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Providence Health Plans (PHP) is pleased to be among the carriers selected to provide health insurance to Oregon school district employees, ESDs and Community Colleges. Our medical plans offer rich benefits at competitive prices with Oregon-based, friendly and fast customer service.
Type of Medical Plans
PHP offers two Point of Service (POS) medical plan options that feature choice, generous benefits and extra values. POS plans are unlike HMOs: members may receive care from in-plan and out-of-plan providers.
Receiving Care from Providers
Although we encourage members to receive care from a Primary Care Physician (PCP), they may receive care from any licensed physician, including out-of-plan providers. Providence Health Plan, however, pays higher benefits when care is received from a PCP or an in-plan provider who contracts with Providence Health Plan.
Providence Health Plan Advantages
- Choice. Our medical plans are Point of Service (POS) plans, not HMO plans. Members can choose to receive care from in-plan and out-of-plan providers.
- Access. Members have access to a broad statewide and national network of providers and facilities anywhere members or early retirees live and travel. We are adding to our provider network regularly to ensure that members can access the services and care they need when and where they need it.
Find a doctor:
Search the Providence Preferred Providers Network
- Friendly, fast and dedicated customer service teams. Providence Health Plan consistently offers fast and friendly customer service from our Oregon-based office:
- Customer Service representatives answer the phone -- on average -- in 22 seconds.
- 98.2 percent of claims paid within 30 days.
- 99.5 percent of claims paid are accurate the first time.
- Extra values and discounts. Members can access discounts on alternative care, outdoor activities, theater, travel and so much more.
Generous Covered Benefits
- Choice to see in-plan and out-of-plan providers; benefits are paid at higher levels when care is received from in-plan providers
- Ability to receive care from a Primary Care Physician (PCP), although members do not have to designate or limit care to a PCP
- Preventive care, such as well baby exams, covered in full; the annual deductible does not apply
- Low office visit copays ($5 or $10) when members see in-plan providers; the annual deductible does not apply
- Access to in-plan specialists without a referral
- Retail and mail order prescription drug benefits with low copays and thousands of participating retail pharmacies across the state
Extra Values and Discounts
- Providence RN – Free health advice available from local registered nurses 24/7.
- LifeBalance Program – Discounts on cultural and recreational activities.
- Discounts on vision services through Binyons and TruVision.
- TruHearing – Digital hearing aids at a reduced price for members, their parents and grandparents
- Health and Wellness Program — Resources to help members live well and OEBB and districts manage costs over time
Dedicated OEBB Customer Service Resources
www.providence.org/oebb
(800) 633-1878
8 a.m. to 5 p.m., Monday through Friday PST
Formulary
To view Providence's formulary, click here:
http://providence.org/resources/oebb/pdfs/OEBBFormulary.pdf#druglist
Frequently Asked Questions
To view some of Providence's most Frequently Asked Questions, click here: FAQ
Transition of Care Form
To download the Transition of Care form, click here: Transition of Care
Transition of care pertains to ongoing services a new member needs to receive within one month before or after the effective date of enrollment. This is called the transition period. The transition period does not apply to pregnancy, organ transplant or other conditions which may require referrals for an extended period of time.
If a newly enrolled member has a transition of care need, they must complete the Transition of Care Form, sign and date it and fax the form to Providence Health Plan Medical Management.
Upon receipt of this form, a RN Care Coordinator will review the request, obtain any necessary medical information and facilitate the authorization of services and referrals within the terms of the plan provisions. If a request falls outside of established service authorization criteria, the request will be sent to a Health Plan Medical Director for review. The RN Care Coordinator can also provide the new member with information about plan services and the status of the request.
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