BlueEdgeSM HMO
Currently available to large groups (151+), BlueEdge HMO incorporates the consumerism concept of helping the member take more control of their healthcare by presenting them with the tools and options they need to become more engaged. BlueEdge HMO is available through HMO Illinois or BlueAdvantageSM HMO.
Advantages
BlueEdge HMO members enjoy:
- An employer funded account that can be used to help cover some of the higher out-of-pocket co-payments. These co-payments are called HMO liable and specifically refer to ER co-pays, Rx co-pays, Inpatient hospital co-pays, and Outpatient surgery co-pays
- A choice of a contracting medical group/independent practice association from one of our HMO networks
- No annual deductible and, generally, no claim forms
Benefits
Members also enjoy access to a range of benefits when care is provided/coordinated through their primary care Physician (PCP), including:
- Online resources/tools
- access to employer funded account details online
- ability to check balance, transactions, dates of service, etc.
- access to wellness tools such as our Personal Health Manager
- access to online medical encyclopedia, our "ask-a-features", and more
- Preventative care and wellness visits for Adults and Children which cover:
- Immunizations
- Diabetes screening
- Tests for breast, cervical, prostate, and colon cancer
- Maternity Care
- Mental health and substance abuse including both inpatient and outpatient visits
- Rehabilitative therapy which includes Physical, Speech, and Occupational therapy
- Other coverages that do not require a PCP referral:
- Emergency Care
- Vacation visits (out-of-area on a temporary status)
- Substance abuse treatment
- Vision exams
