Make the most of your health plan benefits

The following tips can help you save when you receive care:

Tip 1: Use your preventive care benefits; certain services are covered in full

Your plan covers certain preventive services in full when received from an in-network provider. 

Tip 2: Access care from select specialists and receive a higher level of benefit

As a Providence Health Reimbursement or Health Savings medical plan member, you will receive higher coverage if you receive care from a Providence St. Joseph Health or affiliated specialist.

To find a Providence St. Joseph Health or affiliated specialist:

  1. Visit the online provider directory.
  2. Search by member ID number for best results or enter as a visitor (click on browse by provider networks). If you enter as a visitor/browse by provider networks:
    Under the Choose plan type drop down menu, select Specific employer groups.
    Under Choose provider network, select your employer and region then Search.
  3. Choose Find a care provider then Specialists.
  4. Choose the type of specialist you need to see. 
  5. On the right side of the Specialist Search Results page, check the Preferred Network (Tier 1) box and Update Filters.

Tip 3: Choose in-network providers and receive a higher level of benefit

To find an in-network provider and access a wide range of services, visit the online provider directory. For the highest benefit, follow the instructions listed above to find the type of care you need. Providence Health Plan members in Eastern Washington can also access in-network care for select services from Group Health (PDF).

Tip 4: Choose generic medications, use participating pharmacies and mail-order services, and have certain medications prior authorized.

Use participating pharmacies to make the most of your pharmacy benefits. To find a participating pharmacy near you, search the online provider directory. If you prefer, call Providence Health Plan customer service at 800-878-4445, Monday through Friday, 8 a.m. to 5 p.m. to help locate a participating pharmacy or in-network provider. Plus, take advantage of additional pharmacy resources to help you save.

Purchase up to a 90-day supply of maintenance drugs using a participating mail-order pharmacy or a preferred retail pharmacy. Not all drugs are considered maintenance prescriptions, including compounded drugs, drugs from specialty pharmacies and oncology drugs.

Tip 5: Know what services need to be authorized before you receive care.

Certain services require a prior authorization, meaning that before you receive care, the service must be authorized by Providence Health Plan. Learn about prior authorization.