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FHIAP Application Instructions

Premium assistance is now available for three Providence Individual & Family Plans through the Family Health Insurance Assistance program (FHIAP). Read more about our plans and premium assistance.

Are you approved through FHIAP?

If you have received your approval letter from FHIAP for a subsidy, you can apply for these three plans:

  • Optimum 500
  • Optimum 1000
  • Value 500

How to Apply

  1. Learn about our plan benefits and coverage options with our Plan Overview page.
  2. Print out our Individual & Family Plan Application (PDF 196kb). DO NOT enroll online.
  3. Fill out application and personal health statement for each family member you are enrolling. Please be thorough and complete with your information.
  4. Choose your health plan: Optimum 500, Optimum 1000 or Value 500 and check the box on your Individual & Family Plan Application. These are the only plans that are approved for FHIAP subsidies.
  5. Sign your FHIAP Certificate of Eligibility (keep a copy of the certificate for yourself) and attach to your completed Individual & Family Plan Application. Mail to:

    Providence Health Plan
    P.O. Box 4649
    Portland, OR 97208-4649

Questions?

If you have questions about our plans or filling out your application, call our Sales Department at 1-800-988-0088.

If you have questions about FHIAP or your eligibility, call 1-888-564-9669.

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