HSA plans offer lower insurance premiums through a high deductible 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.
| Plan year deductible options | $1,500 (individual) $3,000 (family)(1) | |
| Member Responsibility | ||
|---|---|---|
| In Network | Out of Network | |
| 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. maximum, per person (after deductible) | $3,500 (individual) $7,000 (family) |
no maximum |
| Preventive Care | ||
| Annual women's exam — pap, pelvic, breast | 20%* | 40% |
| Women's routine mammogram | 20%* | 40% |
| Well-baby care | 20%* | 40% |
| Routine physical exams | 20%* | 40% |
| Immunizations | 20%* | 40% |
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(1)Family deductible applies when an individual and a spouse or one (1) or more dependents are enrolled. Therefore, prior to benefits being paid, the entire family deductible must be met. This is a benefit summary only. For a complete description of benefits, refer to your Policy. Effective July 1, 2007 through October 31, 2008 |
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| Professional Services | ||
| Office visits | 20% | 40% |
| Alternative Care ($1000 Annual Benefit Maximum): Chiropractic, Naturopathic and Acupuncture |
20% | 40% |
| Maternity | ||
| All pre/post office visits and doctor delivery; hospital charges | 20% | 40% |
| Hospital Services | ||
| Inpatient and outpatient surgery; room, ancillary and physician charges; skilled nursing facility care |
20% | 40% |
| Emergency Services | ||
| Urgent care | 20% | 40% |
| Emergency room (deductible applies) | 20% | |
| Ambulance | 20% | |
| Other Facilities and Services | ||
| Lab and X-ray services; rehabilitation services; medical supplies and devices; in-hospital care; home healthcare | 20% | 40% |
| Prescription services | 30% | |
Lifetime maximum |
$2,000,000 ($250,000 out-of-network) |
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| Value-Added Services | ||
| When you join ODS, you get health plans enhanced by a wide variety of helpful value-added services. Medical members have access to:
In addition to these tools, you'll discover benefit plans that are actually easy to understand. And teams of ODS Health Professionals dedicated to your healthy, happy life. |
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All of our health plans include access to the largest directly contracted PPO medical provider network in Oregon. With more than 11,000 providers in the ODS Network participating across all specialties — including primary care, surgery, radiology, anesthesiology, vision, chiropractic, naturopathic and acupuncture — your service needs have been anticipated.