You have a prepaid debit card you can use to pay for certain dental, vision, hearing and over-the-counter items.
Earn a bonus card for seeing your primary care provider and staying current on preventive health services. It looks similar to your Benefits Mastercard but is used differently. You can use this card at many retailers or to pay for other expenses.
Feel safe and secure with Samaritan Advantage Health Plan’s Personal Emergency Response Systems or PERS. A PERS device is a wearable electronic device with a button used to call for help during any emergency. When pressed, a 24/7 monitoring center is alerted.
As of Jan. 1, 2024, members can ask for the Mini Guardian, MGMinilite or the MGMove PERS devices by calling our service provider, Medical Guardian at 800-914-5531.
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Learn more about this exciting benefit and the Personal Emergency Response System devices you can choose:
If you need additional copies of your member materials, please contact Customer Service.
Click on the link below to download our Summary of Benefits and review details about your plan’s medical, dental and prescription drug benefits, copays, coinsurance and more.
For detailed plan information including how to use the plan’s coverage to obtain medical services, your rights and responsibilities as a member, important phone numbers and other resources, see your plan’s Evidence of Coverage.
To see how your plan benefits have changed from year to year, see your plan’s Annual Notice of Changes.
Learn which medical services, procedures, supplies and equipment require our written authorization before being performed or supplied. Review the Prior Authorization List.
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As a Samaritan Advantage Health Plan member, you can schedule a ride to your doctor, pharmacy or any health-related location with Cascades West Ride Line. Rides can be scheduled 365 days a year, 24 hours a day. Some restrictions may apply.
Find rules and policies for how we cover medical services.
Medical Coverage policies are developed to communicate Samaritan Health Plans decisions about coverage and benefits for various medical services. Determinations are made after careful consideration of evidence, insurance plan factors, Medicare rules, community standards, service availability and other applicable factors.
For Samaritan’s Medicare Advantage Health Plans, we use applicable content from Medicare National Coverage Determinations, Local Coverage Determinations and the Medicare Benefit Policy Manual.
If there is not a Medicare Guideline (NCD/LCD) available, Samaritan Health Plans will use nationally recognized evidence-based guidelines from MCG Health. Care guidelines from MCG provide evidence-based medicine’s best practices and care plan tools across all areas of treatment, providing clinical decision support and documentation which enables effective transfers between different care settings.
On the rare occasion that no appropriate guideline exists from the sources above, Samaritan Health Plans uses a small number of internally developed Samaritan Health Plans medical coverage policies, listed below:
Our Customer Service Team is happy to help! We are here to serve you.
Call us at 541-768-4550 or toll free 800-832-4580, (TTY 800-735-2900). Our service hours are:
*Samaritan Advantage cannot pay for services rendered by providers who have opted-out of Medicare.
Page Updated 8-30-2024
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Choice, Employer Group & IHN-CCO members call 541-768-4550 or 800-832-4580 (TTY 800-735-2900). Samaritan Advantage members call 541-768-7866 or 866-207-3182 (TTY 800-735-2900). Sales agents are available. Hours: Monday through Friday, 8:30 a.m. to 5 p.m.
Customer Service is available. Hours: Monday through Friday, 8 a.m. to 8 p.m.
Samaritan Advantage Plans members only: From Oct. 1 to March 31, Customer Service is available daily from 8 a.m. to 8 p.m.
Samaritan Advantage Health Plan is an HMO with a Medicare and Oregon Medicaid contract. Enrollment in Samaritan Advantage Health Plan depends on contract renewal. Other providers and pharmacies are available in our network. This information is not a complete description of benefits. Call 866-207-3182 (TTY: 800-735-2900) for more information. Limitations, copayments or restrictions may apply. Contact the plan for more information. Benefits, copayments or co-insurance may change on January 1 of each year. The pharmacy and/or provider network or formulary may change at any time. You will receive notice when necessary. Samaritan Advantage Health Plan complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.
Samaritan Advantage HMO plans are available only in Benton, Lincoln and Linn County, Oregon.
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