Health insurance costs include monthly payments, individual deductibles, drug coverage deductibles, out-of-pocket expenses, copayments, and coinsurance. For BlueEdge plans, here’s what you can expect:

• Monthly payment amounts vary based upon the number of individuals you choose to cover, their habits, and add-ons you include.
• Individual deductibles ranging from $1250 to $2600; out-of-pocket limits ranging from $2000 to $6000 — customize your plan by choosing a deductible amount that works best for your situation
• Family deductibles ranging from $2500 to $5150; out of pocket limits ranging from $4000 to $12000 — customize your plan by choosing a deductible amount that works best for your situation
• Coinsurance ranging from 0–20 percent of services provided in-network, after the deductible is met
• No charge for wellness visits and preventive care services.

For more information on costs, including out-of-pocket costs, see the Benefit Summary documents under What’s Included with BlueEdge, More Health Insurance Plan Details.

BlueEdge is a high-deductible health plan that can be combined with a Health Savings Account (HSA) that you fund for your health care expenses. BlueEdge gives you control over how you spend your health care dollars and includes these major components:

• Preventive care services and wellness visits — at no charge to you.
• Health Savings Account (HSA) funds from you are used to pay for covered health care expenses, which counts toward your deductible.
• PPO benefits begin after you meet the deductible. You have the freedom to see any doctor without a referral.
• Online decision resources help increase your awareness and knowledge of health issues and help you keep track of your health care expenses.
• Tax-favored advantages that come with a Health Savings Account¹

¹ Health Savings Accounts (HSA) have tax and legal ramifications. Blue Cross and Blue Shield of New Mexico 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.

When you receive care from preferred providers (doctors, hospitals, and other providers contracted with Blue Cross and Blue Shield of New Mexico):

• Benefits are paid at the highest level
• There are no claim forms to complete
• You are not responsible for any charges above the Blue Cross and Blue Shield negotiated fee or allowable amount when you receive services from a preferred provider
• You do not need a referral to see the doctor of your choice
• After the deductible is met and your PPO coverage begins, your only other out-of-pocket expenses are any plan-specific coinsurance payments for covered benefits, plus any charges for non-covered services

BlueEdge health plans are compatible with HSAs, which are tax-advantaged¹ accounts that you fund and use to pay for qualified health care expenses. Here's how a health savings account works:

• The account is funded by you, using a qualified bank, and you own the account.
• You select the bank that administers your HSA.
• Funds in an HSA are completely portable, so if you change jobs or stop working, the funds stay with you.
• There are no "use it or lose it" rules like there are with Flexible Spending Accounts — unspent money stays in the HSA from year-to-year.
• Qualified HSA funds can be invested in interest-bearing accounts.
• Contributions you make to the HSA are tax-deductible, which means amounts distributed from the account are not taxed as long as they are used to pay for qualified health care expenses.¹

More Plan Details

It’s important to know the critical features of the health plan you are considering. Our Summary of Benefits document gives you brief descriptions of the basic provisions of our BlueEdge plans, as well as details on renewability, exclusions and limitations.

View the BlueEdge Individual HSA Summary of Benefits .

View the BlueEdge 100 Summary of Benefits .

¹ Health Savings Accounts (HSA) have tax and legal ramifications. Blue Cross and Blue Shield of New Mexico 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.

Every health insurance plan has limitations. These limits are there to keep health care costs down for everyone. Some examples of benefits not covered with this health insurance plan include:

• Maternity Services, including pregnancy-related conditions
• Behavioral (mental) health services
• Prescription drugs for behavioral health diagnoses
• Alcoholism rehabilitation or chemical dependency treatment
• Transplants must be received at facilities that contract with BCBSNM or through the BCBS national transplant network and must be prior-approved in order to be covered

For more information on plan limits and exclusions, see the Benefit Summary documents under What’s Included with BlueEdge, More Health Insurance Plan Details.

You can customize your coverage by applying the dental option when filling out the application form for BlueEdge health insurance.

Dental

• Coverage from day one with no deductible required
• Up to $1,500 of included dental work per person covered per year
• 100 percent coverage for cleanings, examinations, X-rays, sealants and space maintainers*
• 50–80 percent coverage for most other common dental services*
• 20 percent discount on orthodontics, up to a maximum of $1,000*

*These percentages reflect coverage and discounts when using in-networks providers.

For more information on this option, download our dental coverage brochure .

• Prescription drug coverage is included with this plan.
• You have the option to order your prescription drugs through the mail with our
  Prescription Mail-Order Program .
• Prescription drugs for behavioral (mental) health conditions are not covered.
• Prescription Drug Utilization/Benefit Management Programs are being added to policies with effective dates on or after 1/1/2012. See Compare Plans Chart for more information.

We know that choosing a health insurance plan is a big decision. So we want to give you all the information you need to make the right choice for you. Explore our library of documents for comprehensive information on all BlueEdge plans.

BlueEdge Individual HSA Plan

• View a Summary of Benefits .
• View a summary of 25/50 Drug Plan, Copayments/Out-of-Pocket Costs .
• View the plan’s Benefit Booklet .
• View 2008 Benefit Changes .
• View 2007 Benefit Changes .

BlueEdge 100 Plan

• View a Summary of Benefits .
• View the plan’s Benefit Booklet .
• View recent Changes to BlueEdge 100 Plan Benefit Booklet .

Applies to All BlueEdge Plans

• View recent 2009 Benefit Changes .
• View recent 2009 Drug Plan Benefit Changes .
• Endorsement: Out-of-Network Pricing for Fully Insured Health Plans 
• Endorsement: 2011 Transplant Benefits — Per Diem Changes 

The benefit information listed is available as PDF files. If you do not have Adobe^® Reader^®, download it free of charge at Adobe's site .

Helpful HSA Guides

• Learn more about HSAs.
• Get answers to your frequently asked questions about BlueEdge plans.
• Read about HSAs from the U.S. Department of the Treasury .