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Index | Exclusions | Provider Directory | Application
Plan Benefits:
Optimum Benefits | Value Benefits | Prime Benefits | HSA Benefits
Plan Rates:
Optimum Rates | Value Rates | Prime Rates | HSA Rates
Oregon Health Insurance Plans
LifeWise Health Plans of Oregon
Regence BC BS of OR
Moda Health
PacificSource
Providence Health Plans
HealthNet of Oregon
Kaiser Permanente
Oregon Medical Insurance Pool
Medicare Supplement Plans
- Medicare 101
- Medicare Plans Overview
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- ODS Senior Select
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Medicare Advantage Plans
- Medicare Advantage Overview
- Medicare Information Request
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Other Insurance
Providence HSA 2500 |
| Effective Date: 11/01/2012 |
| Expiration Date: 10/31/2013 |
| Available in: 97324, 97330, 97331, 97333, 97339, 97370, 97456, 97004, 97009, 97011, 97013, 97015, 97017, 97022, 97023, 97027, 97028, 97034, 97035, 97036, 97038, 97042, 97045, 97049, 97055, 97067, 97068, 97070, 97086, 97089, 97222, 97267, 97268, 97269, 97102, 97103, 97110, 97121, 97138, 97145, 97146, 97016, 97018, 97048, 97051, 97053, 97054, 97056, 97064, 97751, 97752, 97753, 97754, 97701, 97702, 97707, 97708, 97709, 97712, 97739, 97756, 97759, 97410, 97416, 97417, 97429, 97432, 97435, 97436, 97441, 97442, 97443, 97447, 97457, 97462, 97467, 97469, 97470, 97471, 97473, 97479, 97481, 97484, 97486, 97494, 97495, 97496, 97499, 97812, 97823, 97861, 97817, 97820, 97825, 97845, 97848, 97856, 97864, 97865, 97869, 97873, 97710, 97720, 97721, 97722, 97732, 97736, 97738, 97758, 97904, 97031, 97041, 97044, 97501, 97502, 97503, 97504, 97520, 97522, 97524, 97525, 97530, 97535, 97536, 97537, 97539, 97540, 97541, 97711, 97730, 97734, 97741, 97760, 97761, 97497, 97523, 97526, 97527, 97528, 97531, 97532, 97533, 97534, 97538, 97543, 97544, 97321, 97322, 97327, 97329, 97335, 97336, 97345, 97348, 97355, 97358, 97360, 97374, 97377, 97386, 97389, 97446, 97002, 97020, 97026, 97032, 97071, 97137, 97301, 97302, 97303, 97305, 97306, 97307, 97308, 97309, 97310, 97311, 97312, 97314, 97317, 97325, 97342, 97346, 97350, 97352, 97362, 97373, 97375, 97381, 97383, 97384, 97385, 97392, 97010, 97014, 97019, 97024, 97030, 97060, 97080, 97201, 97202, 97203, 97204, 97205, 97206, 97207, 97208, 97209, 97210, 97211, 97212, 97213, 97214, 97215, 97216, 97217, 97218, 97219, 97220, 97221, 97227, 97228, 97230, 97231, 97232, 97233, 97236, 97238, 97239, 97240, 97242, 97256, 97258, 97266, 97280, 97282, 97283, 97286, 97290, 97292, 97293, 97294, 97296, 97304, 97338, 97344, 97347, 97351, 97361, 97371, 97029, 97033, 97039, 97050, 97065, 97107, 97108, 97112, 97118, 97122, 97130, 97131, 97134, 97135, 97136, 97141, 97143, 97147, 97149, 97001, 97021, 97037, 97040, 97057, 97058, 97063, 97005, 97006, 97007, 97008, 97062, 97075, 97076, 97077, 97106, 97109, 97113, 97116, 97117, 97119, 97123, 97124, 97125, 97133, 97140, 97144, 97223, 97224, 97225, 97229, 97281, 97291, 97298, 97750, 97830, 97874, 97101, 97111, 97114, 97115, 97127, 97128, 97132, 97148, 97378, 97396, 97401, 97402, 97403, 97404, 97405, 97408, 97409, 97412, 97413, 97419, 97424, 97426, 97431, 97434, 97437, 97438, 97440, 97451, 97452, 97454, 97455, 97461, 97463, 97477, 97478, 97487, 97488, 97489, 97490, 97492, 97733, 97737, 97427, 97482, 97472, 97425 | |||||||||
| Deductible: $2,500 | |||||||||
| Age | Applicant Alone | Applicant and Spouse | Applicant and Child | Applicant and Family | |||||
| 0-17 | $136.00 | — | — | — | |||||
| 18-20 | $174.00 | — | — | — | |||||
| 21-24 | $208.00 | — | — | — | |||||
| 25-29 | $225.00 | — | — | — | |||||
| 30-34 | $256.00 | — | — | — | |||||
| 35-39 | $275.00 | — | — | — | |||||
| 40-44 | $349.00 | — | — | — | |||||
| 45-49 | $413.00 | — | — | — | |||||
| 50-54 | $480.00 | — | — | — | |||||
| 55-59 | $577.00 | — | — | — | |||||
| 60-64 | $662.00 | — | — | — | |||||
| Deductible: $5,000 | |||||||||
| Age | Applicant Alone | Applicant and Spouse | Applicant and Child | Applicant and Family | |||||
| 0-17 | — | — | — | — | |||||
| 18-20 | — | $325.00 | $243.00 | $455.00 | |||||
| 21-24 | — | $389.00 | $292.00 | $544.00 | |||||
| 25-29 | — | $420.00 | $316.00 | $619.00 | |||||
| 30-34 | — | $477.00 | $359.00 | $715.00 | |||||
| 35-39 | — | $511.00 | $382.00 | $753.00 | |||||
| 40-44 | — | $651.00 | $490.00 | $943.00 | |||||
| 45-49 | — | $769.00 | $577.00 | $960.00 | |||||
| 50-54 | — | $892.00 | $670.00 | $1,027.00 | |||||
| 55-59 | — | $1,074.00 | $805.00 | $1,235.00 | |||||
| 60-64 | — | $1,232.00 | $924.00 | $1,354.00 | |||||