Provider Directory

1-800-596-3440

"Look for your provider before receiving services"

LifeWise Individual and Family Plans

Whether your clients choose the value-packed WiseEssentials (PDF) plan, the comprehensive WiseChoices (PDF) plan or the tax-advantaged WiseSavings (PDF) they'll get benefits and health-care coverage that fit their lifestyle.

Individual and Family rate sheet (.pdf)

Complete Plan information and Benefits Brochure "Individual and Family Health Insurance Coverage"

Exclusions and Limitation (pdf)

The focus of this website is to provide consumers a simple, and professional environment when looking for Affordable, and Low Cost Health Insurance.  Licensed Health Insurance Agents are available and will take the time to answer all your questions, and help find the Health Plan that best meets the needs of the Individual, Family, or Small Business.

Health Insurance Benefits are always changing, and health insurance companies are providing more options that benefit the consumer.  Alternative, or Holistic health care is now offered through many of the health insurance companies.  You can now see your Naturopathic Physician, and be covered under the doctor office co-pay, and have unlimited visits.  Chiropractic, and Acupuncture are also included as standard health care benefits.

If you are looking for Dental and Vision benefits included within the health plan, we can help you select the Health Insurance Company that will meet your needs.

Health Benefit Solution, Inc is licensed through the Oregon Insurance Division, and has contracted with most all the major health insurance companies to provide the consumer with choice and options when looking for the plan that meets the life style and needs of the insured.

LifeWise Health Plan of Oregon

We’re committed to providing Oregonians with access to quality health care and peace of mind about their health-care coverage. With LifeWise coverage, members gain access to:

• A broad range of products and benefit options
• A stable, extensive provider network
• Responsive, local customer service
• Convenient online services

How can I find out about my benefits in detail?

Your benefit booklet is the best place to start. For most Group members, the booklet is now online and easy to access by logging in to your secure account.

How do I submit a claim when my physician or provider doesn’t bill insurance?

If your provider doesn’t bill us directly, simply send us a copy of your itemized billing statement. Please make sure the statement includes your member identification number and the patient’s name. The member ID number is generally the social security number of the enrolled member or policyholder. The bill must also list the provider’s name and tax ID number, date of service, diagnosis, procedure codes and all charges.

How long does it take to process a claim?

We process your claims promptly. You’ll generally receive a response in less than 30 days. However, if additional information is needed, it may take longer.

Does my plan require prior authorization for certain procedures?

No, but we recommend that before you're admitted for a planned hospital procedure or service that your doctor or hospital contact us. Even though your plan doesn't require prior authorization, advance notice allows us to verify eligibility for your peace of mind.

How is COBRA affected by my health plan?

Funds in an HSA can be used to pay COBRA premiums during the period of unemployment. Funds in HRAs or FSAs are not available to pay for COBRA premiums.

In addition, HSA funds remain available to employees even after they have changed jobs. HRA funds will remain available for as long as the HRA plan is maintained under COBRA continuation coverage. FSA funds remain available to employees until the funds are exhausted or the end of the plan year, whichever comes first.

How do I find out if my doctor is a LifeWise Network Provider?

Although the listing will be subject to change, you can look for a LifeWise Network Provider on our online directory.

Please call Customer Service to confirm the status of a provider. This is the only way to provide you with up-to-date information about your plan benefits. Many factors cause changes in a provider’s status, including changes in location and practice groups. It is important to check status regularly.

Do I need a referral to see a specialist?

No, LifeWise plans do not include requirements for a "primary care provider or gatekeeper."

However, if your plan is a preferred provider plan, referrals may be made to physicians or facilities that are not contracted as LifeWise Preferred Providers. If this occurs, benefits will still be paid for covered services but may be paid at the non-preferred level.

What if I have an emergency and am not near a Network Provider?

You have coverage for emergency care as outlined in your plan. Covered services for a medical emergency will be paid at the preferred provider level associated with your coverage. This also applies if the emergency occurs outside of Oregon or the United States. Non-emergency covered care is also covered outside of Oregon or the U.S., but at the non-preferred level.

What is UCR and can I look it up somewhere?

UCR stands for "Usual Customary and Reasonable." Benefits based on UCR are processed using a national database. The data is frequently updated based on charges by providers in the same location with similar experiences. Because this data varies and is dependent on the final diagnosis and treatment codes, there is not a reference source available to the general public to determine the UCR amount ahead of time.

If I am a custodial parent, how can I access my child’s information?

This information is available to you by calling Customer Service at 1-800-596-3440.

Throughout our web site, you'll find valuable information on getting the most out of your plan’s services, features and benefits.

Glossary

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