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Benefits 101

Your health matters!

SAIF and Providence Health Plan are partnering to bring you quality, comprehensive health care benefits that are designed with your and your family’s health needs in mind. SAIF has designed your health care plans; Providence, as your health plan administrator, will administer these plans and provide you resources to help meet your health goals. We look forward to providing you with excellent customer service and friendly resources that are easy to find and use.

Your health benefits

As a Providence Health Plan member enrolled in a Providence Health Benefits Plan, count on comprehensive in-plan benefits and providers when and where you need them. Highlights of your medical and prescription drug plans include:

  • Provider choice. With over one-million providers in our national network, it's easy to find a doctor wherever you live and where you travel. You can receive care from in-plan providers and/or out-of-plan providers. When you receive care from in-plan providers, you’ll usually pay less for these services.
  • Access to specialist without a referral. You can see a specialist without a referral.
  • Preventive care benefits covered in full as a result of the Patient Protection and Affordable Care Act, meaning you don’t have to pay a copay when you receive these services.

Explore the following topics to learn about your plan’s benefits:

  • Member resource guide

    The guide is 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 for PHP members. 

    View or download

  • Member materials

    This section provides links to your health care benefit summaries and your Summary Plan Description. These resources are designed to help you understand and use your benefits throughout the year.

    2024 Benefit Summaries

    2023 Benefit Summaries

    Summary Plan Description (SPD)

    Summaries of Benefits and Coverage (SBCs)

    As part of the Patient Protection and Affordable Care Act, health insurers and group health plans are required to provide you with an easy to understand document that lists and describes your plan’s health benefits and insurance coverage. This document is called a Summary of Benefits and Coverage, or an SBC. The purpose of the SBC is to provide you with basic benefit information in a format that uses short, plain language. The SBC does not replace your plan’s benefit summary. All insurance companies are required to use the same form ideally making it easier for you to compare health plans, benefits and plan features.

    Get more information about SBCs

    2024 SBCs

    2023 SBCs

    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:

  • Behavioral health resources

    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.

    Access now
  • Pharmacy resources

    Providence Health Plan is pleased to provide plan members with a comprehensive prescription drug formulary designed to promote safe, effective and affordable drug therapy.

    Your formulary has the following enhanced features:

    • It’s easy to search
    • It includes information about the medication
    • It includes special considerations about the prescription, if applicable 

     2024 formulary

    You can search:

    • Alphabetically
    • By entering a portion of the drug name 
    • By therapeutic class

    Tips to help you save when you need a prescription
    • If you take an eligible specialty medication, the Smart RxAssist program helps lower your out-of-pocket costs to $0.
      • The list of medications eligible for this program is available here.
      • There is no cost to you for participating in the Smart RxAssist program.
      • You are automatically enrolled in the program if you take an eligible specialty medication in the Smart RxAssist program.
      • If you are filling an eligible medication in the Smart RxAssist program, a Patient Advocate may reach out to you to complete program enrollment.
      • Medications eligible for the program are subject to change.
      • Because this program provides a $0 cost not subject to the deductible, the tax laws regarding a health savings account make this program unavailable to those enrolled in the Health Savings Account (HSA) medical plan.

    Participating pharmacies

    As a member, you have access to more than 36,000 participating pharmacies, including retail, preferred retail, mail-order and specialty.

    Learn more

    Pharmacy FAQ

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

    Learn more

  • Providence laboratory services

    Your laboratory services are performed and processed at a facility that depends 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 are not in the counties listed above, request that your lab specimen be sent to one of the following facilities that contracts with Providence Health Plan:

    • LapCorp
    • Quest Diagnostics
    • Pathology Associates Medical Laboratories
    • Interpath Laboratories
  • Discounts and wellness resources
    myProvidence: one of many resources to help meet your health goals

    A proactive approach to prevention and early detection can ward off many serious medical problems and help you live a longer, healthier life. Online health and wellness tools are accessible through myProvidence, a secure website designed to help you manage all aspects of your health care. Create a myProvidence account, and you’ll gain 24-hour access to personalized tools and resources built exclusively for Providence Health Plan members. You can:

    • Create a Health Record
    • Take a Personal Health Assessment
    • Utilize health trackers to chart key health measurements
    • Research health conditions, treatment options and costs
    • Review your insurance claims history and details
    • Order a replacement Member ID card
    • Manage your health plan account and pay your medical bills
    • Manage your family's health

    Providence Basecamp

    Basecamp Prevention + Wellness classes and programs reach communities nationally and internationally through a combination of in-person and online offerings. This is where the planning begins to map your route, outfit yourself with the tools you'll need, and set out on your own personal health journey with a community that has your back. We’ll be here, right alongside you.

    Basecamp + The Well at PSVMC
    • In-person classes available at the Providence St. Vincent Medical Center campus. Located in the Mother Joseph Plaza building. Classes held in The Well (fitness studio) and in our conference rooms.
      • 9427 SW Barnes Road, First Floor, Portland, OR 97225

    Body Works at PPMC
    • In-person classes available at the Providence Portland Medical Center campus. Located within structure of the parking garage. Studio is accessed from street level sidewalk.
      • Body Works Fitness Studio 5127 NE Hoyt St., Portland, OR 97213

    For additional information contact us by phone (503) 216-0880 or email

    Extra discounts and savings

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

    • 24/7 nursing support – free medical advice from a Providence Registered nurse, just a phone call away through the ProvRN medical advice line.

      Learn more
    • Health incentives – discounts for health clubs, 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
    • Smoking cessation- Smoking is a powerful addiction. Quitting takes practice, patience and support. 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 cannot attend regular classes. Call 800-292-2336.
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