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

$500, $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.     

Regence BlueCross BlueShield of Oregon (online application)