Providence Health Plans

Health Plans

Optimum

The Optimum Plans offer you the most comprehensive coverage that feature:

  • $20 copay for doctor and specialists visits
  • $10 generic drugs and brand name drugs covered at 50%
  • Deductible waived on doctor visits, urgent care, prescription drugs, most preventive care services and specialists
  • Low out-of-pocket maximum: $2,500 individual or $7,500 family
  • Deductible waived for all covered services within 90 days of an accidental injury
  • Hospital, surgery, X-ray and laboratory services
  • A national network of participating providers
  • Routine Vision Services

Value

The Value Plans offer similar coverage as Optimum Plans, but with slightly higher out-of-pocket costs. Value Plans feature:

  • $20 copay for doctor visits
  • Prescription drugs covered at 50%
  • Deductible waived on doctor visits, urgent care, prescription drugs and most preventive care services
  • Deductible waived on all covered services within 90 days of an accidental injury
  • Hospital, surgery, X-ray and laboratory services
  • A national network of participating providers

Prime

The Prime Plan offers basic coverage for a lower premium. The Prime Plan includes:

  • 50 percent coinsurance for all covered services.
  • Receive covered services from an in-plan participating provider only. (Out-of-plan providers not covered.)
  • Prescription drugs covered at $15 for generics, 50 percent coinsurance for brand name drugs.
  • Deductible waived on most doctor office visits, urgent care, prescription drugs and most preventive care services.
  • Hospital, surgery, X-ray and laboratory services for 50 percent coinsurance.

HSA

The HSA Plans Offer comprehensive coverage while you set aside tax-deductible funds in a health savings account (HSA). HSA Plans feature:

  • $20 copay for doctor visits after deductible is met
  • Prescription drugs covered at 50%
  • Deductible waived on most preventive care services
  • Hospital, surgery, X-ray and laboratory services
  • A national network of participating providers

Service Area

To apply for coverage, you must live in one of the following counties:

  • Benton, Clackamas, Columbia, Crook, Deschutes, Gilliam, Grant, Harney, Hood River, Jefferson,
    Linn, Marion, Multnomah, Polk, Sherman, Wasco, Washington, Wheeler and Yamhill
  • Selected zip codes in Lane and Klamath counties