Welcome to insurance talk with Cheri Martinen. I am here today with a special guest from Providence, Autumn Edwards. We are so glad to have Providence here as they have a bunch of new plans available in Deschutes County for the 2024 Medicare Annual Election Period.
Providence Dental Plan Changes 2024
Some really exciting new news for Providence Dental in 2024. Providence is pleased to announce that they are now partnering with Delta Dental, the Medicare Premier Network. Delta Dental is a well-known name throughout the entire country, not just in Oregon. This benefit is going to be on all of the plans. If you are currently on a Providence plan and not making a change, you will automatically receive the new dental benefits in 2024 plan year. There is nothing you need to do.
Benefits include two cleanings, x-rays and periodontal cleanings. Also new this year with the Timber Plan, which is the $0 HMO plan, in addition to the embedded benefits you get a $350 dental flex card, which works kind of like a credit card. This could be used for things like nitrous for extractions, etc. Just to help you stretch your budget a bit further. If you are currently on the Timber Plan, you will automatically receive this card in the mail. Or you can learn more by talking to an agent.
Providence is Offering a $0 Plan in Deschutes County in 2024
The $0 plan is a true HMO, which means you do need to go to doctors on the list and get a referral to go the next step. But our referrals are a little bit different, because we’re a truly integrated system. Integrated system means that the doctors and the insurance companies are on the same team. So, if the doctor says you need something, then it’s an easy referral because we do what the doctors say. If you need to see multiple specialists, there will be no round and round with this plan.
When you’re talking about specialists, we got to talk about the network. Providence’s network is not just a small, localized network. Providence is a local company and yes, we are Oregon based and yes, our customer service is here in Oregon, but our network is rather vast. You will be very hard pressed to find a doctor here in Central Oregon that’s not in our network. Our network also includes specialty offices in Portland and Seattle, even Spokane.
When it comes to hospitals, Providence is the proud sponsor of five different hospitals that have top five star rated hospital services. This includes the heart clinic in Portland, St. Charles in Bend, High Lakes, Mosaics, Women’s Care, etc. You don’t have to leave Central Oregon to get your care. You can stay right here and get excellent service.
But if you are referred to somebody somewhere else, they’ll probably also be in network probably, which is great. Yeah. I think you guys have something about stars this year too.
Providence is a five-star plan, but what does that mean for everybody? A five-star plan is the highest rating that the Centers for Medicare and Medicaid (CMS) gives out, which means we got a perfect score. That means that if you want to enroll in a Providence plan, you can do so right away. You don’t have to wait until AEP, that’s what time this is now. But you can, but essentially that means that you don’t have to wait until January to enroll in one of our, one of our plans because we have the five-star.
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What is the Providence HMO Network?
An HMO is a health maintenance organization. You must go to doctors on the list. We do not need referrals to any of our plans. No referrals needed. But an HMO means you do need to stay in the network, but our network is Oregon and Washington, so it’s a pretty vast network for an HMO.
Another option is an H-M-O-P-O-S, which allows you to go in or out of network. And that’s the bridge plan. Providence has lowered the cost on the bridge plan this year, to only $29. And if you qualify for extra help through medicare.gov, that plan becomes zero.
With that bridge plan, you have $70 worth of over-the-counter benefits, it’s a per quarter benefit, but the per quarter rolls over. These benefits are great for things like Tylenol, bathroom scales, cold and flu medicines, flu shot, Band-Aids, toothpaste, sunscreen, etc.
What is the Providence HMO POS Plan?
The other Providence plan to discuss is the HMO POS Plan, which is a bridge plan, and an HMO POS is a health maintenance organization point of sale. So, it’s a hybrid. On this plan if you go to doctors on the list and you get the referral, then you’re going to pay a lower copay. But you have the option to go out of network and you have the option to not get a referral. Let’s say you need to go to Cedar Sinai or Cancer Centers of America down in Arizona, you absolutely can and you’re just going to pay an out of network. This plan really opens up the entire US for your care options.
And just for people who might be like going like what, what’s the difference between the zero and this one? So, the big difference is the network flexibility there. Like what you’re paying for in network cost versus out of network costs.
There’s one other thing that makes the difference. The HMO POS, that bridge plan is a little bit more expensive. Like I said, it’s $35, but that also means that our dental network is in or out of network. If you currently have a favorite dentist that you just adore, great. Keep ’em, you don’t have to change, you can absolutely keep ’em. And you’re still going to get your dental cleanings. You get two a year plus your x-rays covered at no charge. In South County it’s hard to get a dentist that’s always on the list. So that extra $35 instead of the $0 might just be worth it. Just for the dental.
Providence Gym Program
All Providence plans come with gym benefits, including Medicare Supplement Plans, and they’ve always used Silver and Fit, but this year they are changing it up a bit. The Silver and Fit program has been fantastic, and they’ve been a wonderful partner, but this one takes all the same gyms that are already with Silver and Fit and kind of takes it to the next level.
Starting in January 2024, you can go to those same gyms, but you can gym hop, meaning you can go to a different gym everyday if you wanted. This does not include all gyms, so please check with Providence for a complete list of options in your area.
Providence Prescription Drugs Coverage
We have removed the deductibles on all of our plans, which means you have first dollar coverage. We also just lowered a bunch of tier twos down to tier ones and that makes it exciting because our tier one drugs are no charge and there’s no charge if you go to a preferred pharmacy or you go through the mail. However, if you go through the mail, you will receive a 90-day supply.
We are also part of the Senior Savings Program, which is the insulin program. For someone on insulin, it is just $35. There is no donut hole for that plan. If you are insulin dependent, you’re not going to fall into the donut hole for the insulin. Which is a really big deal if you’re taking insulin. And this is something that I think a lot of people have been working on for a very long time.
Our vaccines are also no charge. This includes the flu shot, shingles vaccine, whooping cough and pneumonia.
Providence now covers glasses, up to $250 for lenses and frames. There is no network, so participants are free to visit any provider they like.
Telemed has just skyrocketed because of Covid and that is the same price as going to your primary care. So, no charge to see your doctor that way. You can do telemed, you can do our Providence nurse line which is available 24 hours a day. One of the benefits of doing a virtual visit if you don’t want to go into the clinic, like let’s say you’re just not feeling confident in sitting in somebody’s waiting room, you don’t have to, you can do it virtually. It’s all included.
Naturopath or Holistic Medicine
If you are someone that prefers a more holistic approach, we do include naturopath coverages such as massage, acupuncture and chiropractic. Participants now have up to 18 acupuncture, 18 chiropractic, and 6 naturopathic visits all for a $20 copay.
To enroll in a Providence Medicare Advantage Plan, simply request an appointment with one of our insurance agents via phone at (800) 452-6826 or on our online calendar.
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Bancorp Insurance represents 7 companies in Deschutes, Klamath, and Lake County for Medicare Advantage Plans. For additional information about Prescription Drug and Medicare Supplement Plans, please make an appointment with an agent. For a list of all options in your area, you may also visit Medicare.gov, Healthcare.gov or shiphelp.org, or call 1 800 MEDICARE.
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