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Testing the abilities - Regence BlueShield

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<strong>Regence</strong> RealValue<br />

In-Network<br />

Upfront Office Visits<br />

Upfront office visits: first two per calendar year<br />

Not subject to deductible<br />

Preventive Care and Immunizations<br />

Not subject to <strong>the</strong> deductible<br />

Member Responsibility<br />

Coinsurance applies after deductible is met and until<br />

coinsurance maximum is reached<br />

$35 copay<br />

0%<br />

Professional Services<br />

Deductible applies after upfront office visit benefit<br />

35%<br />

limit is met. Office and inpatient services and<br />

supplies.<br />

Outpatient Radiology and Laboratory 35%<br />

Complex Outpatient Imaging (CT Scan, MRI,<br />

PET, MRA, SPECT, Bone Density)<br />

Hospice<br />

Respite care limited to 14 days inpatient/outpatient<br />

per lifetime<br />

50%<br />

35%<br />

© 2012 <strong>Regence</strong>. Private and Confidential.<br />

8

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