Here's a preview of the new benefits and programs we’ve added:

Progyny Family Planning Support

For Providence Health Plan members, PEBB has made an enhanced benefit available through Progyny for assistance with their family planning journey. You can pursue your fertility and family building journey with the support of a dedicated Patient Care Advocate (PCA) for optimal results. Your PCA will be with you every step of the way, providing guidance and support.

Rx Savings Solutions 

Rx Savings Solutions is a digital platform available at no cost. It’s linked directly to your health plan and provides personalized savings based on your medications and coverage. You’ll get alerts by mail, email, phone, or text for chances to save on your medications.

Joon Care

Joon Care provides online personalized suicide and crisis support for teens and young adults ages 13-26. Get individual therapy sessions with a licensed provider to get the help you need.

Mighty Health

Receive personalized virtual support to improve things like losing weight, moving better, and decreasing joint pain. A coach will help guide you through a program. That program can include daily health tasks, nutrition plans, lessons, and more to help you reach your health goals.

Birth Doulas

Trained birth doulas offer guidance, emotional help, and comfort. They are there for you before, during, and after childbirth. Doulas can also help families in other situations. Things like dealing with infant loss, adoption, language help, and more.

Choose from your two plan options below.

With either plan, you get:

• Preventive services, in-network at no cost ($0 deductible)
• Virtual visits, in-network at no cost ($0 deductible)
• Access to the nationwide Cigna PPO Network*
• Wellness resources to help with chronic disease, stress, diet and exercise, sleep, and much more
• Chiropractic manipulation and acupuncture (Statewide plan: 15% coinsurance; Choice: $10 copay)
• 8 professional Birth Doula visits per childbirth
• Visits to in-network specialists without needing a referral

These are the main differences between your plan options:

PEBB Statewide PPO Plan

Get more access with the Providence Statewide plan. You’ll be able to select more primary care providers (PCP), specialists, and pharmacies of your choice.

• $250 individual deductible; $750 family deductible
• Out of pocket maximum: $1,900 individual; $5,700 family
• Primary care: 15% or 10% coinsurance for the first four visits ($0 deductible)
• Specialty care: 15% coinsurance
• Access to the Providence Signature network (OHSU and Providence Hospitals)
  
  

Benefit Summary 

Providence Choice Plan (Medical Home)

The Providence Choice plan is led by a primary care provider at a medical home who knows you and your needs. They also can help coordinate your care with other providers.

• $250 individual deductible; $750 family deductible
• Out of pocket maximum: $1,500 individual; $4,500 family
• Primary care: $10 copay, first four visits ($0 deductible)
• Massage therapy: $10 copay, $1,000 maximum benefit
• Specialty care: $10 copay
• Access to the Providence Choice network, with over 400 medical homes

Benefit Summary 

*The Cigna Healthcare PPO Network refers to the health care providers (doctors, hospitals, specialists) contracted as part of the Cigna PPO for Shared Administration.

Cigna Healthcare is an independent company and not affiliated with Providence Health Plan. Access to the Cigna Healthcare PPO Network is available through Cigna Healthcare’s contractual relationship with Providence Health Plan. All Cigna Healthcare products are provided exclusively by or through operating subsidiaries of Cigna Corporation, including Cigna Health and Life Insurance Company. The Cigna Healthcare name, logo, and other marks are owned by Cigna Intellectual Property, Inc.

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.

Behavioral Health Network

We value whole self-care for all members. That’s why we’ve enhanced our focus on behavioral health and substance use treatment services. To simplify whole self-care, we’ve established a direct access line to a 24/7 dedicated support team that includes a crisis-trained staff.

Behavioral Health Concierge

Members in six states including Oregon and Washington can access virtual and confidential appointments at no cost. This unique solution-focused service is a convenient way to seek help from a mental health provider.

• Behavioral Health Concierge Flyer (PDF)
• Behavioral Health Concierge Flyer (Spanish) (PDF)

Talkspace

As a Providence Health Plan member, you also have access to virtual therapy through Talkspace. Get personal behavioral health and emotional wellness support through online counseling and therapy from one of the thousands of licensed counselors in the Talkspace clinical network.

• Talkspace Flyer (PDF)
• Talkspace Flyer (Spanish) (PDF)

Joon Care

Joon Care provides online personalized suicide and crisis support for teens and young adults ages 13-26. Get individual therapy sessions with a licensed provider to get the help you need.

Learn to Live

For comprehensive whole-health support, we also provide a virtual self-directed program called Learn to Live. Take advantage of interactive resources that are confidential and accessible from anywhere.

Our preferred retail pharmacy network gives you access to over 34,000 participating pharmacies. With in-person and mail order options, you can conveniently access the prescriptions you need. Save yourself both time and money with our resources.

List of covered drugs

We provide members with an in-depth list of covered drugs, called a formulary. It promotes affordable and effective medications including brand-name and generic options.

Participating pharmacies

You have nationwide access to thousands of participating pharmacies. 30-day and 90-day supplies are available.

Mail-order pharmacy

Use mail-order to get a 90-day drug supply, at a reduced cost, delivered directly to your home.

Specialty pharmacy

Specialty drugs include those that require careful handling or administration (like refrigeration or complex injection instructions). Your specialty care team will help coordinate everything for you. We also offer support to help reduce costs.

Two programs available to help you save money on medications:

Rx Savings Solutions is a digital platform available at no cost. It’s linked directly to your health plan and provides personalized savings based on your medications and coverage. You’ll get alerts by mail, email, phone, or text for chances to save on your medications.

Smart RxAssist

Our Smart RxAssist program lowers some specialty drug costs. Eligible members are enrolled automatically. A specialized patient navigator will assist you every step of the way.

Prescription drugs summary of benefits

Providence Statewide PPO Plan & Providence Choice Plan (Medical Home)

• $50 deductible per person or $150 for families
• Out-of-pocket maximum $1,000 per person, family maximum of $3,000
• $0 copay on value drugs
• $10 copay on generic drugs
• $30 copay on brand name drugs
• $100 copay on specialty drugs
• Copay x2.5 for 90-day supplies
• No Rx fertility annual benefit maximum

With Providence Health Plan, you can connect to care in minutes via phone or video chat with a provider or nurse. Virtual care is covered in full, with no cost to you.

Telehealth

Telehealth is a convenient option for getting care wherever you are. It includes all virtual visits using a teleconferencing application, such as Zoom.

ExpressCare Virtual

ExpressCare Virtual is available for members who don’t have the time or ability to travel to a clinic for treatment. You can address non-urgent medical issues. Available nationwide. Access 7 days a week from a tablet, smartphone, or computer.

ProvRN

Providence Health Plan members can call ProvRN 24/7 to ask questions about their health. You can speak with a registered nurse in minutes. Nurses are available to listen and provide answers as best as possible.

Kaia Health

Join over 500,000 people who have turned to Kaia for pain relief

Kaia is an evidence-based digital therapy app. It helps you learn ways to manage joint and muscle pain throughout the entire body. Receive a customized therapy plan that can include exercise, relaxation, and expert advice.

Mighty Health

Programs and support for weight loss and feeling your best

Receive personalized virtual support to improve things like losing weight, moving better, and decreasing joint pain. A coach will help guide you through a program. That program can include daily health tasks, nutrition plans, lessons, and more to help you reach your health goals.

Omada

Take steps to prevent diabetes

The Omada program helps reduce the risk of prediabetes and chronic disease. It offers nutritional guidance and weight loss resources. Your care path includes certified health coaches, condition-specific peer groups, and virtual physician visits.

Virta Health

Type 2 diabetes reversal is here

Virta is a provider-led and research-backed treatment. It can help reverse type 2 diabetes. You can work to lower your blood sugar and A1c, all while reducing diabetes medications and losing weight. With a personalized treatment plan from Virta, you get professional support and useful resources. 

Weight Watchers (WW) 

Assistance in tracking what you eat and working towards your goals

Eat well, move more, and lose the weight you want with a personalized action plan. Get progress reports, easy-to-use-tracking tools, and thousands of recipes. Also take advantage of 24/7 coaching. All from an app on your phone.

With myProvidence, you have on-demand access to your personal health plan information anytime, anywhere. Check out helpful tools and resources specific to your plan. Things like:

• Find in-network providers and pharmacies
• View your digital member ID card
• Estimate medical and pharmacy costs
• View claims and explanations of benefits (EOB)
• View progress towards your deductible and out-of-pocket maximum
• Access exclusive member discounts on fitness memberships, travel, and more

Additional programs and benefits available to you:

One Pass Select™

You have access to thousands of participating fitness centers and workout videos on demand along with grocery delivery.

Providence Health Coaching

Get help from a Providence Health Coach to reach your health and wellness goals. Whether via phone, e-mail or webinar - they’ll help you stay motivated, overcome barriers, and improve your well-being.

Travel Assistance

Get emergency medical help while traveling away from home, or even internationally, with Assist America Travel Assistance.

ID Protection

Get peace of mind with Assist America Identity Theft Protection’s fraud monitoring, warning, and resolution.

LifeBalance

LifeBalance provides savings on more than 20,000 travel, cultural, recreational, and other fun activities.

Use the documents and links below for at-your-fingertips access to resources designed to help you make the most of your coverage.

Member Resource Guide

Learn about benefits, programs, and tools available through your Providence plan coverage.

• Member Resource Guide (PDF)
• Member Resource Guide (Spanish) (PDF)

Provider Directory

Use our online provider directory to locate a doctor, clinic, pharmacy or other care provider near you.

Benefit Resources 

Enjoy more than just great coverage. Access benefit resources designed to support you.