Providence Health Plans
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1 Providence Health Plans v
2 Providence Enrollment Service Area
3 Providence Medicare Advantage Plans Special Attributes Established network of doctors and hospitals Over 11,000 in network providers and growing Eases the way of finding a provider No balance billing Online resources Physician finder Rx formulary Benefit specific detail Value added services and discounts myprovidence Mobile App Visit
4 Providence Medicare Advantage Plans Special Attributes Oregon based company Offices in Beaverton, Portland and Eugene Personal assistance Dedicated customer service for existing and prospective members Health coaching programs Medication therapy management Care management team 24/7 nurse advice line
5 Providence Medicare Advantage Plans Extra Benefits Providence Health express: Visit with a Providence care provider on our smartphone, tablet or computer A visit summary is provided to your PCP No appointment necessary $0 copay
6 Providence Medicare Advantage Plans Extra Benefits (not covered by original Medicare) No lifetime reserve days on hospitalization Streamlined skilled nursing facility admission Bundling of outpatient surgery costs Routing vision exam covered annually $100 vision hardware allowance every two years No cost fitness facility membership 10,000+ fitness or exercise centers Unlimited visits Silver&Fit exercises classes Home Fitness Program option
7 Providence Medicare Advantage Plan Options Features Type of Plan Monthly Premium Out-of-Pocket Costs Provider Access Primary Care Physician Referral Requirement Providence Medicare Align Group HMO Higher Premium Low In-Plan Only Required Referral Required Providence Medicare Flex Group HMO-POS Lower Premium Moderate In-Plan or Out-of-Plan Required Referral Optional
8 Providence Medicare Advantage Plans Emergency & Travel Benefits Service Providence Medicare Align Group Providence Medicare Flex Group Urgent Care (Worldwide coverage) Emergency Room (Worldwide coverage) Ambulance (Worldwide, air or ground) $25 copay $25 copay $50 copay $65 copay $50 copay $50 copay Travel Benefit (Nationwide, must use a Medicare Provider) Follow-up Care $1,000 allowance Providence pays 80% Member pays 20% $30 copay for office visits 20% for all other services
9 Providence Health Plans Non-Medicare Plans
10 Providence Non-Medicare Plans Features Providence Core Value Plan Providence Select Value Plan Type of Plan PPO Deductible $500 $1,000 Primary Care Physician Referral Requirement Network Alternative Care Not Required Not Required Open Option (statewide network) Included
11 Providence Non-Medicare Plans Discount Services Health Education Classes Free or discounted classes including weight management, smoking cessation and more ChooseHealthy Massage therapy Dietician services TruHearing Discounted hearing testing, aids and batteries Vision hardware and Lasik surgery Available through multiple vendors, contact plan for details LifeBalance Program Saving on things like recreational, cultural and wellness activities
12 Providence Health Plans Prescription Drug Plan
13 Prescription Drug Plan Medication Therapy Management (MTM) A free service for our members with Medicare Part D coverage Telephonic consultation with a clinical pharmacist to review medications and over-the-counter drugs MTM services are associated with improved medication use, lower drug costs, improved disease management, reduced hospitalizations and reduced hospital readmissions Prescription Drug Price Estimator Available in myprovidence for current members with active pharmacy benefits Real-time comparison shopping for up to 5 pharmacies showing plan and member cost share Local pharmacy customer service available Hours of operation: Monday Friday, 8 a.m. 6 p.m.
14 Pharmacies Benefit Over 25,000 participating pharmacies nationwide Mail Order Pharmacies Two types of contracted pharmacies: Wellpartner Network Pharmacies Walgreens Mail Service Postal Prescription Service Preferred Network Pharmacies May save you money Preferred Network Pharmacies Examples Albertson / Sav-On Bartell Drugs Bi-Mart Pharmacy Costco Florence Pharmacy Fred Meyer (Kroger Store) Haggen Bend Pill Box Pharmacy OHSU Outpatient Clinic Pharmacies Providence Outpatient and Clinic Pharmacies QFC Safeway SUPERVALU, Inc. Walgreens Yokes Food Doc Pharmacy *Not all contracted network pharmacies are listed. Pharmacies contracted with your health plan may change at any time. Your health plan will notify you if your pharmacy is no longer included in the network. Please contact your health plan for more details.
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