Plan features at a glance
Your benefits are designed to support your well-being. As a Providence Health Plan member you can count on comprehensive benefits and provider choice.
The following are plan highlights; refer to your member materials (available in myProvidence) for complete information.
- Care available from in-network and out-of-network providers. Your out-of-pocket costs are typically lower when you receive care from in-network providers.
- Access to nearly 1 million in-network providers nationwide.
- Care from in-network 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.
- In-network 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 34,500 pharmacies.
- Alternative care benefits for chiropractic manipulation and acupuncture services when care is received from a licensed qualified practitioner and determined as medically necessary.