Health insurance costs include monthly payments, individual deductibles, drug coverage deductibles, out-of-pocket expenses, copayments, and coinsurance. For BlueEdge plans, here’s what you can expect:

• Individual in-network deductibles ranging from $1200 to $5000 – customize your plan by choosing a deductible amount that works best for your situation
• Benefits for preventive care services covered
• Coinsurance ranging from 0 to 20 percent of services provided in-network, after deductible and copayments are met
• Out-of-pocket prescription drug costs range from 0 to 20 percent once you have met your deductible, depending on the plan you choose

The BlueChoice Network option allows you to save on premiums and the cost of covered services when you use a contracting BlueChoice® hospital, doctor or specialist. You do not need to select a primary care physician or obtain a referral to see a specialist.

For more information on cost, including out-of-pocket costs, get a quick quote or see the Outline of Coverage documents under What’s Included with BlueEdge Individual HSA - More Plan Details.

• Coverage for major hospital, medical, and surgical expenses incurred as a result of a covered accident or sickness
• Coverage for daily hospital room and board, miscellaneous hospital services, surgical services, anesthesia services, in-hospital medical services, and out-of-hospital care
• Although you can go to the hospitals and doctors of your choice, your benefits under a BlueEdge plan will be greater when you use the services of network participants
• The freedom of not having to select a primary care doctor or obtain a referral to see a specialist

More Plan Details

It’s important to know the features of the health plan you are considering. Our Outline of Coverage documents give you brief descriptions of the basic details of our BlueEdge Individual HSA plans, as well as details on renewability, exclusions and limitations.

• BlueEdge Outline of Coverage 
• BlueEdge 5000 Outline of Coverage 

At Blue Cross and Blue Shield of Illinois, we understand your concerns about coverage continuity. Blue Cross and Blue Shield of Illinois will never terminate or refuse to renew your Policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a plan may be terminated or a renewal refused:

• Failure to pay premiums
• The plan is discontinued (90 days notice given with an option to convert to any plan we offer)
• Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)
• If you no longer reside, live or work in an area where we are authorized to do business

For more information on renewability, see the Outline of Coverage documents under What’s Included with BlueEdge Individual HSA - More Plan Details.

Every insurance plan has limitations. These limits are there to keep health care costs down for everyone. A pre-existing condition is just one example of a plan limitation. For example:

• A pre-existing condition may limit or exclude your participation in a plan. This means your health care expenses related only to that specific condition will not be covered by the plan during that time.
• Children under 19 cannot be denied coverage due to a pre-existing condition(s).
• There is a waiting period of 365 days for pre-existing conditions.

It’s important to know the limitations of your health plan. For a list of exclusions and limitations, see the Outline of Coverage documents under What’s Included with BlueEdge Individual HSA - More Plan Details.

You can customize either BlueEdge Individual HSA plan with add-on coverage and insurance.

Optional Maternity Coverage

• Covers inpatient and outpatient hospital services.
• Includes coverage for medical and surgical services.
• Maternity benefits 365 days after the effective date of the maternity coverage.

Optional Dental Coverage

• Covers cleanings, check-ups and other preventive procedures immediately – no waiting period
• One of the highest maximum benefit amounts available – up to $1,500 per person per year
• Up to 20 percent discount for orthodontic services at participating providers
• Learn more about optional dental coverage

• Once you’ve met your deductible, your out-of-pocket cost for prescription drugs is 0 percent or 20 percent, depending on the plan you choose.
• Your benefit plan includes a mail service program that offers you the convenience of having covered maintenance medications delivered directly to you.
• Members have access to a variety of online tools that can help you learn more about prescription drugs and manage your pharmacy benefit.
• Prescription Drug Utilization/Benefit Management Programs are being added to policies with effective dates on or after 1/1/2012. See Compare Plans Chart for more information.