Individual and family insurance plan forms
2021 Oregon plans
Providence Individual & Family Plan Open Enrollment is closed.
If you have experienced a qualifying event, you may use the links below to make changes to your 2021 plan.
With this form, you can change your plan, add or remove dependents, or terminate your coverage. If you have a Marketplace policy, go to HealthCare.gov to make changes.
2020 Oregon plans
If you have experienced a recent qualifying event, you may use the links below to make changes to your 2020 plan.
With this form, you can change your plan, add or remove dependents, or terminate your coverage. If you have a Marketplace policy, go to HealthCare.gov to make changes.
2021 Washington plans
Providence Individual & Family Plan Open Enrollment is closed.
If you have experienced a qualifying event, you may use the links below to make changes to your 2021 plan.
With this form, you can change your plan, add or remove dependents, or terminate your coverage. If you have a Washington Health Benefit Exchange policy, go to WaHealthPlanFinder.org to make changes.
2020 Washington plans
If you have experienced a qualifying event, you may enroll
in a 2020 plan at WaHealthPlanFinder.org.
To make changes to your 2020 coverage, visit WaHealthPlanFinder.org.
Transition of care
Claims
Most providers bill Providence Health Plan directly; however, if you must submit a medical claim to Providence, please use these forms:
Pharmacy
Medical home selection