BlueEdgeSM Individual HSA
Health Savings Account Insurance Plans
Policy form # PPO-BLUEEDGE-INDL-HSA-3-1
Are you looking for the kind of health insurance plan that gives you more control? If so, BlueEdgeSM Individual HSA may be right for you. This health savings account (HSA) health insurance plan enables you to decide how, when and where your health care dollars are spent. A high deductible affords you low monthly premiums, plus you gain tax advantages.*
BlueEdgeSM Individual HSA Coverage Overview
This health insurance product provides cost-sharing health coverage for inpatient settings with the freedom to choose your hospitals. Other key coverage and health insurance plan features include:
- Medical services and surgical expenses
- Accident and emergency care
- 100% Preventive Care for adults and children
- 100% coverage in or out of network for childhood immunizations up to age 6
- Three-tier prescription drug program
An HSA, high deductible health insurance plan may be right for you if you:
- Want affordable premiums and need a wide range of benefits
- Don’t expect to have a lot of medical expenses
- Have money saved just in case you have to pay unexpected out-of-pocket health care expenses
- Are looking for more control over your health care choices
BlueChoice® network: You can save money on the cost of covered services when you use a participating network hospital, doctor or specialist.
* A Health Savings Accounts (HSA) has tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice, and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on, for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax advisor regarding the tax consequences of specific health insurance plans or products.
BlueEdgeSM Individual HSA provides different levels of out-of-pocket expense limits, deductibles and coinsurance to allow you to select the plan that best meets your budget. With BlueEdgeSM Individual HSA, here’s what you can expect:
- PPO benefits begin after you meet the deductible
- Coinsurance level determined by health insurance plan selection
- Individual deductibles ranging from $1,250 to $5,000*
- Individual maximum out-of-pocket expenses ranging from $3,000 to $5,000*
- Family deductibles ranging from $2,500 to $10,000*
- Family maximum out-of-pocket expenses ranging from $6,000-$10,000*
- Copayments ranging from 75–100 percent of allowable amount after calendar year deductible for office visits (doctor consultation only) and emergency care
- Coinsurance — you pay 0–25 percent of allowable amount and the health insurance plan pays 75–100 percent of allowable amount*
- To see what your monthly payments would be, get a quick quote.
View the plan's Outline of Coverage, which provides brief descriptions of the basic provisions of BlueEdgeSM Individual HSA, including costs and out-of-pocket expenses.
* These cost ranges represent in-network coverage only. Out-of-network coverage costs can be significantly higher. Your greatest coverage and savings are realized when you use the services of participating providers within the network.
- BlueEdgeSM Individual HSA pays 75–100 percent of allowable amount and you pay 0–25 percent of allowable amount for covered expenses after you meet your deductible (in-network).
- In-network doctor's office visits for routine physicals, immunizations and diagnostic tests are covered at 75–100 percent of the allowable amount, subject to deductible.
- Easy claims processing—no forms to file in most cases
- Emergency room visits are covered at 75–100 percent of allowable amount after calendar year deductible and coinsurance.
- The tax-favored advantages that come with a Health Savings Account*
- Access to online decision tools to help increase your knowledge of health issues and track your health care expenses
More Health Insurance Plan Details
It’s important to know the features of the health plan you are considering. Our Outline of Coverage document gives you brief descriptions of the basic details of our BlueEdgeSM Individual HSA health insurance plan, as well as details on renewability, exclusions and limitations.
* Health Savings Accounts (HSAs) have tax and legal ramifications. Blue Cross and Blue Shield of Texas does not provide legal or tax advice, and nothing herein should be construed as legal or tax advice. These materials, and any tax-related statements in them, are not intended or written to be used, and cannot be used or relied on, for the purpose of avoiding tax penalties. Tax-related statements, if any, may have been written in connection with the promotion or marketing of the transaction(s) or matter(s) addressed by these materials. You should seek advice based on your particular circumstances from an independent tax advisor regarding the tax consequences of specific health insurance plans or products.
Optional Dental Coverage
- Coverage can be used to provide dental benefits to an individual, spouse, children or any combination of dependents.
- A $50 deductible, based on fee schedule allowances, applies for dental procedures or services received by a covered individual during each benefit year.
- Maximum deductible amount of $150 for family coverage
- Learn more about optional dental coverage
- Prescription drug coverage is included with this plan.
- Copayments for prescription drugs vary based on plan options you choose.
- If you take medications for birth control, high blood pressure, cholesterol or other long-term needs, you can also receive up to a 90-day supply at retail. In some cases, you'll pay less for the same amount of medication than at a retail pharmacy.
- View the Complete Prescription Drug List
to see if your prescriptions are included in the plan. - Prescription Drug Utilization/Benefit Management Programs for policies with effective dates on or after 3/1/2012. See Compare Plans Chart for more information.
