Member Benefits
All Cascade Select plans (Gold, Silver, Bronze) cover the same list of medical services. The cost of deductibles, copays, and coinsurance for each service varies depending on the metal level.
CHNW Cascade Select plans are Exclusive Provider Organization (EPO) plans, which means that we cover services only when you receive them from Network Providers, with limited exceptions such as emergency care.
If you are not sure about the list of services or procedures covered, limitations or exclusions, or your out-of-pocket costs, check your plan’s Summary of Benefits and Coverage (SBC) and Evidence of Coverage (EOC) on our Plans page or contact Customer Service.
Here are some select highlights of our coverage.
Medical
Coverage for provider visits applies to in-person and virtual (also known as telehealth or telemedicine) care. Medical coverage includes:
- Preventive care
- Primary care
- Specialty care
- Urgent care
- Emergency room
- Labs and X-rays
- Mental health services
- Acupuncture
- Mammography
- Rehabilitation services
For a detailed list of covered medical services, please see your Evidence of Coverage document. To find a provider in our network, see our Find a Doctor page.
Behavioral Health
Our plans cover inpatient, residential, and outpatient medically necessary treatment of mental health and substance use disorders. This includes chemical dependency treatment for substance use disorders.
See our Behavioral Health page for more details.
Vision
Routine vision services are not covered for adults. Pediatric vision services, including professional fees, supplies and materials, are covered for children under the age of 19. Covered pediatric vision services include:
- Routine vision screening
- Comprehensive eye exam
- Prescription lenses or contacts
- One pair of frames or contact lenses, once per calendar year
Virtual Care
If your regular doctor doesn’t provide virtual visits, or if their office is closed, don’t worry. As a CHNW member, you have access to 24/7 care through CHPW Virtual Care.
With this benefit, you can visit with a doctor by phone or video at any time, day or night, without having to leave your home. See the Virtual Care page for details.
Prescription Drugs
This benefit provides coverage for prescription drugs dispensed by a participating pharmacy (a pharmacy in our network). Your prescriptions are covered under our plan only if they are filled at a participating pharmacy or through our mail-order pharmacy service.
Your Prescription Drugs benefit has four tiers: Generic, Preferred Brand, Non-Preferred Brand, and Specialty. You pay a cost-share of either a copay or coinsurance for each separate new prescription or refill.
For more information, go to our Prescription Drug Coverage page.
Did you know that certain prescription medicines are available as a 90-day supply? Medicine that you take on a long-term basis to manage your health is called a “maintenance drug.” A 90-day supply makes it easier to keep taking the medicine you need to feel your best. You may also be eligible to receive your long-term medications through free home delivery.
