Regence HSA Healthplan - $3,500 Individual Deductible

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.
Unlimited, up-front preventive care, plus personalized tools and support you need to make the plan your own.
Comprehensive wellness programs like Care Enhance^® Nurseline & Regence Health Coach^SM.

Coverage at a Glance

Deductible:	Selected: $3,500 Individual $2,500 Individual $3,500 Individual $5,000 Family $7,000 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:	$3,500 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:	Deductible and coinsurance apply
Maternity:
Mental Health:	12 visit limit for outpatient services annually 8 day limit for inpatient services annually Deductible and coinsurance apply

Other considerations
Network(s):	Participating Network

Benefit Summary

Rates

PDF (26k) Rates: Regence HSA Healthplan

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 annual limit
Cosmetic/Reconstructive Surgery	Not covered
Custodial Care and Rest Cures	Not covered
Drug Abuse/Addiction Treatment	Not covered
Durable Medical Equipment	$2,500 annual limit
Family Planning	Not covered
Growth Hormone Benefit	$20,000 annual limit
Hearing Aids	Not covered
Home Health Care	130 days per calendar year
Maternity
Mental Health Treatment	Not covered
Obesity or Weight Control	Not covered
Orthognathic Surgery	Not covered
Rehabilitative Care (inpatient)	$15,000 annual limit
Rehabilitative Care (outpatient)	$1,500 annual limit
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.