Blue Cross and Blue Shield of Texas BlueEdge Individual HSA Plan VII Plan Information
Coverage Level 100%
Physician/Hospital Network BlueChoice or BlueCard Preferred Provider Organization
Lifetime Benefit $5 Million
Individual Out-of-Pocket Expense $5,000
Office Visit Co-pay Deductible
Family Out-of-Pocket Expense $10,000
Outpatient Physician Medical Services Deductible
Outpatient Physician Surgical Services Deductible
Preventative Care 100% after deductible; $300 max per year
Childhood Immunizations 100% to 6 years of age
Inpatient Physician Medical/Surgical Services Deductible
Outpatient Hospital Services Deductible
Outpatient Hospital Diagnostic Testing Deductible
Inpatient Hospital Services and Diagnostic Testing Deductible
Outpatient Prescription Drugs Deductible and $10 copay/generic; $50 copay/preferred; $65 copay/non-preferred; $5,000 calendar year max
Other Blue Cross and Blue Shield of Texas health insurance plans:
