Oregon Health Insurance-Independent Health Insurance Agents

Portland (503)231-6399  Toll Free (888)426-9544

Blue Selections Premier

 

 

 

Regence BlueCross BlueShield of Oregon Blue Selections Premier Benefit Description, the new plan rates will be effective on July 1, 2009.

New Rates 7-1-2009

Regence BlueCross BlueShield of Oregon (online) Application

Regence BlueCross BlueShield of Oregon (PDF)


The following is a very brief outline of the plan's features. For complete information including limitations and exclusions, please contact us and request a Summary of Benefits for this plan.

Blue Selections
Premier Plan

 

Benefit Features

In-Network 

Provider Benefit

Out-Of-Network 

Provider Benefit

Lifetime maximum benefit

$2,000,000

Individual deductible options per calendar year

$1,000, $2,500, $5,000, $7,500

Family deductible per calendar year

Maximum of three family members

Maximum amount of covered expenses you pay each calendar year per person (maximum coinsurance)

$4,000

$8,000

Family maximum coinsurance per calendar year

Maximum of three family members

After your maximum coinsurance is met each calendar year, we pay

100%

100%

Important note: Your deductible and/or copayments do not accumulate toward your maximum coinsurance.  Your maximum coinsurance accumulates separately for In-Network and Out-Of-Network providers.  Copayments will continue to be collected after your maximum coinsurance has been met.  

Preventive Care Services and Office Visits

Deductible Waived - We Pay 

Immunizations for adults and children

100% after $20 copay

100% after $40 copay

Well-baby care to age 2 and well-child exams

100% after $20 copay

100% after $40 copay

Annual women's exam including Pap test and mammogram

100% after $20 copay

100% after $40 copay

Annual men's exam including PSA test

100% after $20 copay

100% after $40 copay

Office visits including urgent care visits

100% after $20 copay

100% after $40 copay

Other Professional Services  

After Deductible - We Pay 

Office procedures

80%

60%

Therapeutic injections including allergy shots

80%

60%

Surgery

80%

60%

Maternity care

80%

60%

Diagnostic radiology and lab including routine colorectal cancer screening

80%

60%

Hospital Services

After Deductible - We Pay 

Inpatient stay including maternity and rehabilitation

80%

60%

Inpatient mental health stay

80%

60%

Outpatient surgery 

80%

60%

Emergency room care (copay waived if admitted to hospital)

80% after $100 copay

80% after $100 copay

Other Services

After Deductible - We Pay 

Ambulance 

80%

80%

Additional accident (deductible waived for 90 days after injury date)

80%

60%

Outpatient rehabilitation (physical, speech, and occupational therapy)

80%

60%

Skilled nursing facility, home health, and hospice care

80%

60%

Durable medical equipment and supplies

80%

60%

Transplant 

80%

60%

Prescription Benefits and Vision Care Services

No Deductible - We Pay 

Generic prescription medications

100% after $10 copay

All other covered expenses for prescription medications

50%

Vision exam once per calendar year

100% after $20 copay

(Participating vision provider)

60%

Vision hardware (lenses and frames or contacts)

100% up to $250 maximum allowance per calendar year

Additional Benefits

Accidental death 

Provides $25,000 for you and your enrolled adult spouse, $5,000 for each enrolled dependent or a subscriber under the age of 18.

Special Beginnings®

Provides a maternity program designed to promote healthy prenatal care through education and support.

BlueCard® program

Provides savings nationwide by using physicians and other professional providers of the Blue Cross and/or Blue Shield Plan in the area where you receive the service.  Find a provider near you at www.bcbs.com.     

For complete information including limitations and exclusions, please contact us and request a Summary of Benefits for this plan.

Blue Selections Premier Premium Rates July 1, 2009.

Monthly premium for Regence BlueCross BlueShield Blue Selections plan is step-rated based on the age of the oldest family member on the policy.

 

Blue Selections Premier Rates
   

Deductible $1,000 

Age Individual Individual and Spouse Adult and Child(ren) Family
0-17 120  N/A   N/A  N/A  
18-20 158 317 279 433
21-24 190 381 311 501
25-29 203 406 323 527
30-34 231 463 352 584
35-39 247 495 368 616
40-44 317 635 438 755
45-49 374 749 495 870
50-54 435 870 555 990
55-59 524 1048 644 1168
60+ 603 1206 724 1327
   

Deductible $2,500

Age Individual Individual and Spouse Adult and Child(ren) Family
0-17 96 N/A  N/A   N/A  
18-20 126 253 222 349
21-24 151 303 247 399
25-29 161 323 258 420
30-34 184 369 280 465
35-39 197 394 293 490
40-44 253 506 349 602
45-49 298 597 394 693
50-54 346 693 442 789
55-59 417 834 513 931
60+ 480 961 576 1057
   

Deductible $5,000 

Age Individual Individual and Spouse Adult and Child(ren) Family
0-17 78 N/A  N/A  N/A  
18-20 103 206 181 285
21-24 124 248 202 326
25-29 132 264 210 343
30-34 150 301 229 380
35-39 161 322 239 401
40-44 206 413 285 491
45-49 243 487 322 566
50-54 283 566 361 644
55-59 341 682 419 760
60+ 392 785 471 864
   

Deductible $7,500

Age Individual Individual and Spouse Adult and Child(ren) Family
0-17 61  N/A   N/A   N/A 
18-20 80 161 142 222
21-24 96 193 158 255
25-29 103 206 164 268
30-34 117 235 179 297
35-39 125 251 187 313
40-44 161 323 222 384
45-49 190 381 251 442
50-54 221 442 282 503
55-59 266 532 327 594
60+ 306 613 368 675

 

 

Regence BlueCross BlueShield of Oregon (online application)

Regence BlueCross BlueShield of Oregon (PDF)

 

Please contact us to request that a Summary of Benefits and application for this plan be sent to you. Don't forget to give us your mailing address.

Privacy Statement- This request will be absolutely confidential.  The information will not be sold, given away or used for any other purpose but to mail or email requested information.

Information Request Form

This is not an application for insurance.  In the state of Oregon, Individual Health Insurance plans must be approved in the underwriting stage of the insurance application.  This might take a few weeks to complete.  Please leave your name address and questions and any information that you would like.

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