Regence BlueShield

Plan Name
Comprehensive OR Catastrophic Comprehensive Catastrophic Catastrophic Catastrophic Catastrophic Catastrophic Catastrophic
Annual Deductible Option A: $500 per person/$1,500 per family Option B: $1,500 per person/$4,500 per family Option A: $1,000 per person/$3,000 per family Option B: $3,000 per person/$9,000 per family Option A: $2,500 per person/$7,500 per family Option B: $5,000 per person/$15,000 per family $1,750 per person/$5,250 per family $1,750 per person/$5,250 per family $2,500 $5,000
Individual Out-of-Pocket Maximum Option A: $2,500 Option B: $2,500 Option A: $5,000 Option B: $15,000 Option A: $10,000 Option B: $10,000 $3,500 $3,500 $5,000 N/A
Family Out-of-Pocket Maximum Option A: $7,500 Option B: $7,500 Option A: $5,000 Option B: $15,000 Option A: $30,000 Option B: $30,000 $10,500 $10,500 N/A $10,000
Lifetime Maximum $2 Million $2 Million $2 Million $1 Million $1 Million $1 Million $1 Million
Office Visits $20 co-pay $30 co-pay You pay 50% after deductible $15 co-pay + 20% after deductible You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Alternative Care (i.e. Acupuncture or Chiropractic) You pay 20% after deductible You pay 30% after deductible You pay 50% after deductible $15 co-pay + 20% after deductible You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Preventive Care Covered in full up to $400 Covered in full up to $200 You pay 50% after deductible $15 co-pay + 20% after deductible You pay 20% after deductible Covered in full up to $300 Covered in full up to $300
Outpatient Lab & X-ray You pay 20% after deductible You pay 30% after deductible You pay 50% after deductible You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Hospital Services - Inpatient You pay 20% after deductible You pay 30% after deductible You pay 50% after deductible You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible You pay 20% after deductible
Maternity Services You pay 20% after deductible You pay 30% after deductible Not Covered Not Covered Not Covered Not Covered Not Covered
Prescription Drugs $10 co-pay generic/ you pay 30% preferred brand/ you pay 50% non-preferred, Rx max of $3,000 $10 co-pay generic/ you pay 30% preferred brand/ you pay 50% non-preferred, Rx max of $3,000 Rx Discount Program Included Not Covered Not Covered Not Covered Not Covered
Vision Exam $20 co-pay $30 co-pay Not Covered Not Covered Not Covered Not Covered Not Covered
Vision Hardware Up to $400 Up to $200 Not Covered Not Covered Not Covered Not Covered Not Covered
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NOTE: This benefits comparison is for illustrative purposes only. This is not a contract.