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2022 plan comparison

This is only a brief comparison of benefits. Medicare coverage rules apply to the benefits listed below, for instance, you must continue to pay your Medicare Part B premium.

Providence Medicare Align Group Plan + RX (HMO)

Providence Medicare Flex Group Plan + RX (HMO-POS)

   In-plan  In-plan  Out-of-plan
Out-of-pocket maximum $1,500 $3,000 combined in- and out-of-network
Deductible $0 $0

Benefits  You pay  You pay
Fitness center membership  Standard Fitness center membership is included at no additional cost. Premium fitness center memberships are available for an additional cost per month.
Doctor's office visit (PCP)  $15  $20  $30
Specialist Visit  $20  $25  $35
Virtual Visits  $0 $0  No coverage
Preventive Care  $0  $0   $0
Lab  $0  $0  20%
X-ray  10%  10%   20%
Durable Medical Equipment  20%  20%   20% 
Diabetic Supplies  $0  $0   20%
Outpatient Surgery  $75  $150  20%
Inpatient Hospital  Days 1-5: $100
Days 6 and beyond: $0
Days 1-4: $125
Days 5 and beyond: $0 
 20%
Skilled Nursing Facility  Days 1-100: $0  Days 1-20: $0
Days 21-100: $50/day
 20%
Home Health  $0  10%  20%
Mental health and chemical dependency counseling  $20 $25 $35
Therapy: PT, OT, ST  $20 $25 $35
Chiropractic (Medicare covered only)  $20 $20 $35
Podiatry (Medicare covered only)  $20 $25 $35
Cardiac and Pulmonary Rehabilitation (Medicare covered only)  $20 $25 $35
Part B Medications  20%  20%   20% 
Hearing Services (Medicare-covered) $20  $25  $35 
Routine Hearing Exam  $0 $0 No coverage 
Hearing aids $399 – Advanced
$699 – Premium
$399 – Advanced
$699 – Premium
No coverage 
Medical Eye Exam  $20 $25 $35
Prescription Eyeglasses (lenses, frames, upgrades)  Covered up to $200 – every two years  Covered up to $200 – every two years  Covered up to $200 – every two years
Contact Lenses – in lieu of glasses  Covered up to $200 – every two years  Covered up to $200 – every two years Covered up to $200 – every two years 
 Worldwide Coverage
Urgent Care*  $25^  $25^  $25^
Emergency Room*  $50^  $65^  $65^
Ambulance (air/ground)  $50  $50   $50


*Diagnostic imaging may apply.
^Copayment is waived if admitted within 24 hours for the same condition.

Providence Medicare Advantage Plans is an HMO, HMO‐POS and HMO SNP with Medicare and Oregon Health Plan contracts. Enrollment in Providence Medicare Advantage Plans depends on contract renewal.