INDIVIDUAL PLANS FOR 2019        

       

      Before you look at plans and rates, here are a few important things to understand about the Providence Individual Plans. 

Choice and Connect 'Medical Home' Networks

   The plans in the Portland area require you to select a 'Medical Home' clinic in the first 30 days of being enrolled, or they will select a clinic for you.  You must go to that clinic for Primary Care Services and get referrals to go to other contracted providers within the network.   

The Connect Network offers about 70 medical home clinics, and the Choice Network offers about 300 medical home clinics.  There is no coverage outside of your plan's network except for emergency room visits nationwide.

To search to see what providers are in the Choice and Connect Network, please use the link below:

Providence Directory Link

http://phppd.providence.org/?_ga=1.104490944.1163329782.1446576415
 

ARE YOU ELIGIBLE FOR A TAX CREDIT?

       The Marketplace link below will allow you to enter your family size (A tax dependent for 2019), and projected income for 2019 (Adjusted Gross) to see if you qualify for a tax credit.  If you apply directly with Providence, you cannot qualify for a tax credit.  

  https://www.healthcare.gov/see-plans/

 

Providence Company Brochure

    You can view the Providence company brochure at the link below:

 

2019_Providence_Brochure_w_Rates.pdf

You'll find the rates for all the counties in Oregon, including the smoker rates.

 

2 Options to Enroll:  Marketplace or Direct

Advantages of Enrolling through the Marketplace. 

    Even if you don't qualify for a tax credit, you can apply through the Federal Marketplace at http://www.healthcare.gov .   Here are 4 advantages:

1. EASE OF APPLICATION: 
    The process is paperless, and each year you can easily select a new plan.  It's easy to also put different family members on different company plans or policies.  Call me at 503-650-4235 and we can do the Marketplace application together via screen-share/phone or in person.   If you decide to do the healthcare.gov application on your own, please consult with me first as it is easy to make a costly error.

2. TAX CREDITS: 
    The Marketplace is the only way to claim the tax credits.  Even if you don't qualify when you apply, you may later on in the year if your health or income changes.  I've had a few clients make costly mistakes when their income dropped mid-year.

3.  IF YOU SHOULD APPLY OR RENEW ON YOUR OWN:
   
   The Marketplace application asks "Is a Professional helping you complete this application?"  Here I appreciate you saying yes, then adding my agent name, Dan Neils, and NPN number, 757811.  This allows me to be compensated at no cost to you, and appoints as your broker should you need help during the year.   

4.  I'M HERE TO HELP:  
   Should you like my help enrolling or completing the annual enrollment I am at your service.  Just call me at 503-650-4325 or email me at danneils@gmail.com to set up a phone time or in person.  I can complete an application in 1/6 the time you can do so alone, and I can help you avoid common mistakes that are easy to make in an unfamiliar application.

 

Enroll Direct using my Broker Link

    Please only apply directly with Providence if you are certain you will not qualify for a tax credit in 2019.  The application will ask you if you are working with a broker.  Please click yes, and add in Dan Neils agent 175573.  This is how I am compensated at no cost to you.  Click on the link below to begin:

 

Look up Covered Prescription drugs:

    You may have some expensive Prescription Drugs and want to know how they may be covered for 2019.   The Providence Plans will use the Formulary 'J' for 2019.  You can look up drugs online using the tool below:  
 

 https://php.adaptiverx.com/webSearch/index?key=cnhmbGV4LnBsYW4uUGxhblBkZlR5cGUtODM2
 

 

 MAKING YOUR INITIAL PAYMENT:

   After you submit your paper application, you must make payment before the policy is finalized.  After enrollment Providence will either email you or mail you information on making this first payment and they give you an application number for reference.  If you lose this information you can pay online at http://www.providence.org/billpay

Option 2 is to pay by phone by calling the Enrollment dept at 888-821-2097 and make a phone payment.   

 

HANDY CONTACT INFO

Providence customer service:   503-574-7500

Providence Free Nurse Hotline: 800-700-0481 

Dan Neils 503-650-4325  danneils@gmail.com

 

$0 copay Express Care Virtual Video-visits

     This service allows you to conveniently meet as needed with a Providence provider through a laptop, tablet with camera, or smart phone you can set up the video visit with Providence.  From a computer use the link below to set up an account.   

https://virtual.providence.org

From a smart phone, download the Express Care Virtual app to install and set up an account.   If you have the Bronze HSA plan, the cost is $49.00 per visit.  This service is available to non-Kaiser members as well. 

 

$0 Copay Express Care Retail Clinics in Walgreens Locations

      Many plans include access to the nurses in the Walgreen's clinics at $0 copay.  Perfect if you have a cold or need to try to renew a routine prescription.    

https://www.providence.org/our-services/urgent-care/

 

VSP Vision Providers:  If your plan includes vision:  

     If you buy a plan with vision coverage, the in-network provider network is called VSP.  You can search for local providers at:          https://vsp.com

 

ADDITIONAL DISCOUNTS ON PRESCRIPTION DRUGS:

 

     Sometimes the Providence insurance discount is smaller than buying your prescription drugs through www.goodrx.com  Check to see the  price on GoodRX before filling your expensive prescription and ask for the lowest price.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2019 Providence Brochure w Rates

Click filename below to access file

2019_Providence_Brochure_w_Rates.pdf

2019 Providence Plan Comparison

Click filename below to access file

Providence_Plans_Compared_w_Summaries.pdf