Benefits 101
SAIF and Providence Health Plan partner to offer you high-quality, comprehensive healthcare benefits designed with you and your family in mind. SAIF designed your healthcare plans; Providence administers these plans and provides resources to help you meet your health goals. We look forward to providing you with exceptional customer service and easy-to-find resources that are easy to find and use.
Your health benefits
As a Providence Health Plan member enrolled in a Providence Health Benefits Plan, you can count on comprehensive in-network benefits and providers when and where you need them. Highlights of your medical and prescription drug plans include:
- Provider choice
- No referral requirement
- Covered in full preventive care benefits
With our expansive national network of over one million providers, you can easily find a doctor close to home or when you’re traveling, and save money by choosing in-network providers for your healthcare needs.
We've made it easier for you to access the care you need. See an in-network specialist without a referral.
As a result of the Patient Protection and Affordable Care Act, you don't have to pay a copay when you receive preventive care services.
Explore the following topics to learn about your plan’s benefits:
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Member Resource Guide
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)
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myProvidence (secure member portal)
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
Register or log in
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Benefit summaries
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)
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Summary Plan Description (SPD)
- 2025 Summary Plan Description (SPD) (PDF coming soon)
- 2024 Summary Plan Description (SPD) (PDF)
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Summaries of Benefits and Coverage (SBCs)
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.
Learn more
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)
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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.
Learn more
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Pharmacy resources
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 Smart RxAssistTM
If you take an eligible specialty medication, Smart RxAssist may help 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
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.
Learn more
Pharmacy FAQ
Get answers to frequently asked questions about prescription drug coverage, prior authorization, using the formulary, and specialty medication.
Learn more
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Providence laboratory services
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
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Health and wellness resources
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
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Additional resources and tools
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.
- Tobacco quit line
- Care options
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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:
- 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
- LifeBalance Program
Contact customer service
We're here for you.
Reach out to us for help. We're happy to answer your questions or to assist you in finding the resources you need.
Get in touch