Choice plans

Choice plans use a collaborative medical home model that provides members a team of health professionals dedicated to each member's overall well-being. Members select a medical home at time of enrollment from the Providence Choice Network of more than 235 primary care clinics in Oregon and southwest Washington. The medical home team then works collaboratively to support all aspects of a member's health, from wellness and prevention to active management of chronic conditions.

Clinics in the Choice network are designated as medical homes based on access, coordination, quality and cost measures. They're also recognized by the Oregon Health Authority Patient Centered Primary Care Home Program.

View benefit summaries for Choice health plans.

Plan features

  • More than 235 medical homes in Oregon and southwest Washington that provide a patient focused, coordinated care experience
  • Access to a broad network of specialists and facilities via referral from the medical home in order to receive coverage at the in-network level
  • Deductible waived for many services, including office visits, health exams, diagnostic services, women’s health services, routine immunizations and maternity prenatal care
  • Higher cost shares for selected services, such as knee and hip replacement, sleep studies, and sinus surgery
  • Separate deductibles and out-of-pocket maximums in and out-of-network
  • Coverage for Providence Express Care Virtual, our Web-based health care service offering convenient video visits with your care provider on your smartphone, tablet or computer without an appointment

For a complete list of available medical homes and providers by location, visit www.ProvidenceHealthPlan.com/providerdirectory.

Providence Choice Plans are available in select counties within Oregon and southwest Washington. Recognized medical homes are not available in all Oregon and southwest Washington counties. To ensure coverage for members outside the Choice Network service area, a Choice plan must be paired with another Providence health plan that uses the Providence Signature Network (such as an Open Option, Core Advantages, Personal Option or HSA-qualified plan). The multi-plan option gives you the flexibility to offer your employees a choice of plans while ensuring your benefits package aligns with the needs of your business.

Plan design options

Providence Choice uses tiered member cost-sharing to encourage appropriate and effective care choices.

Copay  Coinsurance  OOP Maximum*°  Deductible*° 
$10/$20 10%/30% $2,000  $250
$15/$30 20%/30% $2,500  $500 
$20/$40 20%/40% $3,000 $750 
$25/$50 30%/50% $3,500 $1,000 
$30/$60
$4,000 $1,500 
$35/$70   $5,000 $2,000 
    $5,500 $2,500
    $6,850 $3,000
      $3,500

* Individual amounts are shown. The family out-of-pocket maximum and family deductible are two times the individual amounts.
° There are separate deductibles and out-of-pocket maximums for in-network and out-of-network services. Out-of-network values are two times the in-network values.

View benefit summaries for Choice health plans.

Workforce wellness included

The FitTogether™ suite of programs and services, including health coaching, encourages better health, greater productivity and a more engaged workforce.

Value-added services and buy-up options

Rounding out these health plan benefits is your opportunity to seamlessly integrate other Providence services and benefits like pharmacy, vision, alternative medicine and EAP into the plan you offer.

For more information

Contact us to learn more about Providence medical plans or request a quote.

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