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Oregon Medical Insurance > LifeWise Health Plan of Oregon >

LifeWise Health Plans of Oregon

LifeWise Individual and Family Plans

Whether your clients choose the value-packed WiseEssentials 50 plan, the comprehensive WiseChoices plan or the tax-advantaged WiseSavings they'll get benefits and healthcare coverage that fit their lifestyle.

Preventive Services in our plans:
  • Well-baby and newborn exams
  • Routine physicals (for school, sports, work)
  • Women's and men's annual exams
  • Preventive immunizations (includes HPV vaccine)
  • Cervical (PAP), prostate (PSA), and colorectal* cancer screenings
  • Infectious disease screenings
  • Metabolic, nutrition and endocrine screenings
  • Heart and vascular disease screenings
  • Musculoskeletal disorder screenings
 Other Important features:
  • Prescription drug benefits
  • Alternative Care benefits (Chiropractic and Acupuncture)
  • Mammography coverage
  • Professional office visits coverage (including Urgent Care and Naturopathy)

*A colonoscopy is covered under surgical services benefit.See your benefit booklet for details.

WiseEssentials 50
WiseEssentials
WiseChoices
WiseSavings
LifeWise Health Plans
Effective starting 9/1/09		 Plan Summary
Plan Rates
Features • Affordable basic coverage
• Lowest monthly rates		 • Affordable basic coverage
• Lower monthly rates		 • Broadest coverage
• Choice of deductible and copay options		 • Tax-advantaged savings plan
• Lower monthly rates
Individual Deductible $1,500 / $3,000 $1,500 / $2,500 / $5,000 / $7,500 $500 / $1,000 / $2,500 / $5,000 $3,000 individual
$6,000 family**
Coinsurance
(what you pay) 		50% 25% 20% 20%
Coinsurance Maximum $9,000 $9,000 $7,500 $2,000 individual
$4,000 family
Out-of-Pocket Maximum
 Annual deductible +
coinsurance maximum
 Annual deductible +
coinsurance maximum		 Annual deductible +
coinsurance maximum		 Annual deductible +
coinsurance maximum
Office Visits and
Preventive Exams 		Preventive Exams: No deductible applies, you pay 50% (1 exam PCY)
Office Visits: Deductible
applies first, then you pay 50%		 No deductible applies on first six visits ($25 copay only); subsequent visits subject to deductible and 25% $20 copay per visit Preventive Exams: Dedcutible waived, you pay 20%
Office Visits: Deductible
applies first, then you pay 20%
Alternative Care
 Naturopathy
After paying deductible, you pay 50% 		$25 copay $25 copay After paying deductible, you pay 20%
Pharmacy
(Retail 30-day supply) 		$20 generic only $20 generic only $20 generic; 50% brand
Deductible, then 50%;
Certain preventive generic drugs are reimbursed at 100%
Pharmacy
(Mail Order 90-day supply) 		$50 generic only $50 generic only $50 generic; 45% brand Deductible, then 45%;
Certain preventive generic drugs are reimbursed at 100%
Maternity Deductible, then 50% After paying deductible, you pay 25% After paying deductible, you pay 20% After paying deductible, you pay 20%
Vision Care Not covered Not covered Exams covered in full (one  exam per two calendar years) $200 for frames, lenses and contact lenses (per two calendar years) Not covered
* Reimbursable expenses are covered at 100% of maximum allowable amounts; no deductible applies.
** Services for all family members covered under the same HSA-qualified plan are applied to the family deductible. The family deductible must be met before services are covered for any enrolled family members.

 

 
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