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Regence HSA Healthplan - $2,500 Individual Deductible

Washington Health Plans | Regence HSA Healthplan - $2,500 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 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 per member
Lifetime Max: $2 million per member
Copay: Not applicable on this plan
Coinsurance: 20% Preferred providers, 40% Participating
Coinsurance Max: Not applicable on this plan
Network(s): Preferred Network

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

Basic Features

Cost Sharing
Deductibles: $2,500 per member
Annual OOP Max:
  • $5,000 single
  • Amount includes your deductible
  • Maximum only applies to Preferred providers' services. No maximum for 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 Preferred providers' services.
  • You pay 40% for most Participating providers' services.
Everyday Needs
Prescriptions:
  • RegenceRx discount program only
Preventive Care:
  • You pay 20% for Preferred providers.
  • You pay 40% for Participating providers.
  • Deductible waived
  • No annual limit
Vision: Not covered
Office Visits: Deductible and coinsurance
Diagnostic x-ray services: Deductible and coinsurance
Outpatient Laboratory services: Deductible and coinsurance
Special Needs
Alternative care:
  • 12 acupuncture visits per calendar year
  • 10 spinal manipulations per calendar year
  • Deductible and coinsurance apply
Maternity: Not covered
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): Preferred Network

Benefit Summary

Rates

 

Optional Benefits

Complete your health care plan with Dental coverage: DentalOne


  • No deductibles, no annual maximums
  • $15 per visit copay for basic dental services

Learn more about DentalOne »

Medical Exclusions and Limitations

PDF (35k) Exclusions and Limitations: All Individual Plans

Acupuncture 12 visits per calendar year
Alcoholism Not covered
Ambulance $2,000 per calendar year
Cosmetic Surgery Not covered
Custodial Care and Rest Cures Not covered
Drug Abuse/Addiction treatment Not covered
Growth Hormone Therapy $20,000 per calendar year
Hearing Aids Not covered
Home Health Care 130 visits per calendar year
Home Medical Equipment $2,500 per calendar year
Hospice 6 months maximum
Marital and family counseling Not covered; family counseling covered as specified in the Mental Disorders benefit
Mental Health Treatment Inpatient: 8 days per calendar year
Outpatient: 12 outpatient visits per calendar year
Occupational Injury Provided for subscriber only
Rehabilitative Care (inpatient) $4,000 per calendar year
Rehabilitative Care (outpatient) $2,000 per calendar year
Skilled Nursing Facility Care 30 days per calendar year
Smoking Cessation Not covered
Spinal Manipulation 10 manipulations per calendar year
Sterilization Not covered
Temporomandibular Joint Disorder Not covered
Waiting Periods
Pre-existing conditions 9-month waiting period
Transplants
  • $250,000 lifetime maximum
  • 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 a contract for a complete list and more in-depth explanation of benefits and the limitations and exclusions that apply.

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