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How to sell a deductible on lab and X-ray

Employers drawn to richer benefits for preventive services and cost savings on premiums offered by our Value Based Open Option plans shouldn’t balk when shown the deductible in front of lab, X-ray and emergency services. The most common services are relatively low-cost - and several are covered in full.

Here's what you and your clients should know:

  • The preventive screenings that employees use most to stay healthy are covered in full.
  • All other lab and X-ray in-plan services are covered with a 30 percent coinsurance after meeting the deductible.
  • Copays and coinsurance apply to reasonable out-of-pocket maximums ($3,000 for individuals and $9,000 for families).

View average member costs for lab and X-ray services in Portland

Frequently used lab and X-ray services Average member cost (before meeting your deductible)
Lipid panel No cost, covered in full
Comprehensive metabolic panel $21.27
Complete blood count No cost, covered in full
Pap test No cost, covered in full
Surgical pathology $175.64
General health screen panel $53.10
Thyroid stimulating hormone $33.47
HbA1c blood test No cost, covered in full
Thyroxine (a thyroid hormone) $18.54
Screening mammogram No cost, covered in full

View average member costs for lab and X-ray services in Eugene

Frequently used lab and X-ray services Average member cost (before meeting your deductible)
Lipid panel No cost, covered in full
Comprehensive metabolic panel $21.39
Pap test No cost, covered in full
Complete blood count No cost, covered in full
General health screen panel $52.44
Vitamin D screening $47.88
Thyroxine (a thyroid hormone) $17.93
Thyroid stimulating hormone $33.35
Computer-aided detection $19.64
Screening mammogram No cost, covered in full

How we handle high-cost imaging

"[T]he use of and expenditures for imaging services have increased more rapidly than any other physician ordered services, without concomitant evidence of their value overall."
- "Health Policy Report," New England Journal of Medicine, March 5, 2009

We want the best care for our members. By putting a deductible in front of high-cost imaging, Value Based Open Option plans encourage employees to decide with their doctor if scans such as these are medically necessary and likely to improve their condition.

View the top 10 most common imaging services in Portland

The 10 most frequently used imaging services Average member cost (before meeting your deductible)
Computer-aided detection $17.93
Chest X-ray $50.80
Pelvic ultrasound $216.16
Gynecologic ultrasound $239.39
Foot X-ray $67.40
Breast ultrasound $173.88
Bone density study $82.00
Abdominal CT scan $506.90
Abdominal ultrasound $208.64
Pelvic CT scan $429.00

View the top 10 most common imaging services in Eugene

The 10 most frequently used imaging services Average member cost (before meeting your deductible)
Computer-aided detection $19.64
Screening mammogram No cost, covered in full
Chest X-ray $59.70
Gynecologic ultrasound $254.41
Foot X-ray $80.21
Breast ultrasound $179.43
Bone density study $91.67
Knee X-ray $94.07
Abdominal CT scan $563.77
Ankle X-ray $80.80

How about PET and MRI?

Scans such as these range between $1,000 and $3,000, but are still very rarely prescribed. In the unlikely event that an employee requires one of these services, he or she may meet the deductible with a single scan.

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