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BlueClassicSM Advanced Coverage
BlueClassic provides an affordable solution to maximized coverage. As the optimal offering in the suite, BlueClassic offers a competitive heath-care package with extended benefits and reduced out-of-pocket expenses. It provides advanced health-care coverage for companies that want to showcase their commitment to employees, while also helping attract and retain top talent through competitive benefits. BlueClassic extends other advantages, such as an annual deductible waiver for diagnostic radiology and lab services and predictable copayments for high-demand services like preventive care and office visits.

The snapshot below provides only a partial summary of benefits. Refer to the Benefits Booklet for a complete description of benefits, exclusions and limitations.

Download benefits summaries with full descriptions of each plan.

BlueClassicSM
 
In-network
Out-of-network
Lifetime Maximum
$2,000,000
Provider Networks
  • With Access, out-of-network providers can bill members for uncovered balances
  • With Participating, out-of-network providers will be paid at our allowable amount, not billed charges
Participating
Preferred Provider Plan
Access
Deductible

$300
$500
$1,000 (HRA available for groups of 51+)

Coinsurance
90%
70%
Maximum Coinsurance
Must meet separate maximum coinsurance amount for out-of-network – not a combination of the in- and out-of-network
$1,000
$6,000
Family Deductible
Three individual family members must meet the deductible (no family aggregate)
DRL Deductible Waiver
(Diagnostic Radiology and Lab)
First $500 of DRL covered at 90% per calendar year, no deductible
70%
Preventive Services
Annual Women’s Exam
Includes pap and mammogram
$20 copay
Deductible and coinsurance apply
Immunizations
Adult and children
$10 copay
$10 copay
Well Baby Care
To age 2
  • $20 copay
  • DRL does not accumulate toward the $500 DRL deductible waiver limit
Deductible and coinsurance apply
Routine Health Exams
  • $20 copay
  • $200 limit includes DRL, does not apply toward the $500 DRL deductible waiver limit
Not covered
Professional Services – copays and deductible waiver apply to in-network only; out-of-network subject to deductible and coinsurance
Office Visit
  • With immunization, additional $10 copay collected
  • If more than one office visit per day, applicable copay collected for each visit
  • Personal physician: $20 copay
  • Specialist: $40 copay
  • Above copays for office visits only
  • All other office services subject to deductible and coinsurance
Deductible and coinsurance apply
Outpatient DRL (Diagnostic Radiology & Lab )
  • Includes DRL in an outpatient setting, such as an emergency room
  • Does not apply to preventive services
 First $500 of DRL covered at 90% per calendar year with no deductible, then deductible and coinsurance apply
Deductible and coinsurance apply
Maternity
  • $20 copay
  • DRL accumulate toward the deductible waiver limit
Deductible and coinsurance apply
Urgent Care Professionals
  • Personal Physician: $20 copay
  • Specialist: $40 copay
  • Above copays for office visits only
  • All other office services subject to deductible and coinsurance
  • DRL applies towards the deductible waiver limit
Deductible and coinsurance apply
Facility Benefits
Inpatient/Residential Facility Care
  • Surgery and related services
  • Related services and supplies
  • Maternity care
  • Skilled nursing facility (SNF)
  • Inpatient rehabilitation
  • Deductible and coinsurance apply
  • Payment is limited to semi-private room rate
  • SNF is limited to 14 days. If authorized by health plan the benefit may be increased to 100 days
Outpatient Facility Care
Surgery and Related Services
Deductible and coinsurance apply
Emergency Room
  • Copay waived if admitted to the hospital
  • If true emergency, regardless of location, the in-network benefit applies for facility and professional. If hospitalized, out-of-network benefit applies.
  • For Preferred Provider Plan and Preferred Care Network, out-of-network benefit and hold harmless apply for true emergency
  • $100 copay, deductible and coinsurance apply
  • DRL accumulate towards the deductible waiver limit
Miscellaneous Benefits
  • Hospice services
  • Durable medical equipment and supplies, prosthetic and orthotic devices
  • Outpatient and listed in facility rehabilitation services
Deductible and coinsurance apply
Chemical Dependency/Mental Health
  • Oregon mandates apply
  • In-network: Personal Physician $20 copay / Specialist $40 copay; Out-of-Network: deductible and coinsurance
  • Above copays for office visits only
  • All other services subject to deductible and coinsurance
  • 45-day limit per calendar year for mental health residential treatment
Special Beginnings®
Prenatal Education Program
Included
BlueCard® Program
Nationwide coverage through the one-of-its-kind program
Included
Accidental Death
$25,000 per employee and enrolled spouse; $5,000 per enrolled dependent child

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