Providence Medicare Advantage Plans Review

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Expert reviewed by: Tammy Burns, insurance and healthcare consultant
Updated: October 10, 2021

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Tammy Burns
Medicare advisor and nursing consultant
Tammy Burns
Medicare advisor and nursing consultant

Tammy Burns is an experienced health insurance advisor specializing in Medicare and senior health issues, including Medicare Advantage Plans and prescription drug plans, as well as ACA certified for health insurance and other ancillary, life and annuity products.

Quick Providence Medicare Advantage Plans review: Providence is a regional insurance carrier offering high-performing Medicare Advantage Plans in select counties across Oregon and southwest Washington.

Providence Health Plan provides more than a dozen Medicare Part C Advantage Plans that target customers in eight Oregon counties, including Clackamas and Multnomah, and three counties in southwest Washington. This regional entity is part of Providence Health & Services, an organization with charitable roots and more than 160 years of industry experience. It provides medical insurance and integrated health care services to 650,000 members nationwide.

The company’s Medicare Advantage Plans include a variety of value-added benefits, including free fitness center memberships and access to a 24-hour nurse hotline. Read on to learn more about the Providence Medicare Advantage Plans that may be available in your area.

Pros and Cons of Providence Medicare Advantage Plans

What we like about Providence Medicare Advantage Plans: The drawbacks of Providence Medicare Advantage Plans:
  • Excellent customer satisfaction ratings
  • Optional supplements for dental coverage
  • Premiums starting at $0 per month
  • Limited geographic service area
  • Drug coverage is not available in all counties
  • Medicare plans are HMO only

What Do Providence Medicare Advantage Plans Cover?

Medicare Advantage Plans offered by Providence, also called Medicare Part C, combine Part A and B benefits. These components cover hospital care and all other medical services. Most Advantage Plans also include prescription drug coverage and a wide assortment of extras, such as vision, dental, hearing, fitness programs, and worldwide emergency medical care. Basic or enhanced dental coverage is available in select areas as an optional supplement for an additional $30 to $42 per month.

Providence Medicare Advantage Plan Options

Providence offers nearly 20 Medicare Advantage Plans. Options differ in each part of its 11-county service area. Coverage gives members access to the company’s group of HMO providers. Staying in the network helps members reduce their copays or coinsurance rates. Most plans include medical care and prescription drug benefits plus optional dental supplements and many free perks. Monthly premiums range from $0 up to $195 depending on the coverage tier selected. The company also offers a Medicare Advantage Special Needs Plan for Medicaid-qualified dual enrollees in select areas. Here’s an example of some of the plans that may be available in your area.

Plan Name Monthly premium Annual deductible Office visits Telehealth Emergency room Annual maximum out-of-pocket cost
Providence Medicare Prime + RX (HMO) $0 $0 for health/$150 for drug coverage $0 primary/$40 specialist $0 $90 $5,900
Providence Medicare Bridge 1 + RX (HMO-POS) $35 $0 health/$100 for drug coverage $0 primary/$35 specialist

$35 primary/$50 specialist out-of-network

$0 $90 $4,900 in-network/$10,000 in- and out-of-network
Providence Medicare Select Medical (HMO-POS) $51 $0 $15 primary/$30 specialist

$25 primary/$50 specialist out-of-network

$0 $90 $4,500 in-network/$10,000 in- and out-of-network
Providence Medicare Focus Medical (HMO) $128 $0 $0 primary/$20 specialist $0 $70 $3,400
Providence Medicare Extra + RX (HMO) $173 $0 $0 primary/$20 specialist $0 $70 $3,400

*Based on pricing in Washington County, Oregon

Providence Medicare Advantage Plan Reviews and Ratings

Government agencies and independent organizations give Providence Health Plan excellent ratings for customer satisfaction and quality of care.

Providence has a 4.0 rating from the National Committee for Quality Assurance, which falls into the high-performance category of the organization’s five-point rating system based on customer satisfaction, prevention, and treatment.

The BBB gives Providence an F rating with just four complaints closed in the past year and nine complaints closed in the past three years.

Providence Advantage Plans have an overall quality rating of 4.5 stars from the Centers for Medicare and Medicaid Services (CMS), which puts it well ahead of the industry average. It has a four-star rating for its health services and prescription drug coverage.

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