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BlueEdge HCA for Groups: This benefit information is in Adobe Acrobat PDF format. If you do not have Adobe Acrobat Reader, download it free of charge at Adobe's site. |
BlueEdge gives your employees freedom of choice, flexibility, a broad range of benefits, and the most comprehensive provider network in New Mexico. Across the country, PPO networks are linked through the BlueCard® program, so your employees get help accessing doctors or hospitals when traveling, living, working, or studying anywhere in the United States.
When BCBSNM members receive care from contracting PPO network doctors and hospitals:
- Benefits are paid at the highest level
- There are 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, their only other out-of-pocket expenses are any plan-specific coinsurance payments for covered benefits, plus any charges for non-covered services
They can always choose to receive care from doctors and hospitals outside the network, but benefits will be paid at a lower level
BlueEdge Benefit Overview
Preventive Care Benefits
Preventive care services are covered at 100 percent when received in network (annual $400 maximum for adults, remainder applies to deductible and coinsurance)
- Well-child and adult care, including immunizations
- Screenings, such as cholesterol, breast cancer, and cervical cancer
Doctor and Hospital Benefits
- Doctor 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
- Prescription drug benefits
- Reconstructive surgery following a mastectomy
Care Management
- Blue Care® Connection Disease Managment Programs (including programs for Asthma, Diabetes, Coronary Artery Disease, Congestive Heart Failure, COPD, and Low Back Pain)
- Case management services
- Special Beginnings® Prenatal Program
Welcome Call
Within one month of enrollment, your employees can expect a call from a BlueEdge expert to help them better understand BlueEdge and how to maximize the benefits of BlueEdge. The welcome call provides your employees with a convenient opportunity to get answers to questions they may have about their health plan.
Learn More About BlueEdge HCA
Overview
How BlueEdge HCA Works
Spending Account and the Deductible
BlueEdge HCA FAQs
Common FAQs
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