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What benefits does a Providence Health Plan offer?
Can Providence Health & Services change the cost of coverage?
Does Providence Health Plan pay in-network providers?
How do I choose a health insurance plan?
PHI is information that identifies you as an individual, such as your name and Social Security Number, as well as financial, health, and other information about you that is nonpublic, and that we obtain so we can provide you with insurance coverage.
- Provider Networks
- Preventive Care Coverage
- Deductibles
- Creditable Coverage
- Copayment and Coinsurance
- Out-Of-Pocket Maximum
- Health Insurance Glossary
The best way to maximize the benefits of your health plan is by choosing a participating in-network provider for your covered health care services. Our Individual & Family plans do not have coverage for out-of-network providers except for emergency and urgent care services. We offer three provider networks: 1. Providence Connect Network 2. Providen...
We believe the best way to keep our community healthy is through robust preventive care options. All of our plans cover certain preventive care in full* prior to meeting your deductible, including: 1. Well-baby care (from any provider licensed to provide this service) 2. Periodic health examinations (from any provider licensed to provide this servi...
Your plan’s annual deductible is the amount you pay for covered services before your plan kicks in to pay for those services. A new deductible occurs every calendar year. Deciding what type of deductible you want often comes down to how often you plan on using certain covered services. If you find yourself frequently using services, a lower deducti...
Coverage is creditable when the plan payout for prescription drugs is, on average for all plan participants, as much as the average payout under the standard Medicare Part D benefit. Coverage is non-creditable when the plan payout for prescription drugs is, on average for all plan participants, less than what standard Medicare Part D prescription d...
Once you’ve met your annual deductible, you share the costs of covered health services with your health plan through copayments and coinsurance. 1. Copayment is a fixed amount you pay for a covered service at the time care is provided. For example, if your copay is $20 for an office visit, you pay $20 at the time of your visit. 2. Coinsurance is a ...
We want to protect all our members from the catastrophic costs that may come from a serious injury or health conditions (even with covered services). To do this, we set annual out-of-pocket maximum costs for covered services. This amount includes your deductible. Once you’ve met your out-of-pocket maximum, your plan will cover 100 percent of covere...
Dive further into common health insurance terms that may still be confusing in our Health Plan Glossary.
We provide extensive health plan options for Medicare Advantage, Medicare Supplement, Individuals & Families, and businesses. We've got you covered Medicare Employers Individuals & Families
The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services.
- DeniseWilder
- 11/8/2022 1:48:36 PM
Getting a cost estimate can help you prepare. Providence offers two ways to get estimates for your care. 1. You can use our online estimate tool to assess costs of your treatment. Get an estimate here. 2. You can also reach out to our price transparency team to request an estimate.
Whether you’re new to Medicare – turning 65 or just retiring – or thinking about changing your current Medicare coverage, it’s important to understand your options so that you’ll select the right coverage for your health and financial needs. What is Medicare?
