Clackamas, Multnomah, Washington and Yamhill counties in Oregon
Columbia, Lane, Marion, Polk counties in Oregon and Clark County in Washington
Crook, Deschutes, Hood River, Jefferson and Wheeler counties in Oregon
Linn and Benton counties in Oregon
Spokane County in Washington
Snohomish County in Washington
DSNP area: Clackamas, Multnomah and Washington counties in Oregon
Medical Only No Rx area: Clackamas, Columbia, Lane, Marion, Multnomah, Polk, Washington, Yamhill counties in Oregon and Clark County in Washington
Optional supplemental benefit coverage for dental
Please read enrollment instructions before completing enrollment forms.
Complete the enrollment form and fax it to 503-574-8653 or mail to:
Providence Medicare Advantage Plans
P.O. Box 5548
Portland, OR 97228-5548
You will receive a notice in the mail acknowledging receipt of your enrollment request.
Individuals must have both Part A and Part B to enroll.