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 Washington Health Insurance Plans Regence Blue Shield Breakthru 80

  Robert S. Mori, CPA, President    7429 East Heather Way, Everett, WA  98203-5424    

  Tel. (425) 353-9763     Toll-free (877) 455-7591   Greater Seattle (206) 965-9609   Fax (425) 353-0899  

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Regence BreakthruSM 80-

Washington Health Insurance Plans | Regence Blue Shield Breakthru 80 -  $1500 Deductible

    • Best benefits of our Breakthru plans, including preventive care and vision.
    • Lowest copays for unlimited office visits.
    • Prescriptions: after you reach the $3,000 annual limit, you get a discount through the RegenceRx discount program.

Coverage at a Glance

Deductible:
Annual OOP Max: Not applicable on this plan
Lifetime Max: $2 million per member
Copay: $20 preferred providers
Coinsurance: 20% preferred providers, 50% participating
Coinsurance Max: $2,500 per member
Network(s): Preferred Providers
Find a Doctor
Yes Prescription benefits
No Dental
Yes Vision
Yes No Referrals
Yes Maternity
Yes Preventive Care
Yes Alternative Care
Yes Mental Health
 

Basic Features

Cost Sharing
Deductibles:
  • $500 or $1500 per member
  • Family maximum of three individual deductibles
Annual OOP Max: Not applicable on this plan
Coinsurance Max:
  • You pay $0 after reaching $2,500 coinsurance maximum per member using preferred providers
  • Family coinsurance maximum of three individual maximums using preferred providers
  • No maximum when using participating providers
Lifetime Max: $2 million paid by Regence per member
Copay:
  • You pay $20 when using preferred providers
  • You pay $40 when using participating providers
Coinsurance:
  • You pay 20% when using preferred providers
  • You pay 50% when using participating providers
Everyday Needs
Prescriptions:
  • $10 copay for generic medications purchased at the pharmacy
  • $20 copay for generic mail order
  • You pay 30% using the formulary
  • You pay 50% when not using the formulary
  • $3,000 annual limit on all medications
  • No deductible
  • RegenceRx discount program after limit is reached
Preventive Care:
  • You pay 0% when using preferred providers
  • You pay coinsurance when using participating providers
  • No deductible
  • All preventive care services, including related lab tests, screening procedures and x-rays are limited to $400 per calendar year
Vision:
  • One routine eye exam per calendar year
  • You pay $20 copay using preferred providers
  • You pay $40 copay using participating providers
  • You pay $0 up to $400 per calendar year max on vision hardware
Office Visits:
  • You pay $20 copay using preferred providers
  • You pay $40 copay using participating proiders
  • No deductible
Diagnostic x-ray services: Deductible and coinsurance
Outpatient Laboratory services: Deductible and coinsurance
Special Needs
Alternative care:
  • Covered as any other condition
  • Acupuncture limited to 12 visits per calendar year maximum
  • Spinal manipulations limited to 10 manipulations per calendar year maximum
Maternity: Deductible and coinsurance
Mental Health: Covered as any other condition
Other considerations
Network(s): Preferred Providers
  • Preferred Providers (most medical services)
Participating Providers
  • Providers outside of the preferred network