Get to know your benefits; use them fully throughout the year
Your benefits are purposefully designed to help you become or stay healthy – whatever healthy looks like for you. As a Providence Health Plan member enrolled in either the Providence Open Option Plan or HSA Plan, count on comprehensive benefits and provider choice.
Plan features at a glance
- Care available from in-network participating and out-of-network non-participating providers. Your out-of-pocket costs are typically lower when you receive care from in-network participating providers.
- Medical benefits with access to nearly 1 million in-network providers nationwide.
- Care from in-network participating providers without referrals, including specialists.
- No requirement to designate a primary care provider; however, Providence encourages and promotes the provider and member relationship to enhance your care experience.
- Choice and quality with access to nearly 1 million providers nationwide.
- Participating providers work with Providence Health Plan to prior authorize treatment for certain services, such as hospitalization, high-tech diagnostic imaging and surgery. If care requires prior authorization and you want to receive services from out-of-network providers, you will need to ask your provider to initiate prior authorization.
- Prescription drug benefits with access to more than 26,000 pharmacies. Conveniently fill prescriptions for maintenance medications and have them delivered to your home by using the mail order service.
- Alternative care benefits for chiropractic manipulation and acupuncture services when care is received from a licensed qualified practitioner and determined as medically necessary. See your Chiropractic Manipulations and Acupuncture Plus benefit summary for more information.
To view your benefit summary or handbook, create a myProvidence account or log into your existing account. With a secure myProvidence account, you can also:
- View your claims history, personal deductible and out-of-pocket maximum information
- Create an inventory of your medical history
- Develop a health improvement plan
- Track your health progress
- View and manage your family's medical claims
- See your explanation of benefits (EOB) and sign up for paperless EOBs
- Order a replacement member ID card