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Regence Valiance (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Regence Valiance (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Regence Valiance (PPO) in 2026, please refer to our full plan details page.
Regence Valiance (PPO) is a PPO plan offered by Cambia Health Solutions, Inc. available for enrollment in 2025 to people living in Select Counties in Oregon, including Clark Co, WA. This plan received an overall rating of 3 out of 5 stars in 2026.
It's important to know that Regence Valiance (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Regence Valiance (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Regence Valiance (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $15.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $9550.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $9550.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by Regence Valiance (PPO).
Additional Benefits
The Regence Valiance (PPO) plan offers comprehensive coverage for essential medical services, featuring no copay and no coinsurance for primary care visits, telehealth, and routine preventive care. For specialized treatment, members pay a $40 copay with no coinsurance for specialist visits, physical therapy, and outpatient hospital services. Inpatient hospital stays require a $370 daily copay for days one through four followed by no copay for days five through 90, while emergency room visits carry a $130 copay. In addition to medical care, the plan provides valuable supplemental benefits, including dental coverage up to a $1,500 annual limit with no copay for preventive services. Routine vision and hearing exams are covered with no copay and no coinsurance, alongside coverage for hardware like contacts, frames, and hearing aids. Members also enjoy no copay and no coinsurance for home health care and over-the-counter items, making everyday health needs highly affordable.
Inpatient Hospital See details
Regence Valiance (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $370 daily copay for days 1 through 4 and no copay for days 5 through 90. Prior authorization is required, and while unlimited additional acute days are covered at no copay, additional psychiatric days, hospital upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient services are covered by Regence Valiance (PPO), with outpatient hospital services requiring a $40 copay and 20% coinsurance, and ambulatory surgical center services costing a $40 copay with no coinsurance. Outpatient substance abuse services require a $35 copay with no coinsurance, while outpatient blood services are provided with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Regence Valiance (PPO) covers partial hospitalization services with a $130.00 copay and no coinsurance. Prior authorization is required to receive coverage for this benefit.
Ambulance and Transportation Services See details
Regence Valiance (PPO) covers Medicare-covered ground and air ambulance services with a $300 copay and no coinsurance, with prior authorization required. While some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Regence Valiance (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within 48 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency and urgent care carry a $130 copay ($300 for worldwide emergency transportation) and no coinsurance.
Primary Care See details
Regence Valiance (PPO) offers primary care physician services and select telehealth benefits with no copay and no coinsurance, while specialist visits, physical therapy, occupational therapy, and speech therapy require a $40 copay and no coinsurance. Mental health and psychiatric sessions are covered with a $35 copay and no coinsurance, but podiatry and routine chiropractic services are not covered.
Preventive Services See details
Regence Valiance (PPO) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive benefits are partially covered with no copay or coinsurance for home-based palliative care and safety devices, though services such as health education, weight management, and in-home support are not covered.
Hearing Services See details
Regence Valiance (PPO) covers hearing services, featuring a $40 copay and no coinsurance for Medicare-covered exams, and no copay or coinsurance for annual routine exams and fitting evaluations. Prescription hearing aids are partially covered with a copay ranging from $499 to $999 and no coinsurance for up to two aids per year, though inner ear, outer ear, over the ear, and OTC hearing aids are not covered.
Vision Services See details
Regence Valiance (PPO) features partially covered vision services with no copay and no coinsurance for covered benefits, with no deductibles. Covered services include one routine eye exam per year, one pair of eyeglass lenses, eyeglass frames (up to $100), and contact lenses (up to $100) annually, while other eye exam services, eyeglasses (lenses and frames), and upgrades are not covered.
Dental Services See details
Regence Valiance (PPO) offers partially covered dental services with a $1,500 annual limit, featuring no copay and no coinsurance for preventive care, and a $40 copay with no coinsurance for Medicare-covered dental. Covered comprehensive services require no copay and 50% coinsurance, while adjunctive general services, maxillofacial prosthetics, implants, fixed prosthodontics, and orthodontics are not covered.
Home Infusion bundled Services See details
Regence Valiance (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered under the Regence Valiance (PPO) plan with no copay and a 20% coinsurance.
Medical Equipment See details
Regence Valiance (PPO) covers durable medical equipment with no copay and 30% coinsurance, and prosthetics and medical supplies with no copay and 20% coinsurance. Diabetic equipment and supplies are covered with no copay and no coinsurance, though prior authorization is required and manufacturer limitations apply.
Diagnostic and Radiological Services See details
Regence Valiance (PPO) covers diagnostic and radiological services with prior authorization, offering diagnostic tests for a $10 copay and lab services with no copay, both with no coinsurance. Diagnostic radiological services have no copay, outpatient X-rays require a $5 copay, and therapeutic radiological services incur a 20% coinsurance.
Home Health Services See details
Regence Valiance (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Regence Valiance (PPO) covers Cardiac Rehabilitation Services with no coinsurance, but some services are covered while others are not. Specifically, standard cardiac, intensive cardiac, and SET for PAD rehabilitation services (each with a $25 copay) as well as pulmonary rehabilitation services (with a $15 copay) are not covered.
Skilled Nursing Facility (SNF) See details
Regence Valiance (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring a $10 daily copay for days 1 through 20, a $218 daily copay for days 21 through 44, and no copay for days 45 through 100. Prior authorization is required, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
Other services are partially covered by Regence Valiance (PPO), which offers over-the-counter (OTC) items with no copay and no coinsurance. Acupuncture and meal benefits are not covered under this plan.
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