Regence HSA Comprehensive Healthplan - $1,500 Indiv. Ded.

Oregon Health Insurance

Own your health care dollars with a tax-advantaged account that covers medical expenses beyond your health plan. Or choose to save.
More robust coverage than most HSAs, such as maternity and prescription coverage, plus a lower deductible.
Comprehensive wellness programs like Care Enhance^® Nurseline & Regence Health Coach^SM.

Coverage at a Glance

Deductible:	Selected: $1,500 Individual $1,500 Individual $3,000 Family
Annual OOP Max:	$5,000 single
Lifetime Max:	$2 million per member
Copay:	Not applicable on this plan
Coinsurance:	20% Participating, 40% Non-Participating
Coinsurance Max:	Not applicable on this plan
Network(s):	Participating Network Find a Doctor

	Prescription benefits
	Dental
	Vision
	No Referrals
	Maternity
	Preventive Care
	Alternative Care
	Mental Health

Basic Features

Cost Sharing
Deductibles:	$1,500 Individual
Annual OOP Max:	$5,000 single Amount includes your deductible Maximum only applies to Participating providers' services. No maximum for Non-Participating providers.
Coinsurance Max:	Not applicable on this plan
Lifetime Max:	$2 million paid by Regence per member
Copay:	Not applicable on this plan
Coinsurance:	You pay 20% for most Participating providers' services. You pay 40% for most Non-Participating providers' services.

Everyday Needs
Prescriptions:	You pay 50% at Participating and Non-Participating pharmacies. Subject to deductible
Preventive Care:	You pay 20% for Participating providers. You pay 40% for Non-Participating providers. Deductible waived No annual limit
Vision:	Not covered
Office Visits:	Deductible and coinsurance apply
Diagnostic x-ray services:	Deductible and coinsurance apply
Outpatient Laboratory services:	Deductible and coinsurance apply

Special Needs
Alternative care:	12 acupuncture visits per calendar year 10 spinal manipulations per calendar year Deductible and coinsurance apply
Maternity:	Deductible and coinsurance apply
Mental Health:	12 visit limit for outpatient services per calendar year 8 day limit for inpatient services per calendar year Deductible and coinsurance apply

Other considerations
Network(s):	Participating Network

Benefit Summary

Rates

PDF (25k) Rates: All Individual Plans (Effective Mar. 1, 2009 - Feb. 28, 2010)

Optional Benefits

Dental Plan

Add our Individual Dentacare dental plan to round out your coverage. It offers:

no deductible
$15 copay for each visit
no annual maximum for coverage

Learn more »

Medical Exclusions and Limitations

Acupuncture	12 office visits per calendar year
Alcoholism	Not covered
Ambulance	$5,000 per calendar year
Cosmetic/Reconstructive Surgery	Not covered
Custodial Care and Rest Cures	Not covered
Drug Abuse/Addiction Treatment	Not covered
Durable Medical Equipment	$2,500 per calendar year
Family Planning	Not covered (except sterilization & oral contraceptives)
Growth Hormone Benefit	$20,000 per calendar year
Hearing Aids	Not covered
Home Health Care	130 days per calendar year
Maternity	9-month waiting period
Mental Health Treatment	Not covered
Obesity or Weight Control	Not covered
Orthognathic Surgery	Not covered
Rehabilitative Care (inpatient)	$15,000 per calendar year
Rehabilitative Care (outpatient)	$1,500 per calendar year
Skilled Nursing Facility	14 days per stay
Spinal Manipulation	10 office visits per calendar year
Temporomandibular Joint Disorder	Not covered
Transplants	12-month waiting period $250,000 lifetime maximum
Tobacco Addiction Treatment	Not covered
Vision	Not covered

You must be covered for at least 9 months before we pay for any of the following
Allergies	9-month waiting period
Ear Infections (otitis media)	9-month waiting period
Pre-existing conditions	9-month waiting period
Removal of Tonsils and Adenoids	9-month waiting period
Sterilization	9-month waiting period

This does not contain all limitations and exclusions. Please refer to your policy for a complete list of benefits and the limitations and exclusions that apply.