Providence Health Plans provides health care coverage services to more than 800,000 people in Oregon and southern Washington. Providence focuses on improving the health of its members by creating access to high quality healthcare programs and preventive services through top-rated benefit plans that are preferred by providers and customers. Providence Health Plans is part of Providence Health System in Oregon, ranked one of the top-10 most integrated health networks in the nation.

About Providence Health Plan

Providence Health Plan provides health insurance products for commercial groups, Medicare, Medicaid, individuals, and families in Oregon and southwest Washington. The company also offers diabetes management programs, coronary artery disease, congestive heart failure, end stage renal disease, and rare diseases, as well as respiratory management programs, such as asthma and chronic obstructive pulmonary disease; case management programs, including complex case management, pediatrics, and high-risk obstetrics; and wellness services, and resources and health care advice. In addition, it provides providence health plan provider directories.

Providence Health Plan was formerly known as Providence Health Plans. The company was incorporated in 1984 and is based in Beaverton, Oregon. Providence Health Plan operates as a subsidiary of Providence Health & Services.

Providence Health Plan, Inc.

Corporate Headquarters:
3601 SW Murray Boulevard
Beaverton, OR 97005
503-574-7500
CEO:
Mr. Jack Friedman
Employee Number:
650
2008 Revenue:
$7 billion

Product Types Offered

Individuals

Providence Health Plan offers Health Products for individuals, families and sole proprietors under the age of 65 and not eligible for Medicare.  Providence offers three basic plan types for individuals:

Optimum Plans
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.

Value Plans
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. HSA Plans offer comprehensive coverage while you set aside tax-deductible funds in a health savings account (HSA).

HAS Plans
HSA Plans feature:

• $20 copay for doctor visits.
• 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.

Employers

Providence Health Plan offers plans for four basic employer groups: plans for National accounts (companies with more than 3000 eligible employees), plans for small groups (2-50 eligible employees), medium groups (51-3000 employees) and Labor (for Taft Hartley Labor Unions).

Providence Health Plan offers three types of plans for employers:

Open Option Plans
Rich benefits, predictable copays and a huge national network of providers make Open Option plans Providence’s most popular product. Open Option plans feature low copays and no deductible for the services that employees use most, including Office visits, immunizations and flu shots, health screenings, and Women's health care.

Value-Based Open Option
Providence discounted copays and waived the deductible on the services that employees use most to stay healthy. Employees save money on preventive care, including check-ups, routine immunizations and flu shots, mammograms, colonoscopies and nutritional counseling for weight loss. Unlike their other plans, Value Based Open Option plans have a deductible in front of lab, X-ray and emergency services.

HSA-Qualified Plans
Lower premium, high-deductible health plans give employees an opportunity to save money while managing routine health care expenses. Employees are eligible to set aside pre-tax dollars into a health savings account (HSA) with any of their HSA-Qualified plans.
In addition to Open Option, Value Based Open Option and HSA-Qualified Open Option plans, we offer Personal Option, Dual Option and Traditional Option medical plans to meet your company's needs.

Medicare Plans

Medicare is the nation’s largest health insurance program, covering 40 million Americans. It was designed to provide high-quality health care to people 65 and over, as well as to others with disabilities. Key Features of Providence Medicare Plans include:

• Worldwide emergency coverage
• No health screenings and no exclusions for age
• Coverage for routine vision exam
• 24-hour telephone medical advice from our Providence RN nurses
• Routine physicals and preventive services
• Wellness and Value-Added programs at no additional charge

Providence Health Plan offers two basic types of plans:

1. Providence Medicare Extra / Providence Medicare Extra + RX
   Providence Medicare Extra makes seeing your doctor simple. With Providence handling most of the paperwork, you can relax.


2. Providence Medicare Choice / Providence Medicare Choice + RX
   With Providence Medicare Choice, see any Medicare approved provider or see a provider contracted with Providence. It's up to you.      

Provider Network

Providence Health Plan has one of the country’s biggest provider networks. You can use Providence Health Plan’s online provider directory to learn more about doctors, hospitals, other medical services, dentists, vision care providers and pharmacies that work with your Providence Health Plan. The Provider Directory contains a current listing of participating providers, facilities and pharmacies.

Click here to access Providence Health Plan’s Provider Directory

Network Facts

Health Care Networks:
Providence’s network includes more than 11,000 providers in Oregon and southwest Washington (11,463 participating providers and 57 in-plan hospitals) - and more than 540,000 nationwide.

Recent News

Here are some of the most recent news regarding Providence Health Plan:

Providence Health & Services increases revenue by $35 million using Concuity ClearContracts

WEBWIRE – Monday, June 08, 2009 — Vernon Hills, IL – Concuity, A Healthcare Division of Trintech, Inc. (NASDAQ: TTPA) announced today that Providence Health & Services signed an agreement to expand the breadth of services provided to the multi-hospital system. Providence Health & Services has, based on the success achieved to date, extended its agreement to include the addition of four more facilities using the ClearContracts software-as-a-service revenue management solution from Concuity.

The success of Providence will be honored by Concuity at the annual HFMA show, ANI, in Seattle on Monday, June 15, 2009. (Continue Reading)

Rating

Providence Health Plan’s rating, as rated by A.M. Best Company. A.M. Best Company is a full-service credit rating organization dedicated to serving the financial services industries, including the banking and insurance sectors.

Financial Strength Rating
Rating: A (Excellent)
Financial Size Category: IX ($250 Million to $500 Million)
Outlook: Stable
Action: Affirmed
Effective Date: June 11, 2009