Header Graphic

2024 Provider Directory guidance for

Individual Health Plans

 

 ASKING THE RIGHT QUESTION

     One of the toughest part of evaluating an insurance plan is to understand what provider network your plan offers and how to talk to doctors office about this.    My best  advice is to get the precise name of your plan's network.   Let's say you have a PacificSource plan that uses the Navigator Network.   

 Do not ask the office "Do you accept PacificSource?"  Ask them  "Do you accept specifically the PacificSource Navigator Network?".  If the admitting person replies "Yes we accept PacificSource, ask again specifically   "Do you accept the Navigator Network?    If the front office person hedges, call the business office to confirm.    I stress this because PacificSource offers 15 networks, and a medical office may just accept 3 or 4 of these networks.  Save yourself some grief.

      To help you find contract providers I have update the network information for 2024 by company. If you ever have trouble and would like my assistance looking up providers I am happy to help.

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 as a Kaiser member.


 Click Here  to search Kaiser Providers 

 
    Kaiser members can also visit the non-Kaiser Portland Clinic offices around the Portland area with over 100 providers to choose from.  They will accept you as being In-Network
 
  

PROVIDENCE HEALTH PLANS


MEDICAL HOME REQUIREMENT:
      When you enroll in a Providence Plan you are required to select a Medical Home Primary Care Clinic, not a specific primary care provider.    A Medical Home Clinic is where you go for Primary Care.  You can your MHC selection anytime through your myProvidence portal or by calling Customer Service.   For 2024 a referral to a  Specialist physician is no longer required.  Just verify that they are in the same provider network.      Emergency Room and Urgent Care visits are the only services covered outside of your network nationwide.   

3 DIFFERENT PROVIDER NETWORKS:   
     Providence plans for 2024 will use one of 3 different provider networks:  The Connect,  Choice, or Signature Network.    The plan name will indicate what Network the plan uses.  The Connect Network is the smallest of the 3.   Make sure the doctors you want to use accept the plan network you are a part of by using the search tool below:

Click Here to search Providence Providers
 

 CONTRACTED HOSPITALS: 

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

 

PACIFICSOURCE 


PROVIDER NETWORKS:   
      PacificSource utilizes the Navigator Network in Oregon, Washington, Idaho and Montana.  When you travel outside of those 4 states you can use provider in the Aetna Signature Administrators Network. 

 
ASSOCIATED HOSPITALS LOCALLY:
 
    You are not required to select a Primary Care Doctor (PCP) when you enroll, and referrals are not required.    Legacy 
Meridian Park, Good Samaritan, Emmanuel, and Mt. Hood Medical are covered in the Portland area, as well as  Tuality, OHSU and Adventist Hospitals.  (Not Providence)   Silverton and Salem are also in the network.  
 
 
 MODA HEALTH PLAN


PROVIDER NETWORK:
     Moda uses a broad network of providers called the Beacon Network in the Portland area.  When you travel outside of Oregon,  they use a national network called the Aetna PPO Network for Emergency and Urgent Care.  

CONTRACTED HOSPITALS:
     Moda only contracts with OHSU, Portland Adventist, and Tuality Community Hospitals in the Portland area.  (not Providence or Legacy Hospitals)

Click Here to search Moda Providers
 

  REGENCE INDIVIDUAL PLANS 


    
 

2 PROVIDER NETWORKS BASED ON THE PLAN CHOICE


      LEGACY NETWORK:   Some plans utilize the smaller Legacy Network of providers.   Associated hospitals include Legacy Emanuel, Good Samaritan, Meridian Park,  Mt. Hood Medical and Silverton.   

     INDIVIDUAL & FAMILY NETWORK:   This is the larger network of contracted doctors which includes both Adventist, OHSU and Tuality hospitals in addition to the 5 Legacy Hospitals.

 

Click Here to search Regence Providers

 

 When you search for providers be sure you have selected the correct area and network in the top right corner.

 

NEED HELP?

    I recognize that looking for doctors that match up with your plans network can be a challenging thing to do.  I've been using these provider directories for 20 years now and I can be of assistance if you need help or are having problems.   Send me an email of the problem are having or doctor type you are looking for and I'll try to help.
 
    If you want to email me a list of doctors (first and last names) to danneils@gmail.com, I'd be happy to help you look them up in any of the provider search engines.   You can also give me a call at 503-650-4325    
 
 
 
 
 
 
 
 
 
 
 
 
 
 
UPDATED  12.10.2023
 
     

Currently there is no media on this page