In some cases, your coverage may not coordinate benefits with Medicare Part A and/or Part B. If you wish to cancel your other coverage and recurring payments as well as ensure your dependents still have the coverage they need, please refer to the document below.

Transitioning to Medicare Advantage (PDF)

For assistance please contact 888-816-1300 (TTY: 711) Monday through Friday 8 a.m. to 5 p.m. (Pacific Time).

For questions about insurance through an employer see the next section.

If you plan to work past 65 and stay on your employer’s health plan, you may be able to put off enrolling in Medicare. To do so without penalty, you’ll need to meet the requirements. You must have active employer group coverage through an employer or a spouse’s employer. This may be impacted by the size of your employer group. Please reach out to your HR team or plan provider for more information. COBRA is not considered active group coverage and is not considered creditable coverage for Medicare Part A and Part B. 

Small company (fewer than 20 employees):

Suggest enrolling in Medicare Part B. If your plan assumes that you have enrolled; and if you don’t enroll in Part B, you will pay for the services Part B would have covered.

For example, if you see a physician and are charged $100, and your employer group’s plan covers $20, you will owe $80 if you haven’t signed up for Part B.

Large company:

Ask your employer. Some companies do cover Part B and some do not. Some employer plans may also be considered creditable coverage. “Creditable” means that the plan pays as much as or more than Part B would pay. If you don’t have creditable coverage and you sign up for Part B after your initial election period, you will have to pay a penalty.

It depends. If the employer prescription drug plan is considered creditable coverage, you don’t need to enroll in a Part D prescription drug plan. If the employer prescription drug plan is not considered creditable coverage, you will be subject to the monthly penalty if you do not enroll in a Part D prescription drug plan.

You and/or your Medicare-eligible spouse should receive a letter from the employer about whether the employer’s prescription drug plan meets the Medicare definition of creditable coverage.

If you have an income over a certain amount, you may be required to pay a higher premium for you Medicare Part B medical insurance and Part D prescription drug plans.

The extra premium amount is called the Income-Related Monthly Adjustment Amount (IRMAA). You must pay both the extra amount as well as your plan’s premium each month in order to keep Medicare prescription drug coverage.

Social Security will send you a letter if you have to pay extra for your Medicare medical insurance coverage or prescription drug coverage. Social Security’s letter explains how they determine the amount you must pay and the actual amount. If you disagree with the amount, contact the Social Security Administration at www.ssa.gov or 1-800-772-1213 (TTY: 1-800-325-0778), between 8 a.m. and 7 p.m. Monday through Friday, or visit your local Social Security Office.

If you need healthcare during a disaster and you cannot access an in-network provider, you may obtain care from an out-of-network provider.

Providence Medicare Advantage Plans will cover services rendered by out-of-network providers during a disaster at in-network costs. This coverage is available regardless of the type of plan you are enrolled in. You may not need prior approval from Providence Medicare Advantage Plans to receive out-of-network care during a disaster.

If you have prescription coverage, Providence Medicare Advantage Plans will also cover, at in-network cost, any prescriptions that you fill at an out-of-network pharmacy during a disaster.

A disaster is an event that occurs in a specific geographic location. An event qualifies as a disaster if: 

• The President of the United States declares the event to be an emergency or disaster under the National Emergencies Act or the Stafford Act
• The Secretary of the Department of Health and Human Services declares it to be a public health emergency under the Public Health Service Act
• The Governor declares it to be an emergency or disaster

If you aren’t sure of the status of a disaster, please visit https://www.fema.gov/disasters.

Your healthcare provider will need to bill Providence Medicare Advantage Plans for any care you receive during the disaster. They must do this regardless of the status of their contract with Providence Medicare Advantage Plans.

Depending on the severity of the event, there may be a delay in the time it takes to process your claims. If a delay occurs, you will be notified by mail.

If you have questions or concerns, please call Providence Medicare Advantage Plans customer service at 1-800-603-2340 or 503-574-8000; TTY: 711. 8 a.m. to 8 p.m. (Pacific Time) 7 days a week, October 1st through March 31st and Monday - Friday, April 1st through September 30th.