How is BlueEdge preferred provider health benefit plan (PPO) different from a traditional healthplan?
Most traditional healthplans plans pay a percentage of covered medical expenses only after you satisfy a plan deductible or copayment. With BlueEdge PPO you have an array of choices, including coverage for preventive care and wellness services. Your employer chooses a Spending Account as a standalone benefit or to pair with a BlueEdge PPO. Spending Account funds can pay for covered medical expenses and may also apply toward your deductible (not all BlueEdge products include a deductible).

Will a visit to my doctor be any different now that I have BlueEdge?
No. Be sure to bring your Blue Cross and Blue Shield of Texas ID card to the doctor to assist in filing your claims.

What if I use all the money in my Spending Account?
If you use all your Spending Account funds and you have a healthplan that includes a deductible, you are responsible for paying the remaining balance of your deductible before your healthplan benefits begin.

What is a Health Care Account (HCA)?
An HCA is money set aside for you by your employer. Charges for covered medical care services are first paid from this account. Eligible expenses paid from the HCA are also applied toward your annual deductible. Unspent funds roll over from year to year. If you leave the plan, the funds return to your employer.

How do I access my HCA funds?
When you use an in-network provider, the provider will usually submit the claim for you. Blue Cross and Blue Shield of Texas' integrated claim process will automatically deduct funds from the HCA. There is usually no paperwork for you to file.

If you receive care from a non-network doctor or hospital, the provider will most likely also file your claim with Blue Cross and Blue Shield of Texas. However, if you need to file a claim yourself, you can download a claim form and send it to the address on the back of your Blue Cross and Blue Shield of Texas ID card.

What is a Health Savings Account (HSA)?
An HSA can be established with funds from you, your employer or both. You can use these funds to pay for medical care services and if you spend the money on an eligible expense of your PPO, it will count toward your annual deductible. You own the HSA, so if you change jobs, the funds stay with you. If you are purchasing this product you should first seek professional tax counsel to determine if your individual situation permits use of an HSA.

How does the BlueEdge HSA family deductible work?
The family deductible is an "aggregate" deductible, which means that the entire family deductible amount must be satisfied before benefits begin for any family member. Eligible health care expenses from any covered family member apply toward the family deductible.

How do I access my HSA funds?
If your employer uses Mellon Bank to administer the HSAs with the integrated offering, and you use an in-network provider, the provider will submit the claim for you*. Blue Cross and Blue Shield of Texas integrated claim process gives you the option of having funds automatically deducted from the HSA. There is usually no paperwork for you to file.

If you receive care from a non-network doctor or hospital, the provider will most likely also file your claim with Blue Cross and Blue Shield of Texas. However, if you need to file a claim yourself, you can download a claim form and send it to the address on the back of your Blue Cross and Blue Shield of Texas ID card.

To access your HSA funds you can also use the debit card or checkbook issued by the HSA administrator.

How does the BlueEdge Flexible Spending Account (FSA) First product work?
BlueEdge FSA First allows members to use their own tax-free dollars from a FSA and the employer-funded HCA to help cover the healthplan deductible. The FSA funds are used first to pay for eligible services. When those funds are depleted, HCA funds are spent. Any remaining deductible is the member’s responsibility before PPO benefits begin.

If I have BlueEdge FSA First how do I access my FSA and HCA funds?
If you use a network doctor or hospital, your provider will usually submit the claim for you. Blue Cross and Blue Shield of Texas’ integrated claim process will automatically deduct the appropriate funds from your FSA and/or HCA and/or pay the claim from the PPO. If your plan covers non-PPO eligible expenses, send the receipt and claim form to the address on the claim form to receive a reimbursement from your FSA and/or HCA. Your Explanation Of Benefits (EOB) will show how the claim was processed along with any amount deducted from your FSA and/or HCA. The EOB will also show the HCA balance. For the FSA balance or any other FSA administrative needs, visit Ceridian or call the toll-free number on the back of your Blue Cross and Blue Shield of Texas ID card*.

What happens to the FSA and HCA balances if I leave the BlueEdge plan?
Any remaining balances return to your employer.

How does BlueEdge Wellness Rewards HCA work?
BlueEdge Wellness Rewards HCA rewards you for completing healthy activities from a list selected by your employer. Each time you complete a healthy activity, your employer will set aside funds in a HCA for you.

How does BlueEdge Vitality HCA work?
Each year, your employer will set aside funds in a HCA. The account balance rolls over and is added to the HCA contribution for the following year. Upon retirement, you can use the funds to pay for benefits your employer has chosen.

What is a Limited Purpose HCA?
The law allows employees who are covered under a HSA to also have a Limited Purpose HCA. The Limited Purpose HCA covers specific benefits as defined by the IRS. Your employer funds the Limited Purpose HCA.

*The relationship between Blue Cross and Blue Shield of Texas and Mellon Bank and Ceridian is that of independent contractors.