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Group medical plans

We provide employers with a wide range of medical plans to meet their benefits budgets. Benefit riders such as prescription drug, vision and dental are also available. Medical plans, benefit riders and extra values vary by location and the type of medical plan selected.

Core Plans

Employers need more ways to manage their benefits budget, so we've created Providence Core Plans to give them a range of health insurance options without sacrificing benefits. Available in Oregon in August 2011 and Washington in January 2012.

What's standard?

All Core Plans feature:

  • Common deductible and coinsurance maximum
  • Deductible choices from $1,000 to $7,500
  • Coinsurance maximum of $5,000 per person and $15,000 per family
  • 30 percent/50 percent coinsurance
  • Fourth-quarter deductible carryover

What's different?

Core Essentials

  • Most non-preventive services are subject to the deductible

Core Advantages

  • First $500 in-plan lab and basic X-ray services are covered before the deductible
  • $25 personal provider office visit copay (deductible waived on all office visits; $35 specialist visit copay)

Core Alternatives

  • First $500 in-plan lab and basic X-ray services are covered before the deductible
  • MyChoice benefit. The deductible is waived on the first six MyChoice services, each at $25 copay, including office, specialist, alternative care and urgent care visits.
  • Alternative Care Plus to any licensed provider

Personal Option

  • Plans with and without annual deductibles.
  • Members care is received from in-plan participating providers.
  • Access to participating plan providers without referrals, including specialists.
  • Encourages and promotes provider and member relationship to enhance care without the "gatekeeper" concept.
  • A broad network of physicians and hospitals ensuring choice and quality.

Open Option Plan

  • Members may receive care from in-plan participating and out-of-plan non-participating providers.
  • Members' out-of-pocket costs are typically lower when they receive care from in-plan participating providers.
  • Participating providers work with Providence Health Plan to prior authorize treatment.
  • Members initiate prior authorization when receiving care from non-participating providers.
  • Access to participating plan providers without referrals, including specialists.
  • Encourages and promotes provider and member relationship to enhance care without the "gatekeeper" concept.
  • A broad network of physicians and hospitals ensuring choice and quality.

Dual Option Plans

Available for small employer groups in Oregon (in August 2011) and Washington (in January 2012)

Providence Dual Option Plans provide more flexibility for employers and more choice for employees, offering:

  • More than 100 unique plan combinations for employers
  • Combinations that fit employers' budgets and coverage needs
  • More benefits choices for employees

HSA Plans

Our HSA plans now provide:

  • Better deductible and coinsurance options
  • Enhanced and flexible alternative-care coverage
  • Combined in- and out-of-plan deductible and out-of-pocket maximum
  • Available in Oregon in August 2011 and Washington in January 2012