Medical Overview
Your health is everything.
Avista provides valuable medical benefits through Premera Blue Cross that help you and your family stay healthy and pay for care if you get sick or injured.
When you enroll in an Avista medical plan, you receive:
- Comprehensive, affordable coverage for a wide range of health care services.
Tip: If you need extra protection from large or unexpected medical expenses, you may also choose to enroll in supplemental medical coverage. - Free in-network preventive care, with services such as annual physicals, recommended immunizations, and routine cancer screenings covered at 100%. See more covered preventive services.
- Prescription drug coverage.
- Financial protection through annual out-of-pocket maximums that limit the amount you will pay each year.
Get the Details
No Surprises
Understand your rights and protections against surprise medical bills.
Compare Medical Plan Benefits
Tip: Use the medical plan cost estimator to compare plans.
| Premera Blue Cross HDHP |
Premera Blue Cross PPO Medical | |||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| HSA-eligible | Yes | No | ||
| Avista contribution to HSA | $700 Individual / $1,500 Employee + 1 | None | ||
| Annual deductible (individual/ family) |
$1,600 / $3,200 | $3,200 / $6,400 | $300 / $900 | $400 / $1,2000 |
| Annual out-of-pocket maximum (individual/ family) |
$3,200 / 6,400 | Unlimited | $1,500 / $4,500 | $3,000 / $9,000 |
Your Costs
| Premera Blue Cross HDHP |
Premera Blue Cross PPO Medical | |||
|---|---|---|---|---|
| In-Network | Out-of-Network | In-Network | Out-of-Network | |
| Preventive care | Covered at 100% no deductible |
Not covered | Covered at 100% no deductible |
Not covered |
| Office visit (primary care) | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay; no deductible | You pay $20 copay, then 40% after deductible |
| Office visit (specialist) | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay; no deductible | You pay $20 copay, then 40% after deductible |
| Telemedicine visit | You pay 20% after deductible | N/A | You pay $20 copay; no deductible | N/A |
| Urgent care | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay; no deductible | You pay $20 copay, then 40% after deductible |
| Emergency room | You pay 20% after deductible | You pay 20% after deductible | ||
| Hospital stay | You pay 20% after deductible | You pay 50% after deductible | You pay 20% after deductible | You pay 40% after deductible |
| Mental health office visit | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay; no deductible | You pay $20 copay, then 40% after deductible |
| Fertility Testing, Diagnosis and Treatment | You pay 20% after deductible* | You pay 50% after deductible* | You pay 20% after deductible* | You pay 40% after deductible* |
| Physical, Occupational, Speech and Massage Therapy, and Chronic Pain | You pay 20% after deductible (up to 30 days/year for inpatient and 45 visits/year for outpatient | You pay 50% after deductible (up to 30 days/year for inpatient and 45 visits/year for outpatient | Inpatient: You pay 20% after deductible (up to 15 days/year) Outpatient: you pay $20 copay; no deductible (up to 45 visits/year |
Inpatient: You pay 40% after deductible (up to 15 days/year) Outpatient: you pay $20 copay; then 40% after deductible (up to 45 visits/year |
| Chiropractor | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay; no deductible | You pay $20 copay, then 40% after deductible |
| Acupuncture | You pay 20% after deductible | You pay 50% after deductible | You pay $20 copay; no deductible (up to 12 visits/year) |
You pay $20 copay; then 40% after deductible (up to 12 visits/year) |
* This benefit includes testing, invitro fertilization and artificial insemination. Limit: $2,000 per calendar year; $6,000 lifetime maximum.