HCA – Health Care Account

BCBS administers the HCA.

District 96 offers an HCA to help members of the PPO health insurance plan pay their in-network deductible after the member has paid the employee portion of the deductible.

BCBS automatically processes your HCA Reimbursement when they process your medical claim. BCBS calls this PPO plan the BlueEdge Direct Health Care Account or HCA.

Your claim is processed by BCBS and applied toward your annual deductible, if applicable. You are responsible to pay your share of the in-network deductible. When your portion of the deductible has been met, BCBS will automatically pay the HCA amount directly to the provider.

Health services covered at 100%, co-pays and prescription drugs are not applied toward the deductible. Therefore, the employee is responsible for all co-pays associated with office visits, emergency room visits and prescription drugs. These costs are not reimbursable through the HCA.

The district’s health insurance plan is July 1 through June 30. The annual deductible for the PPO option is based on a calendar year – January 1 through December 31.

HCA In-Network Deductible Chart

The member is responsible for all Out-of-Network deductibles

Below is a flowchart showing how the process works with BCBS.

BlueEdge HCA 1-1-22