Individual Medical Plans at a Glance

All of our plan designs give you the freedom to see any licensed provider you choose, but with a better benefit if you access a preferred providerA provider contracted within a network. By choosing a preferred provider, the member's out-of-pocket expenses will be less than if he or she chooses a physician outside the network. from our statewide network. Coverage varies from plan to plan, so look for the features that best fit your healthcare preferences.

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Co-PayThe insured patient's share of the total medical bill, usually expressed as a specific dollar amount paid for a given service, product or treatment. For example, the patient might pay $20 for each doctor's office visit. The patient is usually responsible for payment at the time of the treatment or service.	Office Visit	Pharmacy	Deductible Choices
Maximizer (PPO)
The Maximizer plan is ideal for individuals who want broad coverage for a range of services, including pharmacy benefits.
$20	$20	$15 generics or 50% brand	$1,000	Benefits \| Rates
			$2,500	Benefits \| Rates
			$5,000	Benefits \| Rates
Beneficial Rx (PPO)
The Beneficial Rx plan is best for those looking for a higher level of benefits and a lower total out-of-pocketA specified amount of applicable claims expenses in a plan year that must be met before benefits are paid in full. Once the member has met his or her out-ofpocket maximum, the plan begins covering eligible expenses at 100 percent. The out-of-pocket maximum starts over every plan year. cost.
Co-PayThe insured patient's share of the total medical bill, usually expressed as a specific dollar amount paid for a given service, product or treatment. For example, the patient might pay $20 for each doctor's office visit. The patient is usually responsible for payment at the time of the treatment or service.	Office Visit	Pharmacy	Deductible Choices
$15	First 3 at $15	$15 generics or 50% brand	$1,000	Benefits \| Rates
			$2,500	Benefits \| Rates
			$5,000	Benefits \| Rates
Beneficial Value (PPO)
The Beneficial Value plan is suited to individuals shopping for a lower premium cost.
Co-PayThe insured patient's share of the total medical bill, usually expressed as a specific dollar amount paid for a given service, product or treatment. For example, the patient might pay $20 for each doctor's office visit. The patient is usually responsible for payment at the time of the treatment or service.	Office Visit	Pharmacy	Deductible Choices
$25	First 3 at $25	Optional¹	$1,000	Benefits \| Rates
			$2,500	Benefits \| Rates
			$5,000	Benefits \| Rates
			$7,500	Benefits \| Rates
¹If selected, prescription rider provides $15 generic/50% brand name.
Health Savings Account (HSA) 3000
HSA plans offer lower insurance premiums through a high deductibleThe portion of an individual's applicable healthcare expenses that must be paid by the member in a given year before the insurance plan will start paying for treatment. health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met. More about HSAs
Co-PayThe insured patient's share of the total medical bill, usually expressed as a specific dollar amount paid for a given service, product or treatment. For example, the patient might pay $20 for each doctor's office visit. The patient is usually responsible for payment at the time of the treatment or service.	Office Visit	Pharmacy	Deductible
0	0	0	$3,000 (individual) $6,000 (family)	Benefits \| Rates
Health Savings Account (HSA) Value
HSA plans offer lower insurance premiums through a high deductibleThe portion of an individual's applicable healthcare expenses that must be paid by the member in a given year before the insurance plan will start paying for treatment. health plan coupled with a bank account in which you accumulate tax-advantaged savings through your contributions to pay for qualified medical expenses until your deductible is met. More about HSAs
Co-PayThe insured patient's share of the total medical bill, usually expressed as a specific dollar amount paid for a given service, product or treatment. For example, the patient might pay $20 for each doctor's office visit. The patient is usually responsible for payment at the time of the treatment or service.	Office Visit	Pharmacy	Deductible
50%	50%	50%	$2,800 (individual) $5,600 (family)	Benefits \| Rates

VALUE-ADDED SERVICES

OUR PROVIDER NETWORK

All of our health plans include access to the largest directly contracted PPO network in Oregon, the ODS Plus Network.

PERSONALIZED MEMBER WEBSITE

ODS members can access all insurance-related information at one convenient online location with myODS,which provides access to member handbooks, claims status and history, detailed benefit information, health tools and more.

These additional services are provided to ODS medical plans at no additional cost.

YOUR PARTNER IN HEALTH

Through our medical management and health coaching programs, clinical professionals will work with you to help you manage your health. With their help, you’ll identify, plan and achieve the goals that are essential in helping you feel your best.

FREE ONLINE HEALTH ADVICE 24/7

A variety of helpful tools, both online and via the phone, are available around the clock to help you improve your health, including:

E-mail answers from physicians, psychologists, dentists, pharmacists, dietitians and fitness experts
Phone advice from a registered nurse
Online tools to track healthy living habits
Web-based health and symptom evaluator
Medication-specific pricing information
Health assessments
Online medical library
Health news articles, forums and more

ODS WELL

ODS is committed to being your partner in health and helping you feel your best. The ODS Well suite of services provides tools and interactive programs to help you get and stay healthy.

PHARMACY DISCOUNT CARD

Save money on prescription drugs through our partnershipwith the Oregon Prescription Drug Program (OPDP). This free program gives you the opportunity to receive discounts on prescriptions not covered under your plan. All prescription drugs are eligible for a discount; you are responsible to pay the cost, in full, after the discount is applied.