Providence Medicare Advantage Plans Review

Fact Checked
Reviewed by: Kelly Blackwell, Certified Senior Advisor®
Updated: April 16, 2022

Does Providence have good Medicare Advantage Plans? See ratings and learn what Providence covers.



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Kelly Blackwell
Certified Senior Advisor (CSA)®
Kelly Blackwell
Certified Senior Advisor (CSA)®

Kelly Blackwell is a Certified Senior Advisor (CSA)®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.

Medicare rating: 5 stars A.M. Best financial strength rating: Not rated BBB rating: F NCQA rating: 4 stars Consumer Affairs rating: Not rated J.D. Power ranking: Not ranked

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:
  • 2022 Plans received 5 star rating from Centers for Medicare and Medicaid Services (CMS)
  • 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?

Also called Medicare Part C, Medicare Advantage Plans combine Part A and B benefits with various extra services. Most Providence Medicare Advantage Plans include:

  • Prescription drug coverage (some plans)
  • Vision
  • Dental (enhanced coverage may be available as an optional supplement for an additional monthly premium)
  • Hearing
  • Wellness benefits, such as free gym memberships
  • Emergency response device
  • Medical transportation (some plans)
  • Wellness over-the-counter medications (some plans)
  • Worldwide emergency care (some plans)

If you are dual eligible for Medicare and Medicaid, you may qualify for a Providence Medicare Advantage Special Needs Plan (D-SNP).

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. All  plans include medical care. Some include prescription drug benefits plus optional dental supplements and many free perks. Monthly premiums range from $0 up to $173 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 2022 Providence Medicare Advantage Plans that may be available in your area.

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

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

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

(plan does not include drug coverage)

$15 primary/$30 specialist

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

$4,500 in-network/$10,000 in- and out-of-network
Providence Medicare Focus Medical (HMO) $128 $0

(plan does not include drug coverage)

$0 primary/$20 specialist $3,400
Providence Medicare Extra + RX (HMO) $173 $0 $0 primary/$20 specialist $3,400

*Based on pricing in Washington County, Oregon in 2022

Providence Medicare Advantage Plan Reviews and Ratings

Trusted ratings and reviews can help you understand how an insurer’s plans stack up against the competition. See how Medicare, the National Committee for Quality Assurance (NCQA), and the Better Business Bureau rate Providence Medicare Advantage plans.

Due to the limited service area and smaller scale size of Providence’s Medicare Advantage plans, ratings are not available from all entities that rate health plans.

Medicare rating: 5 stars Providence’s Medicare Advantage Plans have an overall quality rating of 5 stars, the highest rating possible, from the Centers for Medicare & Medicaid Services.
A.M. Best financial strength rating: Not rated Not rated
BBB rating: F The BBB gives Providence an F rating with just three complaints closed in the past year and eight complaints closed in the past three years. The reason cited for the poor rating is failure to respond to five out of eight complaints.
NCQA rating: 4 stars 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.
Consumer Affairs rating: Not rated Not rated
J.D. Power ranking: Not ranked In its 2021 Medicare Advantage Study, J.D. Power measured Medicare Advantage Plan satisfaction based on coverage and benefits, provider choice, cost, customer service, information and communication, and billing and payment. Providence is not ranked in the top ten.

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