These amounts depend on your level of Medicaid eligibility.  Providence Medicare Dual Plus (HMO D-SNP) is available to you if you have Medicare Part A and B, you have full Oregon Health Plan (OHP) Medicaid benefits, and you live in Clackamas, Multnomah, or Washington County.  You must continue to pay your Medicare Part B premium.  The Part B premium is covered for full dual enrollees who are eligible for Providence Medicare Dual Plus (HMO D-SNP).  Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive.  Please contact the plan for further details. 

*This benefit is part of a special supplemental program for the chronically ill. Members with diabetes mellitus, chronic and disabling mental health conditions, cardiovascular disorders, chronic lung disorders, neurologic disorders, and other eligible conditions not listed may qualify to receive this benefit. Eligibility for this benefit cannot be guaranteed based solely on your condition. All applicable eligibility requirements must be met before the benefit is provided. For more details, please contact us at 1-833-949-0263 (TTY: 711), 8 a.m. to 5 p.m. (Pacific Time) Monday - Friday.

Maximum Out-of-Pocket: You are not responsible for paying any out-of-pocket costs toward the maximum out-of-pocket amount for covered Part A and Part B services. Your yearly limit(s) in this plan in-network: $9,250. Additionally, maximum Out-of-pocket (does not include Rx drugs).