BlueEdge HCA Benefits
BlueEdgeSM Health Care Account (HCA) gives your employees freedom of choice, flexibility, a broad range of benefits and the largest contracting Preferred Provider Organization (PPO) network in Texas. Across the country, PPO networks are linked through the BlueCard® PPO program so it should be easy for employees to find a doctor or hospital when traveling, living, working or studying anywhere in the United States.
When your employees receive care from contracting PPO network doctors and hospitals:
- Benefits are paid at the highest level
- There are usually no claim forms to complete
- They are not responsible for any charges above the Blue Cross and Blue Shield negotiated fee or allowable amount
- They do not need a referral to see the doctor of their choice
- Once PPO coverage begins, the only other out-of-pocket expenses are any plan-specific coinsurance payments for covered benefits, plus any charges for non-covered services
Employees can always choose to receive care from doctors and hospitals outside the network, but benefits will be paid at a lower level.
BlueEdge HCA Benefit Overview
Preventive Care Benefits
Services are covered at 100 percent, of allowable amount, when received in-network.
- Well-child and adult care, including immunizations
- Screenings such as cholesterol, breast cancer and cervical cancer
Doctor and Hospital Benefits
- Doctors office visits
- Hospital and surgical care
- Diagnostic testing
- Emergency care benefits
- Maternity care
Other Coverage
- Rehabilitation therapy (physical, speech, occupational therapy)
- Mental health and chemical dependency treatment (with some health insurance plans)
- Prescription drug benefits (with some health insurance plans)
- Reconstructive surgery following a mastectomy
Utilization Management
- Mental health and chemical dependency treatment (with some health insurance plans)
Learn More About BlueEdge
BlueEdge Product Summary
BlueEdge HCA Benefits
Spending Accounts & the Deductible
Resources
BlueEdge FAQs
