2016 Oregon Individual and Family Plans

The information on this page is for plans beginning January 1, 2016.  

Medical Plans

All plans are available direct with PacificSource and through OregonHealthcare.gov.


 

Plan

Deductible*

OOP*

Co-insurance

HSA-eligible?

SBCs and Policies
by Network
Summaries
by Network
  Balance Bronze 6850
$6,850
$6,850
0%
No
Balance Bronze 6850 (0)***
$0
$0
0%
No
Balance Bronze 6850 (AI)***
$6,850
$6,850
0%
No
Value Bronze 6450
$6,450
$6,450
0%
Yes
Value Bronze 6450  (0)***
$0
$0
0%
No
Value Bronze 6450 (AI)***
$6,450
$6,450
0%
Yes
Standard Bronze
$5,000
$6,350
50%
Yes
Standard Bronze (0)***
$0
$0
0%
No
Standard Bronze (AI)***
$5,000
$6,350
50%
Yes
  Standard Silver
$2,500
$6,350
30%
No
Standard Silver (0)***
$0
$0
0%
No
Standard Silver (AI)***
$2,500
$6,350
30%
No
Standard Silver (73)**
$2,500
$4,300
30%
No
Standard Silver (87)**
$850
$1,500
10%
No
Standard Silver (94)**
$100
$750
10%
No
  Standard Gold
$1,250
$6,350
10%
No
Standard Gold (0)***
$0
$0
0%
No
Standard Gold (AI)***
$1,250
$6,350
10%
No
  Catastrophic
$6,850
$6,850
0%
No

*Deductible and out-of-pocket limit amounts shown above are the costs for individuals. Amounts for families are twice the individual amounts.

**This is a cost-sharing plan. Cost-sharing plans are only available to those who qualify financially and enroll through HealthCare.gov.

***The Affordable Care Act (ACA) has special provisions for members of federally recognized American Indian tribes that purchase healthcare coverage through the Marketplace, including zero-cost health services for those whose income is at or below 300 percent of the Federal Poverty Level. Please note that even with a zero cost-sharing plan, out-of-network providers can bill for the amount over the network rate.

Dental Plans


    Dental Advantage 0-20-50
Dental Advantage Essentials Core
   Kids Dental Advantage 0-20-50     Sample Handbook

Rates


  • Rate Book: All Rate Areas
  • Area 1: Clackamas, Multnomah, Washington, and Yamhill counties
  • Area 2: Benton, Lane, and Linn counties
  • Area 3: Marion and Polk counties
  • Area 4: Deschutes, Klamath, and Lake counties
  • Area 5: Clatsop, Columbia, Coos, Curry, Lincoln, and Tillamook counties
  • Area 6: Baker, Crook, Gilliam, Grant, Harney, Hood River, Jefferson, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, Wasco, and Wheeler counties
  • Area 7: Douglas, Jackson, and Josephine counties
  • Dental Rates

Brochure and Forms


Brochures:

Enrollment Forms:  

Enroll Online:  

Limitations:

Visit our Oregon Forms and Materials page for more sales materials.

Network Availability


Plan availability varies depending on geographic location. All network plans are available direct with PacificSource and through OregonHealthcare.gov.

PacificSource Network (PSN)

 
 Oregon PSN

Available in the following counties:

  • All counties

Notable features:

  • Access to participating PSN providers in Oregon, Oregon, Montana, and southern counties in Washington, as well as access to a nationwide travel network of providers
  • Referrals not required for specialty care
  • Some plans qualified for health savings accounts
 

SmartChoice Network (SCN)

 
 Oregon SCN

Available in the following counties:

  • Benton
  • Clackamas
  • Coos
  • Crook
  • Curry
  • Deschutes
 
  • Douglas
  • Jackson
  • Jefferson
  • Josephine
  • Lane
  • Linn
 
  • Marion
  • Multnomah
  • Polk
  • Washington
 
 

Notable features:

  • Partner with a primary care provider (PCP)
  • Referrals not required for specialty care
  • Some plans qualified for health savings accounts