OHSU Health Silver 7000 Direct Plan Details for 2021- HealthPocket

ZIP Code
County
Applicant Info
Applicant
Date of birth
//
Gender
male
female
Income
$

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Zip Code	97229 (edit)
Applicant	6/28/1987 Male (edit)

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Insurance Type	ACA (Obamacare)
Plan Name	OHSU Health Silver 7000 Direct
Plan ID	hhs-77969OR5280026
Plan Year	2021
Insurance Provider	Regence BlueCross BlueShield of Oregon
Metal Level	Silver
Plan Type	EPO
Deductible	$7,000
Out-of-Pocket Maximum	$8,700
Plan Highlights

Costs for Medical Care
Primary Care Visit to Treat an Injury or Illness	$25 Copay
Specialist Visit	$75 Copay
Laboratory Outpatient and Professional Services	30% Coinsurance after deductible
X-rays and Diagnostic Imaging	30% Coinsurance after deductible
Diagnostic Imaging such as MRIs, CT, and PET scans	30% Coinsurance after deductible
Deductible - Family	$14000 per group
Out-of-Pocket Maximum - Family	$17400 per group

Prescription drug coverage
Generic Drugs	$10 Copay
Preferred Brand Drugs	$75 Copay
Non-Preferred Brand Drugs	50% Coinsurance after deductible
Specialty Drugs	40% Coinsurance after deductible

Access to doctors and hospitals
Provider directory URL	https://www.regence.com/web/regence_individual/finding-doctors
Does this plan have access to a national provider network?	No
Is a referral required to see a Specialist?	No -
Does this plan cover services outside plan service area?	No -
Does this plan cover services outside the country?	No -

Hospital services
Emergency Room Services	30% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)	30% Coinsurance after deductible
Inpatient Physician and Surgical Services	30% Coinsurance after deductible
Emergency Transportation or Ambulance Service	30% Coinsurance after deductible

Maternity
Prenatal and Postnatal Care	30% Coinsurance after deductible
Delivery and all inpatient services for maternity care	30% Coinsurance after deductible

Mental Health
Mental/Behavioral Health Outpatient Services	$25 Copay
Mental/Behavioral Health Inpatient Services	30% Coinsurance after deductible
Substance use disorder outpatient services	$25 Copay
Substance use disorder inpatient services	30% Coinsurance after deductible

Medical Management Programs
Does this plan offer disease managment programs?
Does this plan offer a wellness program?	Not Covered

Vision Coverage
Routine Eye Exam for Children	Covered
Eye Glasses for Children	Covered
Routine Eye Exam for Adults	Not Covered

Child Dental Coverage
Child Dental Coverage - Routine Dental Care	Covered
Child Dental Coverage - Basic Dental Care	Covered
Child Dental Coverage - Orthodontia	Covered
Child Dental Coverage - Major Dental Care	Covered

Adult Dental Coverage
Adult Dental Coverage - Routine Dental Care	Not Covered
Adult Dental Coverage - Basic Dental Care	Not Covered
Adult Dental Coverage - Orthodontia	Not Covered
Adult Dental Coverage - Major Dental Care	Not Covered

Exclusions and Limitations
More Included Benefits	Other Practitioner Office Visit (Nurse, Physician Assistant) Preventive Care/Screening/Immunization Cosmetic Surgery Hearing Aids Imaging (CT/PET Scans, MRIs) Outpatient Surgery Physician/Surgical Services Urgent Care Centers or Facilities Inpatient Physician and Surgical Services Home Health Care Services Durable Medical Equipment Hospice Services Dental Check-Up for Children Routine Foot Care Abortion for Which Public Funding is Prohibited Accidental Dental Allergy Testing Chemotherapy Diabetes Education Dialysis Infusion Therapy Laboratory Outpatient and Professional Services Nutritional Counseling Prosthetic Devices Radiation Reconstructive Surgery Transplant Well Baby Visits and Care Outpatient Facility Fee (e.g., Ambulatory Surgery Center) Tier 1-Zero Cost-Share Preventive Drugs Tier 2-Preferred Generic Drugs Tier 6- Preferred Specialty Drugs Tier 5- Non-Preferred Brand Drugs Tier 3- Non-Preferred Generic Drugs Tier 7- Non-Preferred Specialty Drugs Tier 4- Preferred Brand Drugs Telehealth- Primary Care Visits Telehealth- Specialist Visits
More Limited Benefits	Skilled Nursing Facility Acupuncture Outpatient Rehabilitation Services Habilitation Services Chiropractic Care Rehabilitative Occupational and Rehabilitative Physical Therapy Rehabilitative Speech Therapy
More Excluded Benefits	Bariatric Surgery Infertility Treatment Private-Duty Nursing Weight Loss Programs Treatment for Temporomandibular Joint Disorders Long-Term/Custodial Nursing Home Care

+ See All Coverage Details

Premium	Plan Name	Deductible
from $308	KP OR Bronze 6900/0% HSA	$6,900.00	Select
from $338	HSA Qualified 7000 Bronze - Choice Network	$7,000.00	Select
from $339	Navigator Bronze HSA 6900	$6,900.00	Select
from $344	Navigator Bronze 7000	$7,000.00	Select
from $385	SmartChoice Bronze HSA 6900	$6,900.00	Select

Last Name

Location/Distance

Please select the correct zip

Marilyn, Webber

Laura, Hardebeck

Gary, Geddes

Cynthia, Romero

Barbara, Liebowitz

Hadi Farah, Md, Llc

Dakota, Stewart

Sports Health Northwest Inc

Naviatric Llc

Tracy, Hill

Roberta, Mckenney

Ryan, Ross

Alexandra, Lodwig

Keri-kamryn, Skjei

Madeleine, Knutson

Mariah, Frank

Vernon, Rasmussen

Charles, Gregory

Amanda, Gangstead

April, Henderson

Katherine, Rinella

Adam, Howrey

Marilyn Webber, M.D.

Phone Number
(503) 629-0237
Office Locations
14223 Nw Spruceridge Ln
Portland, OR 97229

14223 Nw Spruceridge Ln Portland OR, 97229

What Is the Silver Plan?
ObamaCare’s Silver Plan is a type of Metal Plan on the Health Insurance Marketplace. Silver Plans qualify for both Tax Credits and Cost Sharing subsidies.Silver Plans have lower out-of-pocket costs than Bronze Plans but higher out- of-pocket costs than both Gold and Platinum Plans. All Silver Plans share the same minimum health benefits, but the way they charge out-of-pocket costs can differ significantly.
How are Silver Plans different than other Obamacare health plans?
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. The Silver Plan pays 70% of covered medical costs for a typical enrollee. Silver Plans are also the only metal plans which offer cost-sharing reduction (CSR) versions to consumers that require financial assistance for out-of-pocket costs.
How much does a Silver Plan cost?
The monthly premium for a Silver Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Silver Plan premiums in your area.
When Can I Enroll in a Silver Plan?
The Open Enrollment period for the 2018 Affordable Care Act health plans begins November 1, 2017 and ends December 15, 2017. See our Open Enrollment article for more information.

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County
Applicant Info
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Date of birth
//
Gender
male
female
Income
$

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OHSU Health Silver 7000 Direct

Apply For This Plan

Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

Similar Plans

Physician Finder

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Silver plan frequently asked questions (FAQ)

What Is the Silver Plan?

How are Silver Plans different than other Obamacare health plans?

How much does a Silver Plan cost?

When Can I Enroll in a Silver Plan?

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Health Plans Found

OHSU Health Silver 7000 Direct

Apply For This Plan

Benefits & Coverage

Costs for Medical Care

Prescription drug coverage

Access to doctors and hospitals

Hospital services

Maternity

Mental Health

Medical Management Programs

Vision Coverage

Child Dental Coverage

Adult Dental Coverage

Exclusions and Limitations

Similar Plans

Physician Finder

Related Articles

Related Searches

Silver plan frequently asked questions (FAQ)

What Is the Silver Plan?

How are Silver Plans different than other Obamacare health plans?

How much does a Silver Plan cost?

When Can I Enroll in a Silver Plan?

Apply For This Plan

Health Plans Found

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