Best Providence Medicare Advantage Plans in 2021

Providence Health Plan is an integrated delivery system of Providence Health & Services. They provide health care coverage to over 650,000 members all over the United States. Individuals and families can get Providence Medicare Advantage, which is a Medicare plan provided by the Providence Health Plan. With expert physicians, hospitals, and pharmacies, they deem to provide the best quality and affordable health care services.

Mission and Values of Providence Medicare Advantage:

Keeping the ministry of Jesus and God’s healing love, PHP serves people from all sectors, especially the poor and the vulnerable.

Providence Health Plan believes in the following values –

  • Compassion
  • Dignity
  • Justice
  • Excellence
  • Integrity

Providence Medicare Advantage

Providence Health Plan offers a wide range of Medicare plans under the Providence Medicare Advantage plans. There are divided into several categories based on service areas. Let’s take a look at the various Providence Medicare Advantage plans:

Service Area 1

Clackamas, Multnomah, Washington, and Yamhill counties in Oregon

Prime + Rx (HMO):
Benefits You Pay
Out-of-pocket maximum $5,900
Doctor office visit (PCP) $0
Specialist visit $40
Alternative Care $20 – $40
Outpatient diagnostic tests & procedures 20%
Outpatient diagnostic & therapeutic radiology 20%
Inpatient hospital Days 1-4: $450/day, Days 5-beyond: $0
Bridge 1 + Rx (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $4,900 $10,000
Doctor office visit (PCP) $0 $25
Specialist visit $35 $50
Alternative Care $20-$35 No coverage
Outpatient diagnostic tests & procedures 20% 30%
Outpatient diagnostic & therapeutic radiology 20%
Inpatient hospital Days 1-6: $325/day
Days 7 & beyond: $0
30%

Service Area 2

Columbia, Lane, Marion, Polk counties in Oregon and Clark County in Washington

Timber + Rx (HMO):
Benefits You Pay
Out-of-pocket maximum $5,500
Doctor office visit (PCP) $0
Specialist visit $40
Alternative Care $20 – $40
Outpatient diagnostic tests & procedures 20%
Outpatient diagnostic & therapeutic radiology 20%
Inpatient hospital Days 1-4: $450/day, Days 5-beyond: $0
Choice + Rx 002 (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $4,500 $10,000 combined
Doctor office visit (PCP) $15 $25
Specialist visit $30 / $50 no referral $50
Outpatient diagnostic tests & procedures 20% 30%
Outpatient diagnostic & therapeutic radiology 20% 30%
Inpatient hospital Days 1-6: $300/day
Days 7 & beyond: $0
30%

Service Area 3

Benton and Linn counties in Oregon

Enrich + Rx (HMO):
Benefits You Pay
Out-of-pocket maximum $5,000
Doctor office visit (PCP) $15
Specialist visit $40
Outpatient diagnostic tests & procedures 20%
Outpatient diagnostic & therapeutic radiology 20%
Inpatient hospital Days 1-5: $350/day, Days 6 and beyond: $0

Service Area 4

Crook, Deschutes, Hood River, Jefferson, and Wheeler counties in Oregon

Compass + Rx (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $5,900 $10,000 combined
Doctor office visit (PCP) $10 $25
Specialist visit $40 / $50 no referral $50
Outpatient diagnostic tests & procedures 0% 30%
Outpatient diagnostic & therapeutic radiology 20% 30%
Inpatient hospital Days 1-5: $360/day
Days 6 & beyond: $0
30%
Latitude + Rx (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $5,500 $5,500 combined
Doctor office visit (PCP) $10 $25
Specialist visit $40 / $50 no referral $50
Outpatient diagnostic tests & procedures 20% 30%
Outpatient diagnostic & therapeutic radiology 15% 30%
Inpatient hospital Days 1-5: $275/day
Days 6 & beyond: $0
30%

Service Area 5

Snohomish County in Washington

Harbor + Rx (HMO):
Benefits You Pay
Out-of-pocket maximum $6,700
Doctor office visit (PCP) $10
Specialist visit $50
Outpatient diagnostic tests & procedures 20%
Outpatient diagnostic & therapeutic radiology 20%
Inpatient hospital Days 1-4: $450/day, Days 5-beyond: $0
Summit + Rx (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $5,500 $10,000 combined
Doctor office visit (PCP) $5 $25
Specialist visit $40 / $50 no referral $50
Outpatient diagnostic tests & procedures 20% 40%
Outpatient diagnostic & therapeutic radiology 20% 40%
Inpatient hospital Days 1-4: $375/day
Days 5 & beyond: $0
40%

Service Area 6

Spokane County in Washington

Pine + Rx (HMO):
Benefits You Pay
Out-of-pocket maximum $5,500
Doctor office visit (PCP) $0
Specialist visit $45
Outpatient diagnostic tests & procedures 20%
Outpatient diagnostic & therapeutic radiology 20%
Inpatient hospital Days 1-4: $395/day
Days 5-beyond: $0
Cottonwood + Rx (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $4,800 $10,000
Doctor office visit (PCP) $0 $25
Specialist visit $35° $50
Outpatient diagnostic tests & procedures 20% 30%
Outpatient diagnostic & therapeutic radiology 20% 30%
Inpatient hospital Days 1-6: $325/day
Days 7-beyond: $0
30%

Medical only, No Rx Area

Clackamas, Columbia, Lane, Marion, Multnomah, Polk, Washington, Yamhill counties in Oregon and Clark County in Washington

Focus Medical (HMO):
Benefits You Pay
Out-of-pocket maximum $3,400
Doctor office visit (PCP) $0
Specialist visit $20
Alternative Care $20 – $40
Outpatient diagnostic tests & procedures 20%
Outpatient diagnostic & therapeutic radiology 15%
Inpatient hospital Days 1-5: $250/day
Days 6 & beyond: $0
Select Medical (HMO-POS):
Benefits You Pay
In-Network Out-of-Network
Out-of-pocket maximum $4,500 $10,000 combined
Doctor office visit (PCP) $15 $25
Specialist visit $30 / $50 no referral $50
Alternative Care $20 – $30 $50
Outpatient diagnostic tests & procedures 20% 30%
Outpatient diagnostic & therapeutic radiology 20% 30%
Inpatient hospital Days 1-6: $300/day
Days 7 & beyond: $0
30%

D-SNP Area

Clackamas, Multnomah, and Washington counties in Oregon

Dual Plus (HMO D-SNP):
Medical Benefits You Pay
Annual wellness visit $0
Primary care physician (PCP) visits $0 or 20%
Specialist visits $0 or 20%
Diabetic supplies $0
Outpatient surgery and hospital services $0
Inpatient hospital $0
Transportation (max. of 25 miles each way) $0 (36 one-way trips)

 

Providence Medicare Advantage plans are very cost-effective and helpful for downtrodden people. Their wide Medicare plans provide robust benefits for the members. If you want to know more about Providence Medicare Advantage plans, kindly visit https://healthplans.providence.org/medicare/plans/compare/.

Frequently  Ask Questions:

  1. How do I enroll with Providence Medicare Advantage?

You can enroll with Providence Medicare Advantage either through their secure enrollment form or by calling them at 1-800-457-6064 (TTY: 711).

  1. How do I mail to Providence Medicare Advantage?

If you want to contact Providence Medicare Advantage Plan by mail, you can use the following address –

Providence Medicare Advantage Plans
P.O. Box 4327
Portland, OR 97208-4327.

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