|
Benefits | Rates
Maximizer (PPO) |
The Maximizer plan is ideal for individuals who want broad coverage for a range of services, including pharmacy benefits.
|
| Deductible Choices |
Co-PayThe insured patient's share of the total medical bill,
usually expressed as a specific dollar amount paid for
a given service, product or treatment. For example,
the patient might pay $20 for each doctor's office
visit. The patient is usually responsible for payment
at the time of the treatment or service. |
Office Visit |
Pharmacy |
| $1,000 / $2,500 / $5,000 |
$20 |
$20 |
$15 generics or
50% brand |
|
Benefits | Rates
Beneficial Rx (PPO)
|
| The Beneficial Rx plan is best for
those looking for a higher level of
benefits and a lower total out-of-pocketA specified amount of applicable claims expenses in
a plan year that must be met before benefits are paid
in full. Once the member has met his or her out-ofpocket
maximum, the plan begins covering eligible
expenses at 100 percent. The out-of-pocket
maximum starts over every plan year.
cost.
|
| Deductible Choices |
Co-PayThe insured patient's share of the total medical bill,
usually expressed as a specific dollar amount paid for
a given service, product or treatment. For example,
the patient might pay $20 for each doctor's office
visit. The patient is usually responsible for payment
at the time of the treatment or service. |
Office Visit |
Pharmacy |
| $1,000 / $2,500 / $5,000 |
$15 |
First 3 at $15 |
$15 generics or
50% brand |
|
Benefits | Rates
Beneficial Value (PPO) |
| The Beneficial Value plan is suited to individuals shopping for a lower premium cost.
|
| Deductible Choices |
Co-PayThe insured patient's share of the total medical bill,
usually expressed as a specific dollar amount paid for
a given service, product or treatment. For example,
the patient might pay $20 for each doctor's office
visit. The patient is usually responsible for payment
at the time of the treatment or service. |
Office Visit |
Pharmacy |
| $1,000 / $2,500 / $5,000 / $7,500 |
$25 |
First 3 at $25 |
Optional1 |
| 1If selected, prescription rider provides $15 generic/50% brand name up to $2000 maximum benefit per plan year. |
|
Benefits | Rates
Health Savings Account (HSA) 3000 |
| HSA plans offer lower insurance premiums through a high deductibleThe portion of an individual's applicable healthcare
expenses that must be paid by the member in a given
year before the insurance plan will start paying for
treatment. health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met. More about HSAs
|
| Deductible |
Co-PayThe insured patient's share of the total medical bill,
usually expressed as a specific dollar amount paid for
a given service, product or treatment. For example,
the patient might pay $20 for each doctor's office
visit. The patient is usually responsible for payment
at the time of the treatment or service. |
Office Visit |
Pharmacy |
$3,000 (individual)
$6,000 (family) |
0 |
0 |
0 |
|
Benefits | Rates
Health Savings Account (HSA) Value |
| HSA plans offer lower insurance premiums through a high deductibleThe portion of an individual's applicable healthcare
expenses that must be paid by the member in a given
year before the insurance plan will start paying for
treatment. health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met. More about HSAs |
| Deductible |
Co-PayThe insured patient's share of the total medical bill,
usually expressed as a specific dollar amount paid for
a given service, product or treatment. For example,
the patient might pay $20 for each doctor's office
visit. The patient is usually responsible for payment
at the time of the treatment or service. |
Office Visit |
Pharmacy |
$2,800 (individual)
$5,600 (family) |
50% |
50% |
50% |
VALUE-ADDED SERVICES
All of our health plans include access to the largest directly contracted PPO network in Oregon, the ODS Plus Network.
PERSONALIZED MEMBER WEBSITE
ODS members can access all insurance-related information at one convenient online
location with myODS,which provides access to member handbooks, claims status and history, detailed benefit information, health tools and more.
These additional services are provided to ODS medical plans at no additional cost.
YOUR PARTNER IN HEALTH
Through our medical management and health coaching programs, clinical professionals will work with you to help you manage your health. With their help, you’ll identify, plan and achieve the goals that are essential in helping you feel your best.
FREE ONLINE HEALTH ADVICE 24/7
A variety of helpful tools, both online and via the phone, are available around the clock to help you improve your health, including:
- E-mail answers from physicians, psychologists, dentists, pharmacists, dietitians and fitness experts
- Phone advice from a registered nurse
- Online tools to track healthy living habits
- Web-based health and symptom evaluator
- Medication-specific pricing information
- Health assessments
- Online medical library
- Health news articles, forums and more
ODS WELL
ODS is committed to being your partner in health and helping you feel your best. The ODS Well suite of services provides tools and interactive programs to help you get and stay healthy.
Save money on prescription drugs through our partnershipwith the Oregon Prescription Drug Program (OPDP). This free program gives you the opportunity to receive discounts on prescriptions not covered under your plan. All prescription drugs are eligible for a discount; you are responsible to pay the cost, in full, after the discount is applied.
