Traditional &
PPO (Washington)
Blue
Selections Plan Overview |
| Available in this county |
Clark County, Washington |
| Find a doctor in this
directory |
Preferred Provider
(PPO) Directory |
Annual medical out-of-pocket maximum,
after deductible
|
$4,000 - $8,000 |
| Lifetime benefit maximum |
$2 million for each covered family member |
Office visit
|
$20 copayment |
| Annual women's exams |
$20 copayment |
| Immunizations all ages |
$10 copayment |
| Well-baby care through age 2 |
$20 copayment |
| Vision exam every 24 months |
$20 copayment |
| Deductibles |
$1,000, $2,500, $5,000 |
| After medical deductible is met |
We pay 80% of eligible preferred provider services
and 60% of eligible non-preferred provider services. |
| Prescriptions |
You pay 50% coinsurance for outpatient prescription medications (does not apply toward your medical maximum coinsurance). See the Pharmacy
Directory, located on the RegenceRx Web site,
for a pharmacy in your area. |
| Travel benefit |
The BlueCard Program allows you to see any participating
or PPO Blue Cross or Blue Shield doctor when you
travel. |
Washington PPO Summary of Benefits
Washington PPO Summary of Benefits - Spanish
Traditional/PPO
Application
Forms - Washington
|
