Yes, if you want to take full advantage of a high-deductible plan that qualifies for an HSA. First you enroll in the high-deductible insurance plan like BlueEdge from BCBSNM; next you open an HSA with a bank that offers HSAs; then you can begin paying your medical expenses from your health savings account.

To build savings for health-related expenses, you will need to pair your BlueEdge health plan with an HSA. You may choose any HSA financial administrator, or set up a health savings account directly with a bank. There are national and local HSA administrators and banks that offer HSAs. To set up your HSA, we recommend you work with your broker, or check with your own bank. Other resources you can check for more information about HSAs and the financial institutions that offer them:

www.treas.gov 

www.irs.gov 

You may contribute your own money to your account by making a lump sum contribution or by making periodic payments at any time (up to your plan's annual deductible), such as through regular pre-tax deposits from your paycheck. For more information about HSA contributions, contact your HSA administrator or bank, or visit www.irs.gov .

Each year, the Internal Revenue Service specifies the maximum annual HSA contribution for individuals and families. For more information about HSA contributions, visit www.irs.gov .

Using funds in an HSA is easy. Typically a financial institution will provide you with a debit card or a checkbook. You can ask about more convenience options from your HSA administrator or bank.

HSAs can be used to pay for many types of medical expenses, even some which are often excluded on health insurance plans. These include:

• Health insurance plan deductibles, copayments, and coinsurance
• Prescription and over-the-counter drugs
• Dental services, including braces, bridges, and crowns
• Vision care, including glasses and lasik eye surgery
• Psychiatric and certain psychological treatments
• Long-term care services
• Medically related transportation and lodging

Check with your tax advisor or go to www.irs.gov  to obtain a current list of qualified medical expenses as determined by the IRS.

For both types of BlueEdge products, the family deductible can be met by any combination of eligible claims from any combination of family members on a policy. However, there are differences:

BlueEdge 100 Plans have, in addition to a family deductible, an individual deductible for each policy
member. If a member happens to satisfy the individual deductible amount, the member is immediately eligible for benefits (which are 100 percent coverage for in-network services) without having to wait until the entire family deductible is satisfied. Once the entire family deductible amount is met, benefits begin for all covered members. This arrangement is called an embedded deductible, because the individual deductible is embedded within the family deductible. Note: It is possible to meet the family deductible without any one family member meeting the individual deductible amount.

The BlueEdge Individual HSA Plans (Basic, Enhanced, and Premier) have an aggregate deductible: the family deductible must be met before plan benefits begin for any covered family member. There is no individual deductible for one family member to meet. Once the deductible is met, plan benefits begin and family members pay coinsurance up to the out-of-pocket limit. Once the out-of-pocket limit is met, the plan begins paying claims at 100 percent. Note: One family member may satisfy the entire PPO deductible for the whole family.

Yes. Although individuals over age 65 cannot contribute to their HSA, they can continue to earn tax-free interest on the balance. They can also use their account to pay for health-related medical expenses tax-free.

You will have one of the prescription drug plans below, depending on which BlueEdge health plan you select.

Percent/Coinsurance Drug Plan

BlueEdge Individual HSA Plans (Basic, Enhanced, and Premier) feature a 25/50 percent prescription drug benefit. Your copayment for prescription drugs purchased through this drug plan is 25 percent of the covered charge for generic drugs and 50 percent of the covered charge for brand-name drugs. If the percentage of the covered charge falls between the minimum/maximum copayment, you will pay the actual percentage amount.

Other Notes:

• Your copayment will never exceed the maximum copayment listed.
• Your copayments are applied to the medical plan annual out-of-pocket limit.
• Be sure to have your prescriptions filled at a participating pharmacy (search the Provider Finder®) or through the PrimeMail Pharmacy mail-order service.
• Coverage is always subject to the limitations of your health care plan. For some medications, prior approval, generic substitution, or quantity limits may apply.

Drug Plan with Deductible

BlueEdge 100 High-Deductible Health Plans feature a deductible prescription drug benefit. Your prescription drugs are subject to the medical plan deductible; once the deductible is met, the plan pays 100%.

If you are applying for BlueEdge and have benefit questions, please call 1-866-445-1396. If you are a BlueEdge member and have questions, call BCBSNM Customer Service at the toll-free number on the back of your BCBSNM member ID card.