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Plan Enhancements and Changes for 2009-10
school house
 
 
 
The following changes and enhancements have been made to the OEBB benefits for the 2009-10 plan year.
 
 
Tobacco Cessation:
Tobacco cessation is now available through all OEBB medical plans. Coverage includes telephone consults, Web coaching, patches and gum and prescription medications if certain criteria are met by the member.
 
 
 
Kaiser Permanente
 
No changes to medical, dental or vision plans.
 
 
 
ODS
 
Medical:
Preauthorization on imaging, such as CT scans, is now required. 
 
Pharmacy:
  • The difference paid between brand name and generic (when a generic is available) will no longer count toward the pharmacy out of pocket maximum
  • Coordination of pharmacy benefits will be paid up to the OEBB benefit amount rather that up to 100 percent of member’s out of pocket cost previously paid
  • Over the counter products (with the exception of covered diabetic supplies) and medications used to treat sexual dysfunction will be excluded
  • Members currently taking covered over the counter products will be grandfathered in to allow coverage for one year.
 
 
ProvidenceHealth Plans
 
Alternative Care:
OEBB members must use Providence’s Alternative Care Network, American Specialty Health Network. To view the letter from Providence to participating OEBB members, click here.
 
Pharmacy:
The co-pay for a non-formulary brand name drug increases from a $15.00 co-pay to a 50 percent co-pay. Non-formulary brand name drugs still require prior-authorization from your provider.
 
 
 
WillametteDental
 
Orthodontia:
Orthodontia has been added to all Willamette dental benefit plans.