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OEBB Benefits News

Thanks for visiting our Benefits News page! We're just getting started. We'll be adding more content each month to help you learn about your benefits in quick and easy "bite-sized" formats.

Do you have a subject you'd like to learn about? Let us know! Your topic may appear on this page in the upcoming months!

Deductibles and copays – sorting it all out

OEBB health plans provide quality health benefits for you and your family. You pay nothing for annual physicals or preventive prescription drugs. But what about everything else? Let's brush up on how you pay for care in the OEBB plans.

If you go to the doctor or need a prescription filled for any other reason, you'll pay part of the cost before your benefits kick in.

Some of our plans feature a copayment or "copay" for certain doctor visits or prescriptions. This is a flat amount you pay, and the plan pays the rest.

Most of our plans also have a deductible. This means, unless the service you receive is "deductible waived" (e.g., preventive care), you pay 100% of the cost until you have paid this amount which is referred to as "meeting your deductible." 

After you have met your deductible, you pay a percentage of the cost (called coinsurance) and the plan pays the rest. Your coinsurance may vary based on the plan you are enrolled in and the service you receive, but it's very common on OEBB plans for you to pay 20% and the plan to pay 80%. 

You should also be aware that OEBB plans have annual "out-of-pocket" maximums to protect you if you need a high amount of medical care. All your copays and coinsurance payments are tracked by plan year. If the total you pay "out-of-pocket" reaches that maximum, the plan will pay 100% of your covered services for the rest of the plan year.

Keep in mind that the OEBB plan year runs Oct-Sept, so each year your deductible and out-of-pocket maximum resets on October 1st. If your spouse or family member is on a health plan with a different employer, their deductibles and out-of-pocket maximums may reset in January. Be sure to factor in this timeline when planning for doctor's visits or procedures.

Click the links below to review your plan details.

Kaiser Permanente Medical Plans

Alternative care may be right for you


Sometimes the care you need may be outside of “traditional" treatment. Over the years, several “alternative" treatments have come into the mainstream.

Learn more about these options and whether they might be right for you. All OEBB medical plans offer an alternative care benefit.

Moda Health: Chiropractic and acupuncture services are covered with 12 visits combined annually.

Kaiser Permanente: Chiropractic, acupuncture and naturopathic services are covered as follows:

  • Plan 1 EOC: $20 copay, up to $2,000 a year
  • Plan 2A EOC: $25 copay, up to $2,000 a year
  • Plan 2B EOC: $30 copay, up to $2,000 a year
  • Plan 3 EOC: $20% coinsurance after deductible, up to $2,000 a year 

Questions about whether a specifc treatment/provider is covered under your plan? Contact Moda Health or Kaiser Permanente directly. They are happy to help you explore your options and find the right provider for you!

Need help now? Try telehealth!

pleasant-woman-on-computer.jpgHealth happens everywhere, and now health care can, too. 

You can connect with a doctor in minutes, from anywhere, with telehealth. 

Many needs can be handled via phone, video or text message, without heading into a doctor's office. Telehealth is a great option for an earache in the middle of the night, allergies on vacation or questions about Covid-19.

Learn more about telehealth through Moda Health
Learn more about telehealth through Kaiser Permanente 

Expanded pharmacy coverage for Moda members


Article provided by Moda Health

Walgreens retail pharmacies are now part of the pharmacy network for OEBB's Moda medical plans.  
Learn more about this exciting update and find additional answers to frequently asked questions.

WDG-Invisalign.jpgIs Invisalign right for you?

Article provided by Willamette Dental Group

Invisalign® is a treatment that uses a series of custom-made clear aligners to reposition teeth over time – a process that’s mapped out by your orthodontist.

In general, this treatment is better suited for simpler cases of misalignment. Compared to traditional braces, Invisalign requires a higher level of commitment from the patient. Aligners must be worn 20-22 hours per day and removed only for eating, brushing and flossing for the most effective treatment. Each case is unique, so the duration of treatment may vary.

Clear aligners are covered by orthodontia benefits under the OEBB dental plans. Learn more at the following links:

How would you pay your bills if you couldn’t work?

Article provided by The Standard

Think of your Short Term Disability benefits as protection when life doesn't go as planned. We insure our houses, our cars and our health, but we often forget to insure our ability to earn a paycheck. Disability insurance helps you do just that, providing a source of income when you are unable to work because of a qualifying illness or injury. 

Learn more about OEBB's Short Term Disability insurance offered by The Standard

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