Health Plans

Lifewise Health Plan of Oregon

Lifewise Health Plans in Oregon

A message from LifeWise Health Plan of Oregon

LifeWise Health Plan of Oregon has decided to exit the state of Oregon. LifeWise Oregon will support existing customers through the duration of their current plan year, with most plans ending by Dec. 31, 2016.

The decision impacts all lines and products, including individual, Medicare Supplement, and self-funded and fully insured groups. LifeWise Oregon will stop selling new employer group coverage in the state effective immediately. Current employer group customers will be able to retain their coverage through their plan year, which in some cases will be in 2017. LifeWise Oregon will renew groups with anniversary dates of Oct. 1, 2016 or earlier, if they choose. However, we encourage you to work with your groups to seek new coverage through another carrier at their anniversary date.

10 Essential Benefits

Healthcare reform says all health plans must include ten essential benefits. The basic benefits include:

  1. Outpatient Care - the kind you get without being admitted to a hospital
  2. Emergency Services - for issues that could lead to death or disable you if you do not treat them.
  3. Inpatient Care - covers room and board, tests, drugs, and care from doctors and nurses while admitted, which may include organ and tissue transplants, and hospice and respite care.
  4. Maternity and Newborn Care - care before and after your baby is born
  5. Mental Health and Substance Use Disorder Services - this includes behavioral health treatment, counseling, and psychotherapy.
  6. Prescription Drugs - covers retail, mail order, and specialty drugs.
  7. Rehabilitative and Habilitative Services - services and devices to help you recover if you are injured, or have a disability or chronic condition. This includes physical and occupational therapy, speech-language pathology, psychiatric rehabilitation, and more.
  8. Laboratory Services - covers lab tests, X-ray services, and pathology, and imaging and diagnostics such as MRI, CT scan, and PET scan.
  9. Preventive and Wellness Services - including mammograms, colonoscopies, vaccines. Covered in full if you use in-network providers for care such as routine physicals, screening, and immunizations. Disease management coordinates care for diabetes, asthma, and other conditions.
  10. Pediatric Services - including dental care (preventive, basic, major) and vision care (eye exam, lenses, and eyewear).