2023 Provider Directory guidance for

Individual Health Plans

       One of the toughest part of evaluating an insurance plan is  the provider networks being offered and how to find those 'In Network' providers for your plan.   

      I hope this page will help you locate the providers you are seeking.  These links only search the Individual Plans, not Medicare or Small Group networks.  

       When you ask your medical provider if they accept a company, it is more important to ask if they are in the specific network that corresponds to your medical plan.    Here is an example of how your conversation should go:   "Do you accept the PacificSource Navigator Network?  "Yes, we accept PacificSource (they reply)",   "Can you check to make sure you specifically accept the Navigator Network?  Thank you! "

   It is important that they not just accept that company, but the specific network you plan utilizes.

KAISER PERMANENTE

    The In-network providers with Kaiser include all of the Kaiser providers in Oregon and other Kasier providers nationwide.  In the Portland area you can also visit the non-Kaiser,  Portland Clinic offices :


 CLICK HERE to search Kaiser Providers 

PROVIDENCE HEALTH PLANS

UNDERSTAND THE "MEDICAL HOME" REQUIREMENT:

        When you enroll in a Providence Plan you are required to select a Medical Home Primary Care Clinic, not a Primary Care doctor.  A Medical Home Clinic is where you go for Primary Care.  You can change clinics anytime through your myProvidence portal or by calling Customer Service.   You have access to in-network Specialists only with a referral from your Medical Home clinic.   Emergency Room and Urgent Care visits are the only services covered outside of your network.

UNDERSTAND THE 2 PROVIDER NETWORKS--CONNECT AND CHOICE NETWORK

         The Providence plans in the Portland area work with either the larger Choice Network, or the smaller Connect network.  Some providers only accept the Choice Network and not the Connect Network.  So do check your doctors to see if they accept the Connect network before you select the plan.   The plan name will reflect which network it utilizes.

CLICK HERE to search Providence Providers

CONTRACTED HOSPITALS IN THE PORTLAND AREA: 

Providence Glisan St., St. Vincent, Milwaukie, Willamette Falls, and Providence Newberg Hospitals. 

PACIFICSOURCE HEALTH PLANS

    Meridian Park, Good Samaritan, Emmanuel, and Mt. Hood Medical in the Portland area, as well as now Tuality, OHSU and Adventist Hospitals.  (Not Providence)