Do you have Medicaid (OHP) and Medicare?
You may qualify for a $0 Providence Medicare Dual Plus (HMO D-SNP) plan with $1,600 for groceries, $0 prescriptions, a $1,700 allowance for dental and more.
1-503-574-8416 (TTY: 711)
A Dual Special Needs Plan (D-SNP) combines your Medicare, Medicaid (also known as Oregon Health Plan), and Part D benefits in a more coordinated, focused care plan. The $0 Providence Medicare D-SNP plan covers everything under Original Medicare plus many extra benefits and services, including:
$1,600 for groceries
$400/quarter allowance for groceries and over-the-counter health items
$0 prescription deductible and $0 copays
$1,700 dental card
$1,700/year to spend on crowns, root canals and more
$0 eye exam with a $250 allowance for glasses and contact lenses
36 one-way trips to the grocery store, pharmacy, or other places
Get more benefits on a
$0 Providence Medicare
By choosing a Providence Medicare D-SNP plan, you gain extra benefits that are not available under traditional Medicare, such as simplified billing and an expert care management team.
Extra benefits to fit your needs
With our D-SNP plan, Medicare and Medicaid work together to help cover out-of-pocket costs and additional benefits not available under original Medicare.
Our Care Managers help you stay healthy by making sure you get the right care, and they help you access community resources and all your benefits.
Coordination of benefits
We simplify healthcare and improve your member experience by coordinating between Medicare and Medicaid to pay for claims and coordinate benefits between the two plans.
See if you qualify
The following are requirements that may qualify you for a Providence Medicare D-SNP plan:
- Dual eligibility (qualify for both Medicare and Medicaid - OHP)
- Reside in the area of service (the Providence Medicare D-SNP plan is currently available in Oregon in Multnomah, Washington and Clackamas counties)
- Residency (U.S. citizen or have legal permanent residency)
When can I enroll?
If you already have both Medicare and Medicaid (OHP), or you already have a D-SNP, you can switch plans once during a Special Enrollment Period (SEP) or during the Annual Enrollment Period (AEP).
Special enrollment period 1
(January 1—March 31)
Special enrollment period 2
(April 1— June 30)
Special enrollment period 3
(July 1 — September 30)
Annual enrollment period
(October 15 — December 7)
Explore our D-SNP benefits in detail
Download the Providence D-SNP benefit highlights guide to learn about advantages and services available to you. Just fill out the form to download.
Need more information about Providence D-SNP?
Download the Enrollment Guide for essential information, enrollment options available to you, and what to do next. Just fill out the form to download.
Frequently asked questions
Is a D-SNP an integrated Medicare-Medicaid plan?
No, a D-SNP is a Medicare Advantage plan type that limits enrollment to dual-eligible members only. However, it only covers the Medicare and Part D benefits, and not Medicaid benefits. Medicaid benefits are still administered through the State’s Oregon Health Plan program.
What is the Providence Medicare Dual Plus (HMO D-SNP) enrollment process, and how does it differ from the enrollment of non-SNP Providence Medicare plans?
Generally, the enrollment process is the same. However, since Providence Medicare Dual Plus (HMO D-SNP) may only enroll full- benefit dual-eligible members, an additional eligibility step is required. Our Membership Accounting team will need to verify Medicaid eligibility status in Oregon’s Medicaid Management Information System (MMIS) prior to enrollment.
When can a member join Providence Medicare Dual Plus (HMO D-SNP)?
Full-benefit eligible dual beneficiaries may enroll and/or switch plans:
- During the annual enrollment period
- Once per quarter for the first 3 quarters of the year
- During special circumstances such as a change in the level of Extra help or Medicaid
How can a member join Providence Medicare Dual Plus (HMO D-SNP)?
A member can join our Providence Medicare Dual Plus (HMO D-SNP) in the same ways that a member can join our other Medicare Advantage plans. For example, an individual can enroll via an agent/broker, a direct paper application, a telephonic application or any other methods we use to enroll Medicare Advantage members. Additionally, their State case worker can assist with enrollment.
Does Providence Medicare Dual Plus (HMO D-SNP) only enroll “in-house” duals (those enrolled in PHP Medicaid as well?)
No, Providence Medicare Dual Plus (HMO D-SNP) is open to any full-benefit dual-eligible members residing in the tri-county area regardless of coordinated care organization (CCO) or health share physical health plan managing their OHP coverage.
Are prescription drugs for Providence Medicare Dual Plus (HMO D-SNP) covered by Medicare or Medicaid?
Dual-eligible members are enrolled in limited drug plans through Medicaid. Providence Medicare Dual Plus (HMO D-SNP) includes Medicare Part D and is the primary prescription drug coverage.
Which drugs are covered by Medicaid?
Over-the-counter drugs on the OHP formulary only.
Can a member with Yamhill Community Care Organization (YCCO) Medicaid also be a Providence Health Assurance D-SNP Member?
Yes, if the YCCO Medicaid recipient lives in Washington County.
Disclaimers & things to know
Providence Health Assurance is an HMO, HMO-POS and HMO SNP with Medicare and Oregon Health Plan contracts. Enrollment in Providence Health Assurance depends on contract renewal.
We're here for you. If you need assistance or have questions please reach out to our customer service team at 503-574-8000 or 1-800-603-2340 TTY: 711 8 a.m. to 8 p.m. (Pacific Time), seven days a week.
To file a complaint about our marketing, you may call us at 1-800-603-2340 (TTY: 711) from 8 a.m.- 8 p.m. (Pacific Time), 7 days a week, by calling Medicare at 1-800-MEDICARE, 24/7, or by submitting an online form at www.medicare.gov. If you experienced issues with agents or brokers, please include their name in the complaint if possible.
Webpage is current as of: 10/01/2023