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Plan Benefits:
BlueSelections Premier | BlueSelections Plus
| BlueSelections Basic | HSA Healthplan
Plan Rates:
BlueSelections Premier | BlueSelections Plus | BlueSelections Basic | HSA Healthplan
Oregon Medical Insurance > Regence BlueCross BlueShield of Oregon > HSA Healthplan Benefits
Your Regence HSA (Health Savings Account) Healthplan provides coverage for services provided by In-Network and Out-Of-Network physicians and other professional providers as listed below. Once enrolled, the Participating Network is the panel of providers for which you will receive the greatest benefits.
HSA Healthplan |
||
| Lifetime benefit maximum | $2 million per individual |
|
| Benefit Features | In-Network Benefit |
Out-Of-Network Benefit |
| Deductibles | Single - $1,500, $2,500, $3,500 Family - $3,00, $5,000, $7,000 |
|
| Out-of-pocket maximum amount per calendar year including deductible | Single - $5,000 Family - $10,000 |
None |
| After your maximum coinsurance is met each calendar year, we pay | 100% |
N/A |
| Preventive Care Services |
Deductible Waived - We Pay |
|
Immunizations for adults and children |
80% |
60% |
Well-baby exam and well child care |
80% |
60% |
Annual women's exams including Pap tests & mammograms |
80% |
60% |
Adult routine physical exams including related lab & x-ray services |
80% |
60% |
| Professional Services | After Deductible We Pay |
|
Office visits and other office procedures |
80% |
60% |
Therapeutic injections and allergy shots |
80% |
60% |
Maternity care |
80% |
60% |
Surgery |
80% |
60% |
Diagnostic radiology and lab |
80% |
60% |
| Hospital Services | After Deductible We Pay |
|
Emergency room care for medical emergency |
80% |
|
Emergency room card for non-emergency |
80% |
60% |
Inpatient stay |
80% |
60% |
Outpatient services |
80% |
60% |
| Other Services | After Deductible We Pay |
|
Ambulance |
80% |
|
Alcoholism treatment |
80% |
60% |
Outpatient Rehabilitation |
80% |
60% |
Skilled nursing facility, home health, and hospice care |
80% |
60% |
Durable medical equipment and supplies |
80% |
60% |
| Prescription Benefits | After Deductible We Pay |
|
Pharmacy purchased prescription medications (30-day supply) |
50% |
|
Oral or self-administered prescription medications for chemotherapy |
80% |
|
Additional Benefits |
||
Accidental death |
Provides $25,000 for an adult enrollee and $5,000 for an enrollee under the age of 18. | |
| BlueCard ® program | Provides savings nationwide. To receive the best benefit, please use BlueCard PPO providers of the Blue Cross and/or Blue Shield Plan in the area where you receive the service. Using providers outside of the Blue Cross and/or Blue Shield Plan may likely result in greater out of pocket expenses. Find a provider near you at www.bcbs.com. | |
| Please note: Single coverage deductible and out-of-pocket maximum applies when an individual is enrolled without dependents. Family coverage deductible and out-of-pocket maximum applies when an individual and one or more dependents are enrolled. Prior to benefits being paid, the entire family deductible must be met. | ||