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BlueEdgeSM Individual HSA

General Benefits

In-Network Benefits Out-Of-Network Benefits
Highest Benefit Levels Lower Benefit Levels
Providers precertify care You must preauthorize hospital admissions and certain services
No claim forms to file You may have to submit claims for reimbursement

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Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.

Copyright 2007. Health Care Service Corporation. All Rights Reserved.
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