| General Benefits |
BlueEdgesm Individual HSA, a Preferred Provider Health Insurance Plan with a Health Savings Account (HSA)
| In-Network Benefits |
Out-Of-Network Benefits |
| Higher Benefit Levels |
Lower Benefit Levels |
| Providers precertify care. |
You must preauthorize hospital admissions and certain services. |
| There are usually no claim forms to file. |
You may have to submit claims for reimbursement. |
| |
|
* |
Texas Department of Insurance Form: |
| |
PPO-BLUEEDGE-INDL-HSA-OLC-3 |
|
