Providence Medicare Dual Plus (HMO D-SNP)

Call us for more information:
1-888-226-7338 (TTY: 711)
8 a.m. to 8 p.m. (Pacific time),
Seven days a week (Oct. 1-Dec. 7)
Monday through Friday (Dec. 8-Sept. 30)

Enroll online

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2020 premium and benefit information

Providence Medicare Dual Plus
Monthly premium with prescription drug coverage  $0
Annual deductible $0
Medical Benefits You Pay*
Annual wellness visit $0
Primary care physician (PCP) visits $0
Specialist visits $0
Preventive care $0
Lab tests $0
X-rays $0
Diabetic supplies $0
Outpatient surgery and hospital services $0
Inpatient hospital $0
Ambulance services $0
Urgent care $0
Emergency room $0
Over-the-counter supplies $175 credit per quarter
Transportation 36 one way trips
Preventive dental includes exams, cleanings, X-rays
 $0 (limits apply)
Prescription Benefits You Pay
Generic drugs $0 / $1.30 / $3.60
All other drugs $0 / $3.90 / $8.95
Additional Benefits  You Pay
Routine eye exam You get $75 each year for one routine eye exam
Prescription glasses or contact lenses You get $210 every year for lenses, frames, upgrades, or contact lenses
24-hour nurse advice line $0
Fitness center membership or home fitness kits $0
Health education – includes weight management, stress management, pain education, childbirth classes, smoking cessation and nutrition classes  You get a $500 annual allowance for health education classes at Providence facilities

* For certain members, the Oregon Health Plan (Medicaid) may only pay cost-sharing amounts for services that the Oregon Health Plan would normally cover. Please contact the Oregon Health Plan or your Oregon Health Plan Coordinated Care Organization for more information. Providence Medicare Dual Plus (HMO D-SNP) members who are enrolled with Health Share/Providence for the Oregon Health Plan will not have out-of-pocket costs for any Medicare-covered medical service. Prescription drug cost-sharing amounts still apply.

Providence Medicare Dual Plus (HMO D-SNP) is available in Clackamas, Multnomah and Washington counties in Oregon.

Providence Medicare Dual Plus (HMO D-SNP) is available to you if you have Medicare Part A and B, you have full Oregon Health Plan (OHP) Medicaid benefits, and you live in Clackamas, Multnomah or Washington County. You must continue to pay your Medicare Part B premium. The Part B premium is covered for full-dual enrollees who are eligible for Providence Medicare Dual Plus (HMO D-SNP). Premiums, co-pays, co-insurance and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. 

Providence Medicare Advantage Plans is an HMO, HMO‐POS and HMO SNP with Medicare and Oregon Health Plan contracts. Enrollment in Providence Medicare Advantage Plans depends on contract renewal.

This information is available in a different format, including audio CDs. If you need plan information in another format, please call Customer Service at 503-574-8000 or 1-800-603-2340 (TTY: 711). Service is available between 8 a.m. and 8 p.m. (Pacific time), seven days a week.

Webpage is current as of 12/4/2019