
allowed amount.
If
a noncontracted provider is used, you will
also be responsible for the difference between
the provider’s billed charges and the
BCBS AZ allowed amount. |
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Out-of-pocket
maximum
The nonPreferred out-of-pocket
maximum is accumulated separately from the
Preferred out-of-pocket maximum. |
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$5,000 self only or $10,000 per family. After you reach the out-of-pocket
maximum expense, BCBS AZ pays 100%
of the BCBS AZ allowed amount for
covered services for the remainder
of the calendar year.
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$10,000 self only or $20,000 per
family. After you reach the out-of-pocket
maximum expense, BCBS AZ pays 100% of the
BCBS AZ allowed amount for covered services
for the remainder of the calendar year.
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Deductible,
coinsurance, copayments and access fees apply
to the applicable out-of-pocket maximum.
Additional deductibles for failure to obtain
precertification do not apply to the out-of-pocket
maximum.
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Services
are subject to the applicable deductible
and any applicable coinsurance. Covered
services include doctor’s office visits
and inpatient consultations, surgeon and
anesthesiologist services, diagnostic lab
and X-ray services. |
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Services are subject to applicable
coinsurance. The deductible
does not apply to preventive care
services.
Preventive
care services include annual physical
exams and related tests and screenings,
well-childcare, routine immunizations,
annual gynecologic exams, routine
mammograms and routine sigmoidoscopy
or colonoscopy. |
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Preventive care is not covered at nonPreferred
providers, except for routine mammograms.
When
mammograms are provided by nonPreferred
providers, the deductible does not apply
and BCBS AZ pays 50% of the BCBS AZ allowed
amount. |
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100%
after meeting deductible |
50%
after meeting deductible |
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Prescription drugs
Most injectable drugs are only
available from home health providers and
specialty pharmacies, and require precertification.
For
certain prescription drugs, FDA dosage limitations
may apply.
Mail
order program is not available. |
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Services are subject to the deductible
and BCBS AZ will pay 100% after meeting
deductible.
When
the price BCBS AZ pays a contracted
pharmacy for a covered drug or the
member’s coinsurance for a covered
drug is less than a $5 minimum copay,
most pharmacies will charge you their
usual and customary price (if also
less than the $5 minimum copay or
the member’s coinsurance), rather
than the BCBS AZ price or coinsurance
payment. Some pharmacies may
charge you the BCBS AZ price or your
coinsurance payment when it is less
than the $5 minimum copayment.
Note:
The $5 minimum copay requirement does
not apply to the 100% coinsurance
plans. |
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After meeting the deductible, BCBS AZ pays
50% of the BCBS AZ allowed amount per prescription.
Member will also be responsible for the
difference between the pharmacy’s price
and BCBS AZ’s reimbursement at non-contracted
providers.
Members
must pay for prescriptions at noncontracted
pharmacies and submit claims to BCBS AZ. |
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Specialty injectable drugs
(Must be precertified.)
Injectable
drugs are also available from home health
providers. |
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Services are subject to applicable
deductible and any applicable coinsurance.
Please
refer to azblue.com for a listing
of specialty injectable drugs and
contracted specialty pharmacies. |
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Specialty injectable drugs are only available
from nonPreferred providers through the
home health benefit. Deductible and
coinsurance apply.
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Specialty
injectable drugs are not available from retail
pharmacies.
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Hospital services
(Must be precertified, except
for emergencies.) |
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100%
after meeting deductible |
50%
after meeting deductible |
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Outpatient services
(Must be precertified.) |
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100%
after meeting deductible |
50%
after meeting deductible |
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Urgent care facility services |
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100%
after meeting deductible |
50%
after meeting deductible |
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Services
are subject to the Preferred deductible
and any applicable coinsurance. There
is also a $150 access fee per visit, per
person, per provider, but it is waived if
you are admitted then BCBS AZ will pay 100%
after meeting deductible. |
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BCBS
AZ will pay 100% after meeting deductible. |
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Inpatient rehabilitation
(Must be precertified.) |
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Services are subject to the deductible.
The first 60 days are subject to applicable
coinsurance. After 60 days,
BCBS AZ pays 50% of the BCBS AZ allowed
amount up to an additional 60 days.
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50% after meeting deductible.
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Limited
to 120 days per calendar year. |
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Outpatient rehabilitation
therapy
“Modalities”
are physical agents such as traction and
ultrasound.
“Therapeutic
services” means the application of
clinical skills/services such as exercise
and gait training. |
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Services
are subject to the applicable deductible
and any applicable coinsurance.
Outpatient
physical and/or occupational therapy:
Services limited to 120 modalities per calendar
year. The average number of modalities
or therapeutic services performed per visit
is 4.
Chiropractic
services: Physical and/or occupational
therapy services performed by a chiropractor
count toward the limit described above.
Outpatient
speech therapy: Services limited
to 20 visits per calendar year. |
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Home health care
(Must be precertified.) |
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Services are subject to the applicable
deductible and then BCBS AZ will pay
100%. Up to 3 visits of 2 hours
or less per day. Certain injectable
drugs are also
available through the specialty drug
benefit
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50% after meeting deductible.
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Skilled nursing facility
(Must
be precertified.) |
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Services are subject to the deductible.
The first 90 days are subject to applicable
coinsurance. After 90 days,
BCBS AZ pays 50% of the BCBS AZ allowed
amount up to an additional 90 days.
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50%
after meeting deductible. |
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Limited
to 180 days per calendar year. |
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Behavioral and mental health
services
(Inpatient care must be precertified.) |
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Professional
services: Covered inpatient and
outpatient services and outpatient facility
services. Benefits are limited to
20 combined outpatient visits per person
per calendar year. |
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Outpatient:
$1,500 and $2,600 plans: 50% after
meeting deductible.
$5,000 plan: BCBS AZ pays 100%
after meeting deductible. |
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50%
after meeting deductible. |
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Inpatient
facility charges: Benefits are
limited to two admissions, up to a combined
total of 30 days per person per calendar
year. |
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after meeting deductible. |
50%
after meeting deductible. |
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Inpatient
professional services:
$1,500 and $2,600 plans: 50% after
meeting deductible.
$5,000 plan: BCBS AZ pays 100%
after meeting deductible. |
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50%
after meeting deductible. |
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$25,000
per person maximum benefit while the
contract is in force. |
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$5,000,000
maximum benefit per person while the
contract is in force. |
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This
information is presented only as a brief overview of some
of the benefits of this plan, and is intended only for general
education. The amount of benefits provided depends
on the plan selected. Premium will vary with the type
of benefits selected. These plans contain exclusions
from and limitations of coverage. Please see the product
brochure for more complete information, as well as information
about terms of renew ability, preexisting conditions, out-of-network
penalties, and notification requirements. Plans are
subject to health underwriting. To be considered for
reimbursement, expenses must qualify as covered expenses.
Expenses are also subject to reasonable and customary limits,
unless you use a network, and all other policy provisions,
including determinations of medical necessity.
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Coverage Synopsis:
Blue
Preferred Saver - Once you have met your deductible,
the plan pays 100% of all covered expenses, up to $5 million
per person. There is also an option for 80% coverage,
with a co-insurance limit of $10,000.
This
plan qualifies as HSA-eligible. Combining a
Health Savings Account with any Blue Cross Arizona plan
allows you to make tax-deductible contributions, pay medical
expenses with pre-tax dollars, and earn tax-deferred interest.
This account works much like an IRA, except you may use
your tax-free savings for qualified medical expenses your
health plan does not cover, such as your deductible, contact
lenses, or most types of alternative medicine (see the qualified
medical expenses). If you do not use these funds,
they simply accumulate, with interest, for distribution
upon your retirement.
The
deductible does not apply to preventive care services.
Services are subject to applicable coinsurance, if any.
Rate
Information:
All
deductible options have a 12 month rate guarantee.
Unmarried children may stay on their parent’s contract
until their 30th birthday.
Preferred
rates without riders are available on our instant
quote page. The quoted rates are for the $5
million maximum benefit, and do not include any possible
optional benefits.
Please contact us for rates on the
optional benefits. Rates depend on gender, smoking
status, zip code, and health status.
PPO Network:
Blue
Cross® Blue Shield® of Arizona gives you access
to one of the largest networks in Arizona, and the entire
country. The large list of doctors and hospitals can
be viewed at the Blue
Cross PPO Online Provider Directory. Policyholders
can go to Blue Cross doctors anywhere in the country, and
can even access a world-wide network.
- In-network
access to healthcare services. As part of a
nationwide network, Blue Cross network participants are
able to access services in almost any state without the
concern of out-of-network penalties.
- Online
access to network providers.
- Network
discount advantage.
Underwriting:
Underwriting
of your application with Blue Cross® Blue Shield®
of Arizona normally takes two to four weeks, though if medical
records are ordered it could take longer.
Effective
dates:
The
earliest your coverage can go into effect is ten days after
you have signed your application. You may request
an effective date any time between 10 and 60 days after
you sign your application.
Blue
Cross® Blue Shield® of Arizona must receive your
application within 15 days of the date you sign the application.
All applications must be sent with the application fee,
unless it's a child or client over age 65.
Please
note, if you are requesting an effective date of less than
21 days from the time you complete the application, you
may not receive notification of your approval until after
your effective date. If you have claims during this
period, they will be eligible for coverage if submitted
after you have been approved.
You
will be billed starting on your requested effective date,
even if you have not yet been notified that you have been
approved. This is very good for someone who does not
have any present coverage and would like for their benefits
to begin right away.
For
those who are already covered, it is suggested that you
maintain your current coverage in force until you have received
notice from either HSA for America or directly from Blue Cross® Blue
Shield® of Arizona that your coverage has been approved
and is in force.
HSA Administrator:
Your
health savings account is totally separate from your health
insurance, and you may use any approved bank or trustee
as your HSA administrator. We recommend that you choose
one from our HSA administrator page, where you can compare rates and features.
About Blue
Cross® Blue Shield® of Arizona:
Blue
Cross® Blue Shield® of Arizona Insurance
is one of 42 independent licensees of the Blue Cross Blue
Shield Association. Nearly 85 million Americans -
or one in four people - carry a Blue Cross and Blue Shield
ID card. The Blue Cross and Blue Shield Association
licenses Blue
Cross® Blue Shield® of Arizona to offer certain products and services under the Blue Cross
and Blue Shield names.
As Arizona's
largest local health insurer, Blue
Cross® Blue Shield® of Arizona has been
offering health insurance products or services to Arizonans
since 1939. They cover 1.8 million Arizonans every
year - from 860,000 individuals, small business owners and
large employers to 690,000 Medicare-eligible Arizonans.
Blue
Cross® Blue Shield® of Arizona has a
Standard and Poor's rating of A+ (Strong).
HSA for America is an independent authorized Blue Cross Blue Shield of Arizona agent.
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"I've
spent some time on my local talk show (which covers most
of the northern half of California) talking about your website."
People
complain about the high cost of healthcare but are not doing
anything about it. I found out about your website
and thought it was beneficial enough to tell my audience. It is a great resource for people who want to learn more
about Health Savings Accounts. I've spent some
time on my local talk show (which covers most of the northern
half of California) talking about your website.
Tom
Sullivan
News Talk 1530 KFBK in Sacramento CA
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