Providence Health Plans of Oregon

Providence knows that health care coverage is important to you and that you have unique coverage needs. That’s why they offer you a variety of plan options. You’ll find that each plan offers comprehensive coverage for a range of medical services.

Optimum Plans

The Optimum Plans provide the most comprehensive coverage. We offer three different Optimum plans:

Plan 1, Plan 2 and Plan 3. The only difference in coverage between these three plans is the annual deductible amount.  Plan 1 has the lowest deductible and Plan 3 has the highest deductible.

Optimum Plans waive the deductible for preventive care services and all participating health care provider office visits, both personal physician/ provider and specialist visits. This means you can get your preventive and routine care for illness or injury covered all year long without having to meet your deductible. With these plans you pay a $20 copayment for each office visit when you see a participating provider through your In-Plan benefit.

Value Plans

The Value Plans offer the same level of coverage as the Optimum Plans with one important difference: the deductible is not waived for participating specialist office visits. Depending on the type of Value Plan you choose, once the deductible is met either a 20 or 30 percent coinsurance applies for each specialist office visit. We offer 10 different Value plans – Plan 1 through Plan 10. A wide range of deductibles and out-of-pocket maximums are available. Value Plan 1 has the lowest deductible/out-of-pocket maximum and Value Plan 10 has the highest. Monthly premiums between plans vary considerably. Value Plan 1 has the highest monthly premium and Value Plan 10 has the lowest.

HSA Plan features

The HSA plan benefits vary considerably from our Optimum and Value plans. Here are the key benefit features:

• Preventive care (In-Plan benefit) – The HSA Plan waives the deductible for preventive care services when these services are received from a participating personal physician/provider. The deductible also is waived for annual gynecological exams and mammograms. You pay a $20 office visit copayment when you see a participating provider. The deductible is not waived for other participating personal physician/provider or specialist office visits.
• Participating personal physician/provider office visits for illness or injury (In-Plan benefit) – You pay a $20 copayment after meeting your annual deductible amount.