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| Deductible: |
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|---|---|
| Annual OOP Max: | Not applicable on this plan |
| Lifetime Max: | $2 million per member |
| Copay: | $30-$40 |
| Coinsurance: | 30% preferred providers, 50% non-preferred |
| Coinsurance Max: | $6,000 preferred providers, $10,000 non-preferred (per member) |
| Network(s): | Preferred Network Find a Doctor |
| Prescription benefits | |
| Dental | |
| Vision | |
| No Referrals | |
| Maternity | |
| Preventive Care | |
| Alternative Care | |
| Mental Health |
| Deductibles: |
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|---|---|
| Annual OOP Max: | Not applicable on this plan |
| Coinsurance Max: |
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| Lifetime Max: | $2 million paid by Regence per member |
| Copay: |
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| Coinsurance: |
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| Prescriptions: |
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| Preventive Care: |
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| Vision: |
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| Office Visits: |
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| Diagnostic x-ray services: | Deductible and coinsurance |
| Outpatient Laboratory services: | Deductible and coinsurance |
| Alternative care: | Not covered |
|---|---|
| Maternity: | Deductible and coinsurance |
| Mental Health: |
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| Network(s): | Preferred Providers
Non-Preferred Providers
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|---|
Need Assistance? Contact Us Oregon | Individual & Family PlansOregon Health Insurance
Regence HSA Healthplan - Oregon onlyBrings together robust preventive care benefits and protection against the unexpected, with the unique power of a tax-advantaged Health Savings Account. For individuals and families. Blue SelectionsSM - Oregon onlyGetting the right fit is important, whether you're talking about shoes or the perfect pair of jeans. For something as important as your health, you want coverage that is right for you -- something that fits you and your family. For individuals and families. Regence HSA Comprehensive Healthplan - Clark County onlyBrings together robust preventive care benefits and protection against the unexpected, with the unique power of a tax-advantaged Health Savings Account. Even includes maternity and prescription coverage. For individuals and families. Regence HSA Healthplan - Clark County onlyBrings together robust preventive care benefits and protection against the unexpected, with the unique power of a tax-advantaged Health Savings Account. For individuals and families. Regence BreakthruSM - Clark County onlyGetting the right fit is important, whether you're talking about shoes or the perfect pair of jeans. For something as important as your health, you want coverage that is right for you -- something that fits you and your family. For individuals and families. Blue Selections PPOSM - Clark County onlyA solid plan with robust coverage to serve all your health care needs: physician and hospital services, vision, and prescriptions. For individuals and families. InterMSMTemporary medical coverage for unexpected accidents and illnesses, offered through our affiliate Regence Life and Health. Good for individuals and families who are between jobs, or waiting for an employer plan to start. There are restrictions on pre-existing conditions, so please check the details carefully. Individual DentacareThis affordable dental coverage is an option for individuals and families purchasing one of our individual and family medical plans. Services for Individual Dentacare are provided by the dentists and staff of Willamette Dental – one of the largest managed dental care groups in the nation. For individuals and families. Individual Dollar-Based DentalA dental plan that puts you in control of your dental health dollars, offered through our affiliate Regence Life and Health. This plan is dollar-based – a unique departure from traditional procedure-based coverage. Imagine spending your benefit dollars almost any way you choose, on care that's important to you and your family. Each year you decide to include an exam and cleaning, you are rewarded with a benefit increase the following year. Individual Incentive DentalImmediate access to quality, affordable dental care, offered through our affiliate Regence Life and Health. This plan is procedure-based, but unlike traditional dental plans you are rewarded for receiving routine preventive care. Each year that you visit the dentist for a checkup and cleaning, means greater benefits and less out-of-pocket expenses the next year. This does not include all benefits, limitations, exclusions and other terms of coverage (such as eligibility and cancellation provisions) applicable to this plan. Please refer to your contract of a complete list and more in-depth explanation of benefits and the limitations and exclusions that apply.
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Fourth quarter rates are effective 10/1/2009 through 12/31/2009. First quarter rates are effective 1/1/2010 through 3/31/2009. |
Complete your health care plan with Dental coverage: Individual Dentacare
Learn more about Individual Dentacare » |
| Acupuncture | Not covered |
|---|---|
| Alcoholism | Limited to $4,500 in any 24-month period |
| Ambulance | Not limited, ground and air |
| Cosmetic/Reconstructive Surgery | Not covered |
| Custodial Care and Rest Cures | Not covered |
| Dental Injury | Not covered |
| Drug Abuse/Addiction Treatment | Not covered |
| Durable Medical Equipment | Not limited |
| Family Planning | Not covered |
| Growth Hormone Benefit | Must be preauthorized |
| Hearing Aids | Not covered |
| Home Health Care | 130 visits per calendar year |
| Mental Health Treatment | Inpatient covered only, 30 day maximum per calendar year |
| Obesity or Weight Control | Not covered |
| Orthognathic Surgery | Not covered |
| Outpatient Counseling | Not covered |
| Preventive Care |
|
| Rehabilitative Care (inpatient) | 30 days per calendar year |
| Rehabilitative Care (outpatient) | 30 sessions per calendar year |
| Skilled Nursing Facility | 100 days per stay |
| Spinal Manipulation | Not covered |
| Temporomandibular Joint Disorder | $1,000 per calendar year |
| Transplants |
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| Tobacco Addiction Treatment | Not covered |
| Allergies | 12-month waiting period |
|---|---|
| Sterilization | 12-month waiting period |
| Elective Procedures | 12-month waiting period |
| This does not include all benefits, limitations, exclusions and other terms of coverage (such as eligibility and cancellation provisions) applicable to this plan. Please refer to your contract of a complete list and more in-depth explanation of benefits and the limitations and exclusions that apply. |
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