Core Silver 4500

PacificSource Health Plans

Silver
Ind. deductible
$4,500
Family deductible
$4,500
Ind. OOP max
$9,750
Family OOP max
$9,750

More PacificSource Health Plans plans in OR

Monthly premiums by age

AgeIndividual
21$490
30$556
40$626
50$875
60$1,330

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$30.00

Specialist

BenefitIn-network
Specialist Visit$50.00

Hospital

BenefitIn-network
Emergency Room Services30.00% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)30.00% Coinsurance after deductible
Outpatient Surgery Physician/Surgical Services25.00% Coinsurance after deductible
Urgent Care Centers or Facilities$30.00

Pharmacy

BenefitIn-network
Generic Drugs$0.00
Medical Service DrugsNot covered
Non-Preferred Brand Drugs25.00% Coinsurance after deductible
Preferred Brand Drugs30.00% Coinsurance after deductible
Specialty Drugs0.00%
Zero Cost Share Preventive DrugsNo charge

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services0.00%
Mental/Behavioral Health Outpatient Services$30.00

Other

BenefitIn-network
Abortion for Which Public Funding is ProhibitedNo charge
Accidental Dental30.00% Coinsurance after deductible
Acupuncture$0.00
Allergy Testing30.00% Coinsurance after deductible
Bariatric SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy30.00% Coinsurance after deductible
Chiropractic Care$30.00
Cosmetic Surgery30.00% Coinsurance after deductible
Delivery and All Inpatient Services for Maternity Care25.00% Coinsurance after deductible
Dental Check-Up for ChildrenNot covered
Diabetes Education$30.00
Dialysis30.00% Coinsurance after deductible
Durable Medical Equipment30.00% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services$0.00
Emergency Transportation/Ambulance30.00% Coinsurance after deductible
Eye Glasses for Children0.00%
Gender Affirming TreatmentSee plan details
Habilitation Services30.00% Coinsurance after deductible
Hearing Aids30.00%
Home Health Care Services$0.00
Hormone TherapySee plan details
Hospice Services25.00% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)30.00% Coinsurance after deductible
Infertility TreatmentNot covered
Infusion Therapy30.00% Coinsurance after deductible
Inpatient Physician and Surgical Services0.00%
Laboratory Outpatient and Professional Services0.00%
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Non-Preferred GenericNot covered
Nutritional Counseling$0.00
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$30.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)25.00% Coinsurance after deductible
Outpatient Rehabilitation Services30.00% Coinsurance after deductible
Preferred Generic30.00% Coinsurance after deductible
Prenatal and Postnatal Care30.00% Coinsurance after deductible
Private-Duty NursingNot covered
Prosthetic Devices30.00% Coinsurance after deductible
Radiation30.00% Coinsurance after deductible
Reconstructive Surgery25.00% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy25.00% Coinsurance after deductible
Rehabilitative Speech Therapy30.00% Coinsurance after deductible
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot Care30.00% Coinsurance after deductible
Skilled Nursing Facility30.00% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services30.00% Coinsurance after deductible
Telehealth - Primary$0.00
Telehealth - Specialist$60.00
TransplantNo Charge after deductible
Treatment for Temporomandibular Joint DisordersNot covered
Weight Loss ProgramsNot covered
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging30.00% Coinsurance after deductible

Plan rules

Service area

This plan covers 1 geographic area.