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Blue
Cross Blue Shield of Texas
is one of the most known and trusted names in the health
insurance industry. They have one of the most competitive
Health Savings Account plans in the state of Texas.
Blue
Cross Blue Shield of Texas offers the BlueEdge
HSA, an integrated, consumer-driven health plan,
which gives access to Blue Cross Blue Shield's extensive
PPO hospital and physician networks and excellent customer
service.
Supplemental
Accident Coverage
The perfect complement to any HSA.
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BlueEdge
Plan at a Glance: View
the Outline
of Coverage brochure
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Features
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Network
|
Out-of-Network
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|
Coinsurance
(% Paid by Insurance Company)
|
100,
90, or 75% of Allowable Amount after Calendar
Year Deductible
|
70
or 60% of Allowable Amount after Calendar Year
Deductible
|
| Out-of-Pocket
Maximum |
- $3,000
Individual
- $6,000 Family |
- $6,000 Individual
- $12,000 Family |
| Lifetime
Maximum |
- $5,000,000
|
- $5,000,000 |
Office
Visits
|
- Deductible
and Coinsurance |
- Deductible
and Coinsurance |
Prescription
Drugs
|
| - |
After
calendar year deductible is met, the copay
will apply until Out of Pocket Maximum has
been met |
| - |
Preferred
Brand Name: $50 |
| - |
Non-Preferred
Brand Name: $65 |
| - |
$5,000
Calendar Year Maximum |
| - |
90-day
supply requires three separate copayment amounts |
|
| - |
After
calendar year deductible is met, the copay
will apply until Out of Pocket Maximum has
been met |
| - |
Preferred
Brand Name: $50 |
| - |
Non-Preferred
Brand Name: $65 |
| - |
$5,000
Calendar Year Maximum |
| - |
90-day
supply requires three separate copayment amounts |
|
| Emergency
Room |
- Deductible
and Coinsurance |
- Deductible
and Coinsurance |
Adult
Preventive Care
|
| - |
Deductible
and Coinsurance
($300 Calendar Year Maximum) |
| - |
Childhood
immunizations from birth to 6th birthday -
does not include allergy injections. |
|
| - |
Deductible
and Coinsurance
($300 Calendar Year Maximum) |
| - |
Childhood
immunizations from birth to 6th birthday -
does not include allergy injections. |
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| Lab
/ X-ray |
- Deductible
and Coinsurance |
- Deductible
and Coinsurance |
Maternity
|
- Not
Covered |
- Not
Covered |
Skilled Nursing
|
100,
90, or 75% of Allowable Amount after Calendar
Year Deductible (Limited to $5,000 each calendar
year)
|
70
or 60% of Allowable Amount after Calendar Year
Deductible (Limited to $5,000 each calendar year)
|
Home Health Care
|
100,
90, or 75% of Allowable Amount after Calendar
Year Deductible (Limited to $5,000 each calendar
year)
|
70
or 60% of Allowable Amount after Calendar Year
Deductible (Limited to $5,000 each calendar year)
|
| Ground
and Air Ambulance |
- $1,500
per calendar year
|
- $1,500
per calendar year |
All
Other Services
|
- See
Brouchure |
- See
Brouchure |
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This
information is presented only as a very 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:
This
plan qualifies as HSA-eligible. Combining a
Health
Savings Account (HSA) with any Blue Cross Blue Shield
of Texas HSA 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.
Plan
Options :
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Plan
Option
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| Plan
I: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
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| Plan
II: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
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| Plan
III: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
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| Plan
IV: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
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| Plan
V: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
|
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| Plan
VI: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
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| Plan
VII: |
Deductible |
| |
Out
of Pocket Limit (after deductible) |
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Coinsurance
- Based on Your Plan selection, after the applicable Deductible(s),
if any, are met, Your coverage pays a percentage of the
Allowable Amount for Eligible Expenses provided by a Network
Provider and an Out-of-Network Provider, subject to other
provisions of the Contract. Any remaining unpaid Eligible
Expenses, if any, become Coinsurance and is applied to the
Out-of-Pocket Maximum and must be paid by You.
|
Plan
Option
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Network
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Out-of-Network
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| Plans
I, II, III |
90%
of Allowable Amount after Calendar Year Deductible
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70%
of Allowable Amount after Calendar Year Deductible
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| Plans
IV, V, VI |
70%
of Allowable Amount after Calendar Year Deductible
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60%
of Allowable Amount after Calendar Year Deductible
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| Plan
VII |
100%
of Allowable Amount after Calendar Year Deductible
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70%
of Allowable Amount after Calendar Year Deductible
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This
information is presented only as a very 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
Brouchure 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.
Rate
Information:
Rates
are available on the instant
quote page, or you can quickly view rates for each
plan below:
Initial
premium will be based on an applicant's age at the time
of underwriting approval. If approved, each person
applying for coverage will be assigned a rate based on health
status, type of product and requested deductible level of
product.
The
total rate will consist of each individual's rate, based
on their individual health history, added together.
Rates are also based on sex, age, and zip code. Individual
members of a family may be assigned either preferred or
standard rate from the same application. If an applicant/spouse/dependent
has a birthday that puts them into a new age category while
their application is being underwritten, their initial premium
will be based on that higher rate if coverage is approved.
The
premium can be paid by monthly direct bill, monthly bank
draft, or quarterly direct bill. The initial premium
can be paid with a check or bank draft, and must include
payment for the first month or quarter, plus a $30 application
fee.
PPO
Network:
Blue
Cross Blue Shield of Texas gives you access to one of the
largest networks in Texas, working with the majority of
the health care providers and hospitals throughout the state.
Having access to the PPO network can mean substantial discounts
in what you pay for your health care, even before
you meet your deductible. The large list of doctors
and hospitals can be viewed on BCBS
of TX Provider Finder website. Make sure to
choose the "PPO" plan. Policyholders can
go to Blue Cross doctors anywhere in the country, and can
even access a world-wide network.
Underwriting:
Blue
Cross Blue Shield of Texas has one of the easiest, most
efficient underwriting teams in the industry. The
process is usually very fast if no medical records are needed.
While it is always a good idea to apply at least three weeks
prior to the time you need your new coverage to take effect,
coverage can often be approved in a matter of days once
your application is received, assuming medical records are
not needed.
The
company does have the right to accept or decline any individual
or family application. Certain conditions may be waivered
with a temporary rider (usually for one to two years), or
an indefinite rider. If you are currently being treated
for depression, anxiety, or high cholesterol, please let
us know before you apply so we can help avoid delays in
getting you covered.
When
coverage is approved with a rider, the applicant is notified
in writing. Following this notification, a contract
is issued with the rider(s) attached. If the applicant
chooses not to accept the contract with the rider(s), the
contract must be returned within ten days and any premium
submitted will be refunded. Please remember that the
application fee is non-refundable.
Effective
dates:
The
coverage can go into effect in as early as the day your
application is approved. You may request an effective
date any time after the date you sign the application and
60 days later. Please note that 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
and Blue Shield of Texas that your policy 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 Texas:
Blue
Cross Blue Shield of Texas is the only statewide, non-investor
owned health coverage provider in Texas, serving more than
3.3 million members in all 254 counties. Blue Cross
Blue Shield of Texas is a division of Health Care Service
Corporation (HCSC), a Mutual Legal Reserve Company, an Independent
Licensee of the Blue Cross and Blue Shield Association.
HCSC is an independent licensee of the Blue Cross and Blue
Shield Association.
Blue
Cross Blue Shield of Texas has been assigned
a rating of A+ (Superior) from the A.M.
Best Company, an independent insurance rating organization.
HSA
for America is an independent authorized
Blue Cross Blue Shield of Texas agent.
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IT Consultant
Amarillo, TX
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