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Regence HSA Healthplan - $1,500 Individual Deductible

Individual Health Insurance Utah | Regence HSA - $1,500 Deductible

    • 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 and wellness programs, plus personalized tools and support you need to make the plan your own.
    • Comprehensive wellness programs like Care Enhance® Nurseline & Regence Health CoachSM.

Coverage at a Glance


Deductible:
Annual OOP Max: $5,000
Lifetime Max: $2 million per member
Copay: Not applicable on this plan
Coinsurance: 20% In-Network, 40% Out-of-Network
Coinsurance Max: Not applicable on this plan
Network(s): Regence Traditional/ValueCare

Find a Doctor
Yes Prescription benefits
No Dental
No Vision
Yes No Referrals
No Maternity
Yes Preventive Care
No Alternative Care
Yes Mental Health
 

Basic Features

Cost Sharing
Deductibles: $1,500 Individual
Annual OOP Max:
  • $5,000 single
  • Amount includes your deductible
  • Maximum applies to in-network services only. No maximum for out-of-network services.
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 in-network services.
  • You pay 40% for most out-of-network services.
Everyday Needs
Prescriptions:
  • You pay 50% at participating and non-participating pharmacies.
  • Subject to deductible
Preventive Care:
  • You pay 20% for in-network providers.
  • You pay 40% for out-of-network 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: Not covered
Maternity: Not covered
Mental Health:
  • You pay 50% for in-network and out-of-network providers.
  • Limited to $1,500 per calendar year.
Other considerations
Network(s):
  • Traditional (Regence BlueCross BlueShield of Utah) Network
  • ValueCare Network

Benefit Summary

Rates

About rate changes: We typically adjust rates once a year in July, but the state legislature may mandate changes that affect the cost at other times of the year. Your rate may be adjusted at those times, even if you enrolled for coverage in the previous month.

Medical Exclusions and Limitations

Alternative Care Excluded
Birth Control Included (except for non-prescription contraceptives)
Cosmetic OR Reconstructive Surgery Excluded
Counseling Excluded
Custodial Convalescent Cures Excluded
Dental Services Excluded (accidental injury to sound natural teeth is covered)
Durable Medical Equipment $2,500 limit per enrollee per calendar year
Erectile Dysfunction Excluded
Foot Care Excluded
Gastric Procedures such as gastric bypass Excluded
Genetic Services Excluded
Growth Hormone Benefit $20,000 limit per enrollee per calendar year
Hearing Treatment Excluded
Home Health Care 130 visits per enrollee per calendar year
Infertility Excluded
Maternity Care Excluded
Mental Health Treatment $1,500 limit per calendar year
Obesity or Weight Control Excluded
Orthognatic Surgery Excluded
Pre-existing conditions 12 month waiting period
Rehabilitative Care (inpatient) $4,000 limit per enrollee per calendar year
Rehabilitative Care (outpatient) $2,000 limit per enrollee per calendar year
Sterilization 12 month waiting period
Temporomandibular Joint Disorder Excluded
Transplants Limited to $250,000 per person per lifetime
Tobacco Addiction Treatment Excluded
Vision Excluded
You must be continuously covered for at least 12 months before we pay for any of the following
Pre-existing conditions 12 month waiting period
Sterilization 12 month waiting period
Preventative Care
Children — first 24 months No annual limitations
Children — age 2—5 No annual limitations
Children — ages 6 and older No annual limitations
Adult men and women No annual limitations

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