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Blue
Cross of Idaho has designed HSA BlueSM
to meet the federal requirements of a high deductible
health plan that is compatible with HSA legislation.
HSA contributions are tax deductible, and if not used
roll over each year and grow tax-deferred.
HSA
Blue
is
a Preferred Provider Organization health plan, and
the choice of health care providers is yours.
HSA Blue has both in-network and out-of-network benefits.
To get the most in benefit payments, you should choose
providers from Blue Cross of Idaho’s PPO contracting
network. Their extensive provider network will
ensure that you receive quality health care at affordable
rates.
Before
applying please read the Exclusions and Limitations
information, as well as the Enrollment Guidelines
on the plan brochures below.
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80
/ 60 Coinsurance
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90
/ 70 Coinsurance
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100%
Coinsurance
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Benefit
Period Deductibles
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$2,000
or $3,000 - Individual
$4,000 or $6,000 - Family
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$2,000
or $3,000 - Individual
$4,000 or $6,000 - Family
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$5,000
- Individual
$10,000 - Family
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Out-of-Pocket
Maximum
(includes deductible,
copayments and coinsurance)
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$4,000
or $5,000 - Individual
$8,000 or $10,000 - Family
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$4,000
or $5,000 - Individual
$8,000 or $10,000 - Family
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$5,000
- Individual
$10,000 - Family
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$1,000,000
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$1,000,000
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$1,000,000
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Benefit
— Outpatient Services
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-
Office Visits – Professional
Services and Supplies
- Professional Services at the hospital
(i.e., physician visits, surgery and/or
anesthesiology)
- Diagnostic Lab & X-Ray
- Outpatient Physical and Speech Therapy
(limited to $800 per insured, per
benefit period, per therapy)
- Chemotherapy, Renal Dialysis, Radiation,
Enterostomal, Growth Hormone, Home
IV and Respiration Therapies
- Outpatient Surgery at an Ambulatory
Surgical Facility
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80%
(after deductible)
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60%
(after deductible)
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90%
(after deductible)
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70%
(after deductible)
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100%
(after deductible)
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100%
(after deductible)
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Benefit
— Chiropractic Services
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(limited
to $800 per person per benefit period)
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80%
(after deductible)
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50%
(after deductible)
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90%
(after deductible)
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50%
(after deductible)
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100%
(after deductible)
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100%
(after deductible)
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Benefit
— Wellness / Preventive Services
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(Immunizations
and office visits. Includes Pap, PSA,
fecal occult blood, cholesterol panel,
PKU and Rubella)
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$30
copay
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No
coverage
(except for Pap)
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$30
copay
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No
coverage
(except for Pap)
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$30
copay
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No
coverage
(except for Pap)
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Benefit
— Screening Mammography
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$30
copay
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60%
(after deductible)
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$30
copay
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70%
(after deductible)
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$30
copay
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100%
(after deductible)
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-
Mental Health (3)
- Alcoholism or Substance Abuse (3)
- Diabetes Education (limited to $500
per insured per benefit period)
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80%
(after deductible)
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No
coverage
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90%
(after deductible)
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No
coverage
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100%
(after deductible)
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No
coverage
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Benefit
— Hospital Services
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-
Inpatient Hospitalization (including
room, board, nursing services, ancillary
services and special services)
- Inpatient Surgery
- Outpatient Surgery at the hospital
- Skilled Nursing Facility (30 day
limit per person per benefit period)
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80%
(after deductible)
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60%
(after deductible)
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90%
(after deductible)
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70%
(after deductible)
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100%
(after deductible)
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100%
(after deductible)
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-
Rehabilitation
- Alcoholism or Substance Abuse (3),
(4)
- Mental Health (3),
(4)
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80%
(after deductible)
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No
coverage
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90%
(after deductible)
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No
coverage
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100%
(after deductible)
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No
coverage
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-
Emergency Room Services, Ambulance
Services, Durable Medical Equipment,
Prosthetics & Orthotics
- Home Health Skilled Nursing Services
(limited to $5,000 per person per
benefit period)
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80%
(after deductible)
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60%
(after deductible)
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90%
(after deductible)
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70%
(after deductible)
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100%
(after deductible)
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100%
(after deductible)
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(limited
to $5,000 lifetime per person)
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100%
(after deductible)
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No
coverage
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100%
(after deductible)
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No
coverage
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100%
(after deductible)
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No
coverage
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Benefit
— Prescription Drugs
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(limited
to $1,200 per person per benefit period)
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50%
coinsurance
after deductible
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50%
coinsurance
after deductible
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50%
coinsurance
after deductible
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50%
coinsurance
after deductible
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100%
coinsurance
after deductible
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100%
coinsurance
after deductible
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(1)
Members must utilize Blue Cross of Idaho’s contracted
PPO network to receive in-network coinsurance payment.
Blue Cross of Idaho coinsurance payment is based on our
pre-established maximum allowance.
(2) If an enrollee chooses a noncontracting
in or out-of-state provider, they may also be responsible
for any charges that exceed our pre-established maximum
allowance.
(3) The combined maximum for Mental
Health and Alcoholism or Substance Abuse is 20 visits per
insured per benefit period. Visits include outpatient
facility visits as well as inpatient and outpatient professional
visits.
(4) The combined maximum for Mental
Health and Alcoholism or Substance Abuse is 8 days per insured
per benefit period for inpatient facility charges.
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.
Coverage
Synopsis:
HSA
Blue allows you to choose between two different
plan options: an Individual Plan (coverage for
only one member of a household) or a Family Plan
(coverage for two or more members of a household).
Individual
Plan: Your deductible under this plan option will
consist of the first $2,000, $3,000 or $5,000 in eligible
covered services per benefit period. For the $2,000
and $3,000 options, once you have met your deductible
and you have paid $2,000 out-of-pocket, your benefits
will be covered at 100% for the duration of the benefit
period. For the $5,000 option, once you have met
your deductible, your benefits will be covered at 100%
for the duration of the benefit period.
Family
Plan: Your deductible under this plan option will
consist of the aggregate of $4,000, $6,000 or $10,000
in eligible covered services per benefit period for all
members of your family covered under this plan, regardless
of which individual, or combination of individuals, meets
the deductible requirement. For the $4,000 and $6,000
options, once you have met the deductible and you have
paid $4,000 out-of-pocket, your benefits will be covered
at 100% for the duration of the benefit period.
For the $10,000 option, once you have met your deductible,
your benefits will be covered at 100% for the duration
of the benefit period.
Complete
details can be seen by opening the"Outline
of Coverage" brochure:
You
can also refer to the chart above for a coverage overview.
Rates:
Rates
vary based upon zip code, age, and effective date. Blue
Cross of Idaho guarantees your initial premium for 12
months for the benefits selected. Your premium may
change if you change your benefits. Any new premium
applies from the date benefit changes begin. An
exception to the premium guarantee may be made if any
state or federal law unexpectedly increases administrative
costs or claims liability. Each policy is subject
to a premium adjustment at its renewal.
You
can view current rates by getting an instant
quote online.
PPO
Network:
Blue
Cross of Idaho gives you access to one of the largest
networks in Idaho, with thousands of health care providers
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
at their online
directory.
Underwriting:
Blue
Cross of Idaho has one of the easiest, most efficient
underwriting teams in Idaho. The process is 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,
some applications can be approved within one week.
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 make sure
there are no delays in getting you covered.
Effective
dates:
The
coverage can go into effect in as quickly as 24 hours,
though you risk being declined if claims are submitted
before the underwriting process is completed. You
may request an effective date any time the date after
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 of Idaho that your coverage has
been approved and is in force.
Your
earliest possible effective date will be the day after
Blue Cross of Idaho has received all the necessary documents
and information needed to process your application.
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 of Idaho:
Blue
Cross of Idaho has been a leader in Idaho's
health care industry since it began serving customers
in 1945. They are proud of their Idaho heritage
and Idaho focus. With a reputation as the state's
premier insurer, they're committed to help shape the future
of health care in Idaho with their members' best interests
at heart.
As
an independent licensee of the Blue Cross and Blue Shield
Association, Blue Cross of Idaho is a tax-paying, not-for-profit
mutual insurance company, with more than 400,000 members
enrolled in Traditional, Preferred Provider Organization
(PPO), Managed Care, Medicare
Supplement and Medicare Advantage products.
HSA
for America is an independent authorized
Blue Cross of Idaho agent.
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"The
personalized service I've received has been excellent: responsive,
informative, clear, and helpful."
There
are many things that really set you apart from other insurance
consultants. These include your communication ability,
both written and spoken, and your non-manipulative approach
to providing useful information.
Quality
customer service is all but gone in today's automated and
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non-existent in the insurance industry. But the personalized
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I
have told a lot of my friends about you. I have
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people just because it was such a pleasurable positive experience.
Their question is: "What other states can you provide
service to?
Joy
Amulya
Fort Collins, CO
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