Here is what members need to know about their coverage
-
Individual and Family
Current members will maintain coverage through the 2026 plan year.
Policies will be discontinued effective January 1, 2027. Providence will not offer individual and family plans in 2027 or beyond.
Members will be able to shop for a new plan during the open enrollment period this fall.
-
Medicare Advantage
Current members will maintain coverage through the 2026 plan year.
Providence Medicare Advantage members may be able to keep their plan in 2027. We will share more details as they become available.
Members should connect with their agent/broker to explore options for 2027. Members can also research plans on Medicare.gov.
To find an agent:
In Oregon, visit: https://healthcare.oregon.gov/pages/find-help.aspx
In California, visit: https://www.insurance.ca.gov/01-consumers/105-type/findagtbrk.cfm
In Washington, visit: https://www.insurance.wa.gov/agent-and-company-lookup-tool
Medicare Annual Enrollment Period begins October 15.
-
Medicare Supplement
Coverage for current members remains in effect at this time.
Members will receive individual notice well in advance of changes for 2027.
-
Medicaid
Coverage will continue through 2026.
Members will continue to be covered by Health Share of Oregon CCO.
Providence is currently evaluating options with Health Share for 2027.
-
Large Group, Association and Administrative Services Only (ASO)
Current members will maintain coverage through 2026.
Providence Health Plan will not offer commercial plans in 2027.
-
Small Group
Current members will maintain coverage in 2026.
Small group plans will end at the end of 2026, with notice of at least 180 days to the employer group sponsor.
Frequently Asked Questions
-
1. Am I still covered? Will my 2026 plan remain active through the end of the year?
Nothing changes for members right now. Current members and customers will maintain their coverage through 2026. Members can continue to access medical services, fill their prescriptions and see their doctors just as they do today.
-
2. How will I be updated on what to do next and before the end of the year?
Members and employer policyholders will receive a series of communications to guide them through the transition and support them as they shop for and enroll in a new plan for 2027.
Over the coming weeks and months, you can expect:
- Written notices by mail and/or email
- Clear timelines and next steps
- Information about alternative coverage options
Medicare Advantage members, Medicare Supplement members and Medicaid members will receive additional communication as decisions are finalized.
Written notices may be sent by mail and/or email as required by regulation.
Updates will also be shared at: www.providencehealthplan.com/status-update. -
3. Can I keep seeing my current doctors?
Yes, if you are a current member, nothing will change in 2026. You can continue to make appointments and fill prescriptions as you have done in the past. If you are shopping for a new plan for 2027, it will be important to ensure your providers are in the new plan’s network.
-
4. Do I need to cancel existing medical appointments?
No. You should continue your care as scheduled in 2026. So long as your coverage remains active in 2026 that coverage will be honored.
-
5. I have Oregon Health Plan (Medicaid), what happens now?
Your coverage remains the same in 2026 and, as long as you are eligible for Medicaid, you will remain covered by Health Share of Oregon in 2027. Providence and Health Share or Oregon will be in contact with you with next steps.
-
6. What if I am in active treatment for a complex or long-term medical condition?
Nothing changes for your coverage right now. Your current plan remains in place through 2026, and you should continue your care as scheduled.
-
7. Who can I contact now with questions?
We’ll share updates as they become available at providencehealthplan.com/status-update.
-
8. How can I avoid a gap in coverage?
For Individual and Family or Medicaid members, the best thing you can do to avoid a gap in coverage is to keep a close eye out for communications, including USPS mail, email and phone calls, from Providence Health Plan or Providence Health Assurance. If you currently have coverage through your employer, they will be the best source of information for your coverage options beyond 2026.
We will provide you with clear and consistent communications from now through the end of 2026. You will want to pay close attention to any Special Enrollment or Open Enrollment dates, so you do not miss your opportunity to enroll in a new plan for 2027.
-
9. As a provider, what does this mean for my patients, and should I continue treating patients with coverage from Providence Health Plan?
Your patients’ current health coverage will continue until the coverage expires or is terminated according to its terms. Most plans will terminate at the end of 2026. You should continue to see and treat your patients at this time, verifying eligibility in the same way you do today. They should continue to attend their medical appointments and fill their prescriptions as they do today.
Leer más
Providence Health Plan da la bienvenida al Dr. Kyu Rhee al Consejo de Administración
Leer más
Providence Health Plan recibe el reconocimiento de Mejor compañía de seguros en U.S. News & World Report 2026
Leer más
Providence Health Plan nombra a Gillian Hays Directora de Estrategia y Gestión de la Red
Leer más