PacifiCare has been marketing insurance in Oregon since 1987.

PacifiCare Individual Plan Benefit Description

The following is a very brief outline of the plan's features. For complete information including limitations and exclusions, please contact us and request a Summary of Benefits for this plan.

 

Maximum Lifetime Benefit	unlimited
Annual Deductible	none

The benefit amounts shown below are for use of participating providers. Nonparticipating provider benefits are lower.

Primary Care Physician Services The Primary Care Physician (PCP) you select from PacifiCare's provider directory oversees all your care, including specialty care.
	Plan I	Plan II
Maximum Annual Out of Pocket	$5,000 (3x Family)	$3,000 (3x Family)
Routine Physicals	$20 copay	$15 copay
Routine Gynecological Exams	$20 copay	$15 copay
Well Baby and Well Child Care	$20 copay	$15 copay
Immunizations	$20 copay	$15 copay
Allergy Testing	$20 copay	$15 copay
Allergy Injections	$20 copay	$15 copay
Physician Office and Home Visits	$20 copay	$15 copay
X-rays and Lab Tests	$20 copay	$15 copay
Outpatient Surgery	$250 copay	$100 copay
Home Health Care	$20 copay	$15 copay
In-Hospital Services	$500 copay per day	$200 copay per day
Skilled Nursing Facility Care	$250 copay per day	$100 copay per day
Maternity Care, Hospital Services	$500 copay per day	$200 copay per day
Durable Medical Equipment	20% copay	20% copay
Emergency Room Services	$100 or 50% whichever is less	$75 or 50% whichever is less
Urgent Care	$50 copay	$50 copay
Prescription Drug	Not Available	$15 generic; $25 preferred brand; $40 non-preferred brand. Limited to $1,000 per person per calendar year.
Mental Outpatient Services	$20 copay Limited to 20 visits	$20 copay Limited to 20 visits
Mental Inpatient Services	$500 copay per day	$200 copay per day
Alcohol Outpatient Services	Not Covered	$20 copay
Alcohol Inpatient Services	$500 copay per day	$200 copay per day

privacy Statement- This request will be absolutely confidential.  The information will not be sold, given away or used for any other purpose but to mail or email requested information.

Information Request Form

This is not an application for insurance.  In the state of Oregon, Individual Health Insurance plans must be approved in the underwriting stage of the insurance application.  This might take a few weeks to complete.  Please leave your name address and questions and any information that you would like.

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