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. 

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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.

2023 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)

2022 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)

Summary Plan Description (SPD)

• 2023 Summary Plan Description (SPD) (PDF)
• 2022 Summary Plan Description (SPD) (PDF)

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.

2023

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

2022

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

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:

• Know what types of care are available to you and what is the most affordable choice for your health needs.
  
  Explore care options
  
• Get to know what a word or phrase means.
  
  Health care glossary
• Estimate and plan health care costs with the Treatment Cost Estimator.
  
  See how it works
• Access online health resources with myProvidence.
  
  Go now
• Know your preventive care benefits.
  
  Preventive care

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.

Formulary

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 
  
  

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.

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 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:

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

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

If you are located in Marion County, please see our list of participating lab locations. If you prefer, you can ask your provider to send your lab work to a facility that contracts with Providence Health Plan.

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

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.

More wellness information

If you have questions or need more information about our health and wellness options, visit our member website for additional details.