PacificSource Health Plans - Electronic Application

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Plan Benefits:
Elect Premiere | Elect Preferred | Elect HSA | Elect Value Option
Plan Rates:
Elect Premiere | Elect Preferred | Elect HSA | Elect Value Option

PacificSource Elect Individual Policies

PacificSource Health Plans (Pacific Source) offers an array of health plans to meet the needs of Oregon individuals and families. Choosing the right plan is easy if you know what features are important to you.

All Elect plans cover treatment for illness and injury, maternity care, and prescription drugs. Coverage levels differ from plan to plan, and some plans also cover preventive care and alternative practitioner services. Our Elect plans are not HMO plans, so you don’t have to choose a primary care physician or seek referrals for specialist care.

The list below highlights a few key features of our Elect plan designs. For more details, please see the Benefit Comparison on the following pages.

Elect Premiere

“Elect Premiere” is our most comprehensive individual policy, featuring:

• First-dollar preventive care, illness, accident, and prescription drug coverage
• $25 copayments for urgent care, and physician and naturopathic office visits
• Combined acupuncture, and chiropractic care benefits
• Annual deductibles from $500 to $7,500

Elect Preferred

“Elect Preferred” is another comprehensive individual policy, featuring:

• First-dollar preventive care, illness, accident, and prescription drug coverage
• $30 copayments for physician office visits
• Chiropractic, acupuncture, and naturopathic care benefits
• Annual deductibles from $500 to $7,500

Elect HSA Qualified

"Elect HSA" is the line of HSA-qualified high deductible health plans. These plans feature:

• First-dollar accident benefit
• Prescription drug coverage subject to the deductible
• Annual deductibles from $1,100 to $5,000
• $1,100 and $2,900 deductibles are indexed to federal HSA limits and may change from time to time, based on future changes to the Consumer Price Index
• Optional HSA banking arrangement available through HSA Bank

Elect Value Option

“Value” is a low-cost catastrophic coverage policy, offering:

• Annual deductibles of $2,500, $5,000, $7,500, or $10,000
• Most in-network services covered at 60% after the deductible
• In-network prescription drug coverage at 50% after the deductible