Providence Choice Plan (Medical Home)
Coordinated care from a dedicated health care team
A medical home is a team-based healthcare model led by your primary care provider (PCP). They work with other health professionals to coordinate care – like nurses, specialists and pharmacists – also known as your health care team. The members of this team work together to make sure they’re all on the same page when it comes to your health.
Medical homes are located in Clark, Klickitat, and Skamania counties in southwest Washington and most counties in Oregon. To find a medical home near you, visit the provider directory.
Provider directory
What you pay for certain services
| Providence Choice Plan (Medical Home) | ||
|---|---|---|
|
Medical
|
Deductible (in-network) | $250 individual; $750 family |
| Out-of-pocket maximum | $1,500 individual; $4,500 family | |
| Primary care | $10 copay for the first four visits per calendar year ($0 deductible) | |
| Specialty care | $10 copay | |
| Preventive services (in-network) | No cost ($0 deductible) | |
| Virtual visits (in-network) | No cost ($0 deductible) | |
| Massage therapy, chiropractic, and acupuncture | $10 copay (deductible waived) | |
|
Prescription Drugs
|
Deductible | $50 per person; $150 family |
| Out-of-pocket maximum | $1,000 per person; $3000 family | |
| Value drugs | $0 copay | |
| Generic drugs | $10 copay | |
| Specialty drugs | $100 copay | |
| 90-day supplies | Copay x2.5 | |
| Rx fertility | No Rx fertility annual benefit maximum |
For more coverage details, check out your benefit summary.
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Plan features
- Your choice of more than 400 medical homes*
- Access a broad selection of local Providence Choice Network providers, or national health care providers through the Cigna Healthcare PPO Network**
- In-network benefits apply for covered services provided or arranged by the medical home
- No referral requirements
- Coverage for urgent care and emergency services away from home
- Covered alternative care services include massage therapy
For more plan features, please refer to your Providence Choice Plan member handbook.
*Members must choose a medical home and notify the health plan of that choice to receive in-network benefits for covered services. See how to inform the plan of your medical home selection.
**The Cigna Healthcare PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna Healthcare PPO for Shared Administration. Cigna Healthcare is an independent company and not affiliated with Providence Health Plan. Access to the Cigna Healthcare PPO Network is available through Cigna Healthcare’s contractual relationship with Providence Health Plan. All Cigna Healthcare products are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Intellectual Property, Inc.
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Privacy disclosure
We respect the privacy of your protected health information. Your health care is a personal matter, and we are committed to protecting your confidentiality. We may share your protected health information with others as part of your treatment, to provide payment for your treatment, or during our business operations. Learn more about how we protect your health information.
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