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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 Utah. This plan received an overall rating of 3.5 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 $30.00. 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:
Sign up for Regence Valiance (PPO)
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Drug Coverage
Prescription drugs are not covered by Regence Valiance (PPO).
Additional Benefits
Regence Valiance (PPO) offers comprehensive medical coverage, featuring primary care visits, preventive care, and home health services with no copay or coinsurance. Inpatient hospital stays require a $295 copay for days 1 through 4 and no copay for days 5 through 90, while specialist visits carry a $30 copay. Emergency services are covered with a $130 copay, and skilled nursing facility care starts with a $10 daily copay for the first 20 days. The plan also includes valuable supplemental benefits, such as routine vision and hearing exams with no copay, plus a $1,500 annual maximum for dental services. Preventive dental care is covered with no copay, while comprehensive dental services require a 50% coinsurance. Additionally, members can access over-the-counter items with no copay, and durable medical equipment is covered with a 30% coinsurance and no copay.
Inpatient Hospital See details
Regence Valiance (PPO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $295 copay for days 1 through 4 and no copay for days 5 through 90. Unlimited additional days for acute stays are covered with no copay, while room upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Regence Valiance (PPO) covers outpatient hospital services with a $30 copay and 20% coinsurance, and ambulatory surgical center services with a $30 copay and no coinsurance. Outpatient substance abuse services require a $15 copay per session with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization services are covered by Regence Valiance (PPO) with a $130.00 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
Ambulance services are covered by Regence Valiance (PPO) with a $300 copay and no coinsurance for both ground and air transport, though prior authorization is required. Transportation services to health-related locations are not covered.
Emergency Services See details
Regence Valiance (PPO) covers emergency services with a $130 copay (waived if admitted within 48 hours) and urgently needed services with a $50 copay, both with no coinsurance. Worldwide emergency and urgent services are also covered with no coinsurance, carrying a $130 copay for medical care and a $300 copay for emergency transportation.
Primary Care See details
Regence Valiance (PPO) covers primary care physician visits with no copay and no coinsurance, while specialist visits and physical, occupational, and speech therapy services require a $30 copay and no coinsurance. Mental health and psychiatric sessions have a $15 copay and no coinsurance, though prior authorization is required for therapy, psychiatric, and telehealth services. Podiatry and chiropractic services are not covered under this plan.
Preventive Services See details
Regence Valiance (PPO) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and Medicare-covered screenings. Additional preventive services are partially covered, but health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional/dietary benefits, in-home support, caregiver support, additional smoking cessation, enhanced disease management, telemonitoring, and counseling services are not covered.
Hearing Services See details
Regence Valiance (PPO) covers hearing services, including Medicare-covered exams for a $30 copay and routine exams or fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered for up to two devices per year with a copay ranging from $499 to $999 and no coinsurance, while inner ear, outer ear, over the ear, and over-the-counter (OTC) hearing aids are not covered.
Vision Services See details
Vision services are partially covered by Regence Valiance (PPO) with no copay, no coinsurance, and no deductible for routine eye exams, contact lenses, eyeglass lenses, and frames. Annual limits of $150 apply to frames and contact lenses, while other eye exam services, upgrades, and combined eyeglasses (lenses and frames) are not covered.
Dental Services See details
Regence Valiance (PPO) offers partially covered dental services with a $1,500 annual maximum, featuring a $30 copay and no coinsurance for Medicare-covered dental, and no copay and no coinsurance for preventive care. Covered comprehensive services—including restorative, endodontics, periodontics, removable prosthodontics, and oral surgery—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. Associated Medicare Part B chemotherapy, radiation, and other drugs carry up to 20% coinsurance, while Medicare Part B insulin is covered with a $35 copay and up to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by Regence Valiance (PPO) with no copay and a 20% coinsurance.
Medical Equipment See details
Regence Valiance (PPO) covers medical equipment, including durable medical equipment (DME) with no copay and 30% coinsurance, and prosthetic devices and medical supplies with no copay and 20% coinsurance. Diabetic equipment and supplies from specified manufacturers are also fully covered with no copay and no coinsurance.
Diagnostic and Radiological Services See details
Regence Valiance (PPO) covers diagnostic and radiological services with prior authorization, featuring no copay for lab services, outpatient X-rays, and diagnostic radiological services. Diagnostic procedures and tests require a $5 copay with no coinsurance, while therapeutic radiological services require a 20% coinsurance.
Home Health Services See details
Home health services are covered under the Regence Valiance (PPO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Regence Valiance (PPO) provides Cardiac Rehabilitation Services with no coinsurance, but only some services are covered. Sub-services that are not covered under this plan include cardiac rehabilitation ($20 copay), intensive cardiac rehabilitation ($20 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for symptomatic peripheral artery disease ($20 copay).
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 40, and no copay for days 41 through 100. Prior authorization is required, a prior three-day hospital stay is not required, and additional days beyond the standard Medicare-covered 100 days are not covered.
Other Services See details
Regence Valiance (PPO) partially covers other services, providing over-the-counter (OTC) items with no copay and no coinsurance. However, acupuncture, meal benefits, and nicotine replacement therapy are not covered under this plan.
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