Oregon Health Insurance Quotes & Comparisons
quote Oregon Health InsurancequoteQuote Dental Insurancequotecontact us
Oregon Health Insurance
Call 800.884.2343 or
541.434.9613
FAX - 541.284.2994
Oregon Medical Insurance > Providence Health Plans > Optimum Plan Benefits


Providence Health Plans of Oregon

Optimum Plan Benefits
  General Benefits
Annual Deductible
Individual/Family		 Optimum 1000 - $1,000/$3,000
Optimum 2500 - $2,500/$7,500
Optimum 5000 - $5,000/$15,000
Optimum 10000 - $10,000/$30,000
Annual Out-of-Pocket Maximum
Individual/Family		 $4,000/$12,000
Accidental Injury Benefit The deductible is waived for all covered services, except for chiropractic services, required to treat an accidental injury within 90 days of injury.
After meeting your deductible, you pay the following amounts for covered services:
The deductible is waived for some covered services.  These services are marked with †.
  In-Plan Out-of-Plan
Preventive Care
Periodic health exams, well-baby care Covered in full † 40% †
Routine immunizations/shots Covered in full † 40% †
Mammograms Covered in full † 40% †
Gynecological exams, Pap tests Covered in full † 40% †
Physician/Provider Services
Office visits $20 copay † 40% †
Office visits to specialists $20 copay † 40% †
Inpatient hospital visits, surgery and anesthesia 20% 40%
Hospital Services
Inpatient & observation care 20% 40%
Maternity care 20% 40%
Routine newborn nursery care 20% 40%
Rehabilitative care 20% 40%
Emergency/Urgent care
Emergency services $250 copay
Urgent care visits $20 copay † 40% †
Emergency transportation
 20% 20%
Outpatient Diagnostic Services
X-ray; lab services 20% 40%
Imaging services (PET, CT, MRI) 20% 40%
Other Covered Services
Medical & diabetes supplies 20% 40%
Outpatient surgery, radiation therapy, chemotherapy 20% 40%
Mental health and alcohol treatment 20% 40%
Prescription Drugs
Covered at participating retail and mail-order pharmacies only Generic drugs - $10 †
Brand-name drugs - 50% †
Alternative care services
Acupuncture, chiropractic care, massage therapy and dietitian services Receive 25% off provider rates through the Choose Healthy network.
Routine Vision Services (administerd by VSP)
Routine Vision Exam
(covered once per 12 months)		 $30 copay Covered up to $29
Frames
(covered once per 24 months)		 Covered up to $120 Covered up to $33
Basic Lenses (covered once per 24 months)
Single Covered in full Covered up to $28
Bifocal Covered in full Covered up to $42
Trifocal Covered in full Covered up to $56
Contact Lenses
(covered once per 24 months in lieu of complete pair of glassess)		 Covered up to $120 Covered up to $65
Extra Discounts and Savings:

Contacts: 15 percent off cost of contact lens exam (fitting and evaluation)

Laser Vision Correction: Average 15 percent off regular price or 5 percent off promotional price from contracted facilities.
Out-of-plan Vision Services: You get the best value from your benefit when you see a VSP doctor. If you see a non-VSP provider, you'll typically pay more out-of-pocket. You will pay the provider in full and then have 6 months to submit a claim to VSP for partial reimbursement less copays.

 

 

 

 

 
CDA Privacy Policy | About us | Contact us
Copyright © 2003 - 2013 CDA Insurance LLC