Welcome, PEBB Statewide plan members
The PEBB Statewide plan is a PPO plan. The PEBB Statewide plan allows you to access care from primary care providers, specialists and pharmacies of your choice without a referral, from a network of nearly 1 million providers nationwide. You pay less for in-network services, more for out-of-network services.
- Full access to the nationwide Providence Signature Network, with approximately 1 million providers (includes OHSU)
- No referral requirements
- Coverage for medically necessary services when traveling internationally
- No-cost care visits through Providence Express Care retail clinics (where available), Providence Express Care Virtual and Web-direct visits
- Any amount paid toward your Providence plan deductible in October, November, and/or December 2019 is applied to your 2020 Providence plan deductible
PEBB Statewide plan members can pay less out-of-pocket for certain health care services when care is received at an OHA-approved patient-centered primary care home, also referred to as a PCPCH (i.e., a health clinic recognized by the Oregon Health Authority for their commitment to quality, coordinated care).
Refer to the provider director for an up-to-date listing of OHA-approved patient-centered primary care homes.
Searching on your own? To isolate these clinics, search:
- "Find a service or place"
- "See all facilities and clinics"
- In the "Filters" section on the left, click the box next to "OHA-approved patient centered primary care homes" (located near the bottom of the Filters column), then, "Update filters."
Tip: You can create a PDF of your results by clicking on the "PDF" icon (found at the top right of search results).
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.
You’re covered when you travel outside the U.S. Explore the following topics for answers to frequently asked questions about your benefits abroad:
What are my health plan benefits when I travel outside of the U.S.?
A. PEBB Statewide plan covers medically necessary services at the in-network benefit level when you and/or your covered dependents are outside of the United States.
How can I make sure I have the medications I need while on my trip?
A. The following will help you prepare for travel:
- Fill your maintenance medications. Allow at least 21 days to fill these prescriptions through a mail-order pharmacy or fill up to a 90-day supply at a preferred retail pharmacy.
- If you’re going to be out of the country for more than 90 days, please contact Providence customer service for extended request assistance.
- Keep prescriptions in their original containers with their original label.
- Take a copy of your prescription in case medications are lost or stolen.
What if I need to get a prescription filled while I'm in another country?
A. When filling a prescription outside the U.S., you will need to pay the pharmacy directly and submit a claim request (PDF) to Providence Health Plan for reimbursement. If you are taking a maintenance drug, you may be able to avoid this process by arranging to have your medications filled through a mail-order service or requesting an extended supply via Providence Health Plan. If you are on sabbatical or extended training that takes you outside the country for more than 90 days, contact Providence customer service to request extended supplies.
I rely on durable medical equipment to manage my health condition. What should I consider before I travel?
A. Know the airlines’ travel guideline associated with durable medical equipment.
Is there contact information I should take with me?
What documents will I need if I receive health care services outside the U.S.?
A. You will need your member ID card. You may also need an International Claim Form.
How will I find a hospital or emergency room if I need one when I'm outside the U.S.?
A. If it’s an emergency, that is you’re suffering from a life-threatening injury or illness, or a condition that would place your health in serious jeopardy, call the country’s emergency number. For instance, in the U.S. the emergency number is 9-1-1. In most European countries, the emergency number is 1-1-2. You can also call ProvRN – available 24/7 – to help navigate your health need.
How do I access medically necessary urgent care services?
A. Call Providence customer service at 800-878-4445. A representative will help locate a provider.
How are claims for health care services received outside of the U.S. paid?
A. How claims are paid depends on the provider. Some international providers submit a claim for health care services to Providence Health Plan on your behalf. In some cases, however, you may be required to pay for services when you receive care and file an International Claim Form with the plan.
How do I get reimbursed if I'm required to pay for services at the time I receive care?
A. Follow these steps to get reimbursed:
- We encourage you to call customer service about international travel health care services before you travel. This will streamline our efforts to assist you with any claims you may need to make while you’re out of the country.
- If you receive health care, request an itemized bill for the services you receive. If the bill is in a foreign language, please request that it be translated into English.
- Use this information to complete the International Claim Form.
- Ask the provider to complete the Health Care Provider section on the form.
- Submit your itemized bill, proof of payment and a completed International Claim Form to Providence Health Plan. Be sure to include your group and member ID numbers, both of which are located on your member ID card.
- Please note: Claims must be submitted within one year from the date of service.
What should I include on the itemized bill?
A. Itemized bills must include:
- Date of service
- Name, address, tax identification number, and address of the physician or other medical provider who provided the service
- Diagnosis and procedure code(s)
- Amount charged for each service
Where can I get additional information about benefits when I travel outside the U.S.?
Contact customer service
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Reach out to us for help. We’re happy to answer your questions or to help you find the resources you need.Get in touch