Providence Option Advantage Plan

• Benefit summary (PDF)
• Summary of Benefit and Coverage (PDF)

Providence CDHP/HSA Plan

• Benefit summary (PDF)
• Summary of Benefit and Coverage (PDF)

• 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 over 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.
• Access to a health education reimbursement.
• A health and well-being hub that offers a personal customized dashboard, nutrition and activity resources, health trackers, online wellness workshops, and more.
• Health coaching including one-on-one sessions with a Providence health coach and guidance to help you identify and take action towards healthier lifestyle and behavior choices.
• A comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy.

Refer to your member materials (available in myProvidence) for complete information about your plan's benefits.

Get the right care at the right time at the right place.

• ProvRN (free*) – With access to care 24/7, speak with a registered nurse anytime, any day. An easy first step when you have symptoms and you want to know if you need face-to-face care.
• ExpressCare Virtual (free*) - Talk with a provider from anywhere using your tablet, smartphone, or computer. This is a great option for prescriptions and treatment that doesn’t require hands on care. Available nationwide.
• ExpressCare Clinics - When you need to see someone and your regular care provider is not available. With many convenient locations (some in your local Walgreens), it’s easy to find a clinic near you.
• Primary Care - Primary care providers develop a relationship with you and know your health history. Visit them for check-ups, managing chronic conditions, and specialist referrals.
• Urgent Care - Urgent care is where you turn when you know you need help and can’t wait for an appointment. This is best for minor injuries, cuts, burns, pains, and sprains.
• Emergency Care - Use emergency care for suspected heart attack, stroke, severe abdominal pain, poisoning, choking, loss of consciousness, and uncontrolled bleeding.

*ExpressCare Virtual and ExpressCare Clinics are free with most plans. HSA plan members must first meet their plan deductible; then services are covered in full.

• Behavioral Health Resources: We're here for you when you need us. Meet with a licensed mental health provider that best suits your needs, fully confidential – always. Or, access Providence Behavioral health Concierge for virtual and confidential same-day or next-day appointments at no cost, with Providence licensed mental health providers.
• Our Providence health coaches are here to support your journey to a healthier, happier life.
• Active&Fit Direct™: Access more than 16,000 participating fitness centers, and over 4,000 workout videos on demand for only $25 a month.
• Save big on fitness and wellness products, services, and memberships with ChooseHealthy.
• LifeBalance provides savings on more than 20,000 travel, cultural, recreational, and other fun activities.
• Get peace of mind with Assist America Identity Theft Protection’s fraud monitoring, warning, and resolution.
• Get emergency medical help while traveling away from home, or even internationally, with Assist America Travel Assistance.

Use the documents and links below for at-your-fingertips access to resources designed to help you achieve True Health.

• Navigate your health plan with assistance from your Member Resource Guide (PDF).
• Learn more about how to make the most out or your preventive care options in our guide to preventive health care (PDF). Preventive care allows you to detect potential health concerns early before a more serious health issue shows up. It’s much easier — and far less expensive — to address health problems now rather than to try to cure them once they occur.
• Visit our online provider directory to locate a doctor, clinic, pharmacy or other care provider near you. The provider directory has recently been updated with more search options, including personal and professional attributes to help you select a provider, such as gender, race and ethnicity, personal identity, cultural sensitivity training, religious communities and more!
• myProvidence is your secure total health management website. Register for your account and log in any time to access plan information including plan materials, amounts met towards your deductible and out-of-pocket maximum, and a treatment cost estimator.
• Additionally, myProvidence includes access to Wellness Central, a health and well-being hub that offers:
• A personal and customized dashboard that's based on the your unique health needs, risks and activity.
• Nutrition and activity resources.
• Health trackers.
• Online wellness workshops built around a variety of health and wellness topics.
• Searchable library of health topics.


• Pride Employee Resource Group: we believe health is a human right and every person deserves the chance to live their healthiest life.
• Visit our COVID-19 resources page for answers to frequently asked questions about the COVID-19 vaccine, testing and treatment.
  Providence Health Plan encourages you to get the COVID-19 vaccine wherever there is availability. All COVID-19 vaccines approved or authorized for use by the U.S. Food and Drug Administration (FDA) are highly effective at preventing hospitalizations and death from COVID-19.