An added benefit of the PHIP is the excellent travel benefits that are included with your medical and dental plan.
Additionally, if you are going to be out of your service area for more than 60 days, PHIP offers a unique feature known as the Snowbird Option.
Please note: You must maintain a permanent residence within a plan’s service area and reside in the United States in order to participate in PHIP.
Members may stay enrolled on the PERS Moda Health PPORX (PPO) plan for up to 12 months when traveling outside of the state of Oregon. This travel benefit allows members to receive services from out-of-state Medicare providers. For members enrolled in the PERS Moda Health PPORX (PPO) plan and traveling outside the U.S., emergency care is covered worldwide.
Coverage is limited to eligible emergency medical care expenses incurred outside the U.S.. These are emergency room, urgent care and ambulance services. Coverage for emergency and urgent services outside of the United States is limited to $50,000 lifetime limit per member.
Kaiser Permanente members temporarily outside the service area are covered for emergency care, urgent care and medically necessary ground or air ambulance service worldwide under Medicare plans. Medicare members also have a limited travel benefit that covers routine and follow-up care worldwide.
Currently enrolled Medicare members who permanently move outside the Kaiser Permanente Northwest service area or who are out of the service area for six consecutive months or more must disenroll from their Medicare Advantage plan.
Members temporarily visiting other Kaiser Permanente regions or Group Health Cooperative service area may receive visiting member care from designated providers in those areas for Medicare plans. For information about service areas and facility locations in other regions, please call Kaiser Membership Services.
If you do not use Kaiser Permanente’s physicians and hospitals, neither Kaiser Permanente nor Medicare will cover your services, except for emergency and urgent care, authorized referrals, renal dialysis outside the service area per Medicare criteria and travel benefits.
Members are covered worldwide for the following four services.
These services do not require prior authorization.
All plans offer worldwide coverage for urgent and emergency care and include ambulance coverage (air and ground).
Includes a travel benefit for necessary follow-up care from any Medicare provider outside the plan service area. Providence pays 80% and the member pays 20%, up to a combined $1,000 annual limit.
The Point of Service (POS) benefit with the plan allows you to see any Medicare-approved provider.
Members traveling outside of the primary service area may receive the in-network benefit level by using a Travel Network provider (First Health). The in-network benefit level only applies to a Travel Network provider only if members are outside the primary service area and the travel is not for the purpose of receiving treatment or benefits.
Treatments of emergency medical conditions are covered worldwide. All emergency services will be reimbursed at the in-network benefit level. However, benefits are subject to our contracted rates for in-network physicians and providers. Members may be responsible for any amounts outside the maximum plan allowance.
Kaiser Permanente members temporarily outside the service area are covered for emergency care, urgent care and medically necessary ground or air ambulance service worldwide for non-Medicare plans.
Members temporarily visiting other Kaiser Permanente regions may receive visiting member care from designated providers in those areas for non-Medicare plans. For information about service areas and facility locations in other regions, please call Kaiser Membership Services.
The PacificSource plans give you the freedom to see either in-network or out-of-network providers for covered services. This includes access to in network providers nationwide through the First Health Network and First Choice Network. You will generally pay less for services from providers in the PacificSource network. Travelers have the added protection of worldwide coverage for:
These services do not require prior authorization.
Providence Health Plan gives members access to nearly one million providers nationwide. If you are traveling and use a national network provider such as First Choice Health Network or MultiPlan/PHCS network, the benefits are paid at the in-network level. If you choose an out-of-network provider, benefits are paid at the out-of-network level.
The Delta Dental dental plan gives you the freedom to choose any licensed dentist. Delta Dental Premier Network is the largest dental network in the country; you can visit any of the 151,000 Delta Dental dentists in the U.S. and still be covered in-network.
If you have a dental emergency while traveling outside the service area, you may go to the nearest dental office. You have limited coverage for qualifying emergency dental care.
For more information about your specific plan’s travel benefits, please contact to your health plan directly.