Benefits 101

A single resource you can use to take an active role in your health and engage with your health plan. It provides useful information about myProvidence, care options, and other programs available to you. 

• 2024 Member Resource Guide (PDF)
• 2025 Member Resource Guide (PDF)

You have on-demand access to your personalized health plan information any time, anywhere. Explore helpful tools and resources specific to your plan coverage. myProvidence is where you can:

• Find in-network providers and pharmacies
• Choose a medical home
• View your member ID card
• Estimate costs for services
• Access claims and explanation of benefits (EOBs)
• View annual deductible and out-of-pocket maximum progress
• Take a health assessment to better understand your current health status
• Access exclusive member discounts on fitness memberships, travel, and more

2025 Benefit Summaries

• SAIF Active Plan (PDF)
• SAIF Prescription Drug Plan (PDF)
• SAIF Early Retiree Plan (PDF)
• SAIF Early Retiree Prescription Drug Plan (PDF)

2024 Benefit Summaries

• SAIF Well Plan (PDF)
• SAIF Well-aware Plan (PDF)
• SAIF Well-aware and Engaged Plan (PDF)
• SAIF Early Retiree Plan (PDF)
• SAIF Prescription Drug Plan (PDF)
• SAIF Early Retiree Prescription Drug Plan (PDF)

• 2025 Summary Plan Description (SPD) (PDF coming soon)
• 2024 Summary Plan Description (SPD) (PDF)

As part of the Patient Protection and Affordable Care Act, we are required to provide you with a document called a Summary of Benefits and Coverage, or an SBC. This document outlines and explains your plan's health benefits and coverage. The SBC is designed to help you easily understand the basic details of your plan, although it does not replace the detailed benefit summary. Since all insurance companies use the same format for the SBC, you can easily compare different health plans and their offerings. This helps you choose the best option for your healthcare needs.

2025 SBCs

• SAIF Active Plan (PDF)
• SAIF Early Retiree Plan (PDF)

2024 SBCs

• SAIF Well Plan (PDF)
• SAIF Well-aware Plan (PDF)
• SAIF Well-aware and Engaged Plan (PDF)
• SAIF Early Retiree Plan (PDF)

We know behavioral health care isn’t a one-size-fits-all solution. We’re all unique, and our journey and needs vary depending on our personal situation. At Providence, we want that lens to drive us when looking at the mix of services and solutions we offer for your well-being. Whether you’re looking for some support to relax, ready to try self-directed therapy that helps you to engage when you feel like it, or looking for immediate connection to a provider – via text, voice, video or face to face – we have many options to fit your needs.

Plan formulary

A list of FDA-approved medications, including brand-name and generic options, as well as medications that need prior authorization, follow a step therapy program, or have prescription refill limits. This comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy.

There are three ways to search your plan formulary:

• Use the alphabetical list to search by the first letter of your medication
• Search by typing part of the generic (chemical) or brand (trade) names
• Search by selecting the therapeutic class of the medication you are looking for

Save on eligible specialty medications with HelpScript^TM*

*Formerly Known as Smart RxAssist

A service that may help you lower your copay cost on certain high-cost medications.

HelpScript may reduce your copay to $0 on select specialty medications. Eligible members are enrolled automatically. A specialized patient navigator will assist you every step of the way.

Service Features and Eligibility

The HelpScript service may help lower your out-of-pocket costs to $0 for eligible specialty medications. In some cases, you may have a small fee which you will be reimbursed for via check within 45 days.

• There is no cost to members for participating in the HelpScript service.
• The medications currently eligible for the HelpScript service are listed below. Medications eligible for the service are subject to change.
• Because this program provides a $0 cost not subject to deductible, the tax laws regarding a health savings account makes the service unavailable to those enrolled in a Health Savings Account (HSA) medical plan.

HelpScript Service Eligible Medication List

Rx Savings Solutions

Providence Health Plan partners with Rx Savings Solutions to provide a free, confidential service to help you save money on prescriptions. This new service is linked to your health plan, so everything is personalized for your medications and insurance. Rx Savings Solutions alerts you via mail, email, phone call, or text (if you enroll in SMS messaging) if you have an opportunity to save on your prescription. A team of certified pharmacy technicians and pharmacists help walk you through every step of the process.

Here's how it works:

• Rx Savings Solutions uses software connected to your health plan. It looks at all the medications you take and finds options that may save you money.
• Your online account shows which lower-cost prescriptions may be available under your insurance plan and lets you compare prices. It also automatically lists all medications you’ve filled so everything is in one place.
• Rx Savings Solutions will contact you anytime you can be spending less.
• Switch to a lower-cost option with ease. At your request, the Rx Savings Solutions pharmacy support team is available to work with your doctor and pharmacy to help you switch to lower cost drugs, pharmacies, or mail order pharmacy.

To register for Rx Savings Solutions, visit myrxss.com/ASO/ProvidenceHealthPlan.

For additional support, contact Rx Savings Solutions at 1-800-268-4476 (TTY 1-800-877-8973), Monday-Friday, 5 a.m. to 6 p.m. (Pacific Time).

Participating pharmacies

Our preferred retail pharmacy network allows you to save time and money when getting prescription drugs. With this network, you have access to more than 34,000 participating pharmacies, including retail, preferred retail, mail-order, and specialty locations nationwide.

Pharmacy FAQ

Get answers to frequently asked questions about prescription drug coverage, prior authorization, using the formulary, and specialty medication.

Learn more

Your laboratory services are performed and processed at a facility based on your location. If you receive laboratory services in the following counties, ask that your lab work be sent to the nearest Providence Health & Services hospital or visit your nearest Labcorp:

• Clackamas
• Clatsop
• Hood River
• Jackson
• Multnomah
• Yamhill

For a list of Providence laboratory facilities and services in Oregon, visit our website.

If you do not reside in one of the counties listed above, request that your lab work be sent to one of the following facilities that contracts with Providence Health Plan:

• LapCorp
• Quest Diagnostics
• Pathology Associates Medical Laboratories
• Interpath Laboratories

Kaia Health

Kaia Health provides convenient self-care through a mobile app for any type of pain—sudden, occasional, or chronic. You'll get pain relief, unlimited access to health coaching, personalized physical exercises, and relaxation techniques, all at no cost to you.

Visit KaiaHealth.com to register and learn more.

Providence Basecamp

Basecamp Prevention and Wellness classes and programs are available both in-person and online, locally and globally, providing you with the tools and support you need to start and continue your personal health journey. We're here to support you every step of the way.

Basecamp

In-person classes are available at the Providence St. Vincent Medical Center (PSVMC) campus. Classes take place in The Well fitness studio and conference rooms in the Mother Joseph Plaza Building.

Providence St. Joseph Medical Center

9427 SW Barnes Road, First Floor

Portland, OR 97225

Body Works

In-person classes are available at the Providence Portland Medical Center (PPMC) campus. Classes take place within structure of the parking garage. The studio can be accessed from street level sidewalk.

Body Works Fitness Studio

5127 NE Hoyt Street

Portland, OR 97213

As a Providence Health Plan member with SAIF, access these resources to get the most appropriate and affordable care you need when and where you need it:

• Care options

  Know what types of care are available to you anytime, anywhere with in-person and virtual care options.

  
  Find care
  


• Healthcare Glossary

  Healthcare doesn’t have to be confusing. Visit Providence Health Plan’s Health Care Glossary to learn basic terms and phrases.

  
  Learn more
  


• Treatment Cost Estimator

  Estimate costs using the treatment Cost Estimator via myProvidence. You’re able to compare costs between providers and pharmacies and find copay and coinsurance information.

  
  Learn more
  


• myProvidence secure member portal

  On-demand access to your personalized health plan information and tools specific to your plan coverage.

  
  Log in or register
  


• 24/7 nurse advice line

  Free medical advice from a Providence Registered nurse, just a phone call away through the ProvRN medical advice line.

  
  Learn more


• Smoking cessation

  Quitting tobacco of any sort takes a commitment. And keeping your commitment can be challenging if you're trying to do it on your own You can get the help you need with one of our award-winning support groups and telephone counseling programs:

  
  
  • Tobacco quit line

    A free telephone service to help you develop a personalized quit plan and find counseling and resources in your area. Call 1-800-QUIT-NOW or 877-2NO-FUME (Spanish).

  • Free & Clear

    A telephone-based program designed for smokers who want a structured program, but are unable to attend regular classes. Call 800-292-2336.

There’s more. We encourage you to take advantage of these extra discounts and savings designed to help you stay active and healthy:

• LifeBalance Program

  Discover discounts for fitness memberships, retail stores, tours and museums, performing arts, massage, spa services and other healthy activities.

  
  Learn more
• Fitness, health, and nutrition classes

  Discounts on small-group classes that focus on everything from weight loss to yoga to childbirth. Classes vary by location; please select your location to see what classes are available near where you live or work. You can also request nutrition services to help meet your goals.

  
  Learn more