BlueEdge Individual HSA Benefit Information

The BlueEdge Individual HSA high-deductible plan exemplifies BCBSNM's commitment to offer lower premiums without sacrificing dependable, reliable coverage. BlueEdge provides freedom of choice, flexibility, a broad range of benefits, and the most comprehensive provider network in New Mexico.

Benefit Overview

A Choice of Deductibles to Fit a Variety of Budgets

BlueEdge Individual HSA offers a choice of annual deductibles: $1,200, $1,700, and $2,600 for individuals; and $2,400, $3,450, and $5,150 for families.

BlueEdge Individual HSA covers 80 percent of out-of-pocket costs once the plan deductible is met. Members pay the remaining 20 percent for covered services once their deductible is met when using preferred providers (doctors, hospitals, and other providers contracted as Blue Cross and Blue Shield PPO providers). Once the member's deductible and coinsurance is paid and the out-of-pocket limit is reached, all covered services are paid at 100 percent when preferred providers are used.

Unlimited Lifetime Benefit

With BlueEdge Individual HSA, there is no lifetime maximum benefit. This means members have substantial protection for today and the years ahead. Please note: Certain services have maximum annual limits.

Freedom of Choice – Without Referrals

BlueEdge Individual HSA provides access to the most comprehensive network of doctors, hospitals, and other health care providers in New Mexico. And no referrals are needed – members can see the doctors they choose, including doctors who are not the network (nonpreferred providers).

Coverage Away From Home

Whether your clients are traveling across the country or around the world, our unique BlueCard® program helps them access physicians, hospitals, and health services across the nation and in more than 200 countries around the world. Over 97 percent of all hospitals and 83 percent of physicians in the United States contract with Blue Cross and Blue Shield (BCBS) Plans.

Preventive Care Benefits

Preventive care services are covered at 100 percent when received from preferred providers (annual $400 maximum, 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

Other Coverage

• Rehabilitation therapy (physical, speech, occupational therapy)
• Prescription drug benefits
• Reconstructive surgery following a mastectomy
• Case Management Services

Please note: BlueEdge Individual HSA does not provide benefits for maternity (including any pregnancy-related condition) or mental health (including substance/alcohol abuse).

Learn More About BlueEdge Individual HSA:
Overview
Is an HSA right for your client?
Helping your client set up a health plan and HSA
HSA Sales Guidelines
BlueEdge FAQs

Prospective Producers: To apply to become a contracted producer, see our Instructions, Agreement, and Business Associate Addendum (BAA).

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