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Index | Exclusions & Limitations | Locate Providers & Pharmacy | Application
Plan Benefits:
Maximizer | Beneficial Value (PPO) | Beneficial Rx (PPO) | HSA Value | HSA 3000
Plan Rates:
Maximizer | Beneficial Value (PPO) | Beneficial Value w/ Rx option | Beneficial Rx (PPO) | HSA Value | HSA 3000
Index | Exclusions & Limitations | Locate Providers & Pharmacy | Application
Plan Benefits:
Maximizer | Beneficial Value (PPO) | Beneficial Rx (PPO) | HSA Value | HSA 3000
Plan Rates:
Maximizer | Beneficial Value (PPO) | Beneficial Value w/ Rx option | Beneficial Rx (PPO) | HSA Value | HSA 3000
LifeWise Health Plans of Oregon
Regence BC BS of OR
ODS Health Plans
PacificSource
Providence Health Plans
HealthNet of Oregon
Kaiser Permanente
Oregon Medical Insurance Pool
Medicare Supplement Plans
- Medicare Plans Overview
- Medicare Supplements
- Medicare Advantage
- Medicare Part D
- AARP
- American Republic
- Humana
- Lifewise
- ODS Senior Select
- Regence
- United of Omaha
- UCT
- Woodmen
Other Insurance
Oregon Medical Insurance > Beneficial Value Rx >
Effective date : 11/1/2009
Valid thru : 10/30/2010
Counties : Available in all counties
| Family Status : | Applicant | Applicant and Spouse | Applicant and Child(ren) | Applicant and Family |
| Age | Deductible : 1000 | |||
| 0-19 | 82.00 | 164.00 | 143.00 | 228.00 |
| 20-24 | 120.00 | 238.00 | 206.00 | 333.00 |
| 25-29 | 130.00 | 277.00 | 242.00 | 391.00 |
| 30-34 | 153.00 | 324.00 | 280.00 | 446.00 |
| 35-39 | 167.00 | 351.00 | 299.00 | 465.00 |
| 40-44 | 206.00 | 409.00 | 340.00 | 546.00 |
| 45-49 | 244.00 | 485.00 | 350.00 | 595.00 |
| 50-54 | 289.00 | 573.00 | 394.00 | 687.00 |
| 55-59 | 342.00 | 679.00 | 445.00 | 792.00 |
| 60-64 | 398.00 | 796.00 | 478.00 | 854.00 |
| Age | Deductible : 2500 | |||
| 0-19 | 65.00 | 131.00 | 113.00 | 182.00 |
| 20-24 | 96.00 | 191.00 | 165.00 | 266.00 |
| 25-29 | 105.00 | 222.00 | 193.00 | 313.00 |
| 30-34 | 122.00 | 259.00 | 223.00 | 357.00 |
| 35-39 | 133.00 | 281.00 | 240.00 | 372.00 |
| 40-44 | 164.00 | 327.00 | 272.00 | 436.00 |
| 45-49 | 195.00 | 387.00 | 280.00 | 476.00 |
| 50-54 | 231.00 | 459.00 | 316.00 | 549.00 |
| 55-59 | 273.00 | 544.00 | 355.00 | 634.00 |
| 60-64 | 319.00 | 637.00 | 383.00 | 682.00 |
| Age | Deductible : 5000 | |||
| 0-19 | 51.00 | 101.00 | 88.00 | 141.00 |
| 20-24 | 74.00 | 147.00 | 126.00 | 205.00 |
| 25-29 | 80.00 | 171.00 | 150.00 | 241.00 |
| 30-34 | 94.00 | 200.00 | 172.00 | 275.00 |
| 35-39 | 103.00 | 217.00 | 184.00 | 287.00 |
| 40-44 | 126.00 | 253.00 | 209.00 | 336.00 |
| 45-49 | 150.00 | 299.00 | 216.00 | 367.00 |
| 50-54 | 179.00 | 352.00 | 243.00 | 423.00 |
| 55-59 | 210.00 | 418.00 | 273.00 | 488.00 |
| 60-64 | 246.00 | 491.00 | 295.00 | 526.00 |
| Age | Deductible : 7500 | |||
| 0-19 | 39.00 | 78.00 | 68.00 | 109.00 |
| 20-24 | 58.00 | 114.00 | 98.00 | 160.00 |
| 25-29 | 63.00 | 133.00 | 116.00 | 187.00 |
| 30-34 | 74.00 | 155.00 | 134.00 | 214.00 |
| 35-39 | 80.00 | 169.00 | 143.00 | 223.00 |
| 40-44 | 98.00 | 196.00 | 163.00 | 261.00 |
| 45-49 | 117.00 | 232.00 | 168.00 | 286.00 |
| 50-54 | 139.00 | 274.00 | 189.00 | 330.00 |
| 55-59 | 164.00 | 326.00 | 213.00 | 380.00 |
| 60-64 | 190.00 | 382.00 | 230.00 | 409.00 |
* - not all of the zip codes are eligible in this county
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