Is my doctor covered?

Is my doctor covered?

Stay in the Samaritan health care system or go outside—your choice
With a Samaritan Advantage plan, you’ll have lots of options for getting the routine and specialty care you need. You’re free to use any of the doctors, specialists and hospitals that are part of our network, including those outside the Samaritan family. It’s comforting to know that more than 95% of the doctors, hospitals and clinics in our area, and numerous specialists from Portland to Eugene are all part of the Samaritan Health Plans network.

Out-of-network coverage
In general, beneficiaries must use network providers to access their medical benefits, except in non-routine circumstances requiring urgent or emergent care. A prior authorization is required to see a non-contracted provider. If you don't have appropriate authorization from our plan before you see a provider that is not part of our plan's network, you may have to pay for the services he/she provided yourself.

Provider Directory
Samaritan Advantage Health Plan HMO has an extensive provider network for your needs. See "Search Tips" below for instructions on how to search this document for a specific provider or facility. Please note that provider information may change at any time. We recommend that you confirm your provider's network status and level of coverage PRIOR TO SEEKING SERVICE by contacting Samaritan Advantage Customer Service at 541-768-4550 or 1-800-832-4580 (TTY 1-800-735-2900), 8 a.m. to 8 p.m. daily.

List of Primary Care Providers, updated weekly
List of Specialty Providers, updated weekly

ADOBE READER SEARCH TIPS for your Provider Directory
Once you have opened the links to the Provider Directory found above, you can search the document for a specific network provider. Just hold down the Ctrl + f keys on your keyboard to use the "Find" function within Adobe Reader, then type in the name of the facility or provider that you are seeking.

Getting care when you travel
When you are away from the plan’s service area you may get care when you are outside the service area, but your coverage is limited. The services we cover when you are outside our service area are:
  • Care for medical emergency (worldwide)
  • Urgently needed care
  • Renal dialysis
  • Care that Samaritan Advantage Health Plan or a plan provider has approved in advance

If you have questions about your medical costs when you travel, please call Samaritan Advantage Customer Service. For full details, see: the Evidence of Coverage for your plan.

Last modified: October 1, 2013
H3811_MA4001_2013A CMS Approved 11/06/2013