UnitedHealthcare of Oregon, Inc. Cascade Silver – EPO
94% cost sharing reduction [Popular Plan]
Network type: EPO
Coverage tier: Silver
Primary care visit: $5 copay
Specialist visit: $15 copay
Urgent care visit: $15 copay
Description
This plan has 94% cost sharing reduction [Popular Plan]
Health Care Plan Details
| Network type | EPO |
| Deductible | $0 per person $0 per person |
| Out-of-pocket max | $1,200 per person $2,400 per family |
| Metal tier | Silver |
Visit Copay
| Primary care visit | $5 copay |
| Specialist visit | $15 copay |
| Preventive care visit | No charge |
Urgent, Emergency Care, and Hospital Care
| Urgent care | $15 copay |
| Emergency room | $150 copay |
| Ambulance | $75 copay |
| Hospital stay (facility) | $100 copay per Day |
| Hospital stay (physician) | No charge |
| Outpatient procedure (facility) | $100 copay |
| Outpatient procedure (physician) | $25 copay |
| Physical rehabilitation | $5 copay |
Maternitowny and Pregnancy
| Well baby care | No charge |
| Labor, delivery, hospital stay | $100 copay |
Pharmacy, Drugs, and Medication
| Generic | $5 copay |
| Brand | $12 copay |
| Non-preferred Brand | $35 copay |
| Specialty | $35 copay |
Lab Tests and Diagnostic Procedures
| X-rays | $15 copay |
| Imaging (CT/PET/MRI) | 15% coinsurance |
| Blood work | $5 copay |
Mental and Psychiatric Health Care
| Mental Health outpatient services | $5 copay |
| Psychiatric hospital stay | $100 copay per Day |
Health Plan Provider Information
| Health Plan Benefits | https://www.uhc.com/ifp/sbc.62650WA0020003-06.en.2024 |
| Drug and medication plan formulary | https://www.uhc.com/xwadruglist2024 |
| Search doctor list | https://www.uhc.com/xwadocfindg2024 |
