Providence Health Plan Reviews
1.64 / 5 based on 26 Reviews | Submit Your ReviewSatisfactionClaimsCostBillingService
Company Information3601 SW Murray Boulevard
Beaverton, OR 97005
Last Updated: 2019-04-23
Company Reviews (26)
Unethical, uncaring, expensive, February, 2016
I had to keep Providence as my PCP is on their plan, but my experience is one of Providence being completely unethical but just within the law (I went all the way to the Dept. of Insurance, that's how I know).
For a Catholic institution with platitudes plastered everywhere, they are also hypocritical. They're also expensive, nickel and diming a person. I can barely pay the premium, but God forbid I should need any services as they're all out-of-pocket and under the deductible. They make sure of it.
Plan run by Admin, not Doctors, February, 2016
Oct 2: Initial pain in left leg noted. The pain progressed from a pulled muscle to all the symptoms of a sciatica, radiating down my left leg to the knee.
Nov 12: Diagnosed via inspection/symptoms by GP with a Disc issue, at the L4/L5 and L5/S1. PT suggested. After some discussion, printed PT instructions provided.
Nov 17: Pain progressing/debilitating, resulting in little sleep. GP refesrs me to Pain Dr, My GP’s nurse indicated Pain Dr's office may be able to do the Epidural injection without an MRI. An appointment made with Pain Dr. for Dec 8th, no mention was made during the initial appointment set-up regarding MRI or prior tests.
Dec 8th: At Pain Dr's office. Upon a physical inspection similar to the one performed by the GP on Nov 12, a disc issue was suspected, but no Epidural could be submitted for approval without an MRI. Therefore an MRI appt made for Dec 14th. MRI approved by Providence.
Dec 14th: MRI performed ; Dictated on Dec 15th ; Appt made for MRI read.. Dec 23
Dec 23rd: At Pain Dr's office /review of the MRI. It confirms the source of Sciatica on Left leg. Based on their reading of the MRI and the symptoms, they believe I'm a candidate for an Epidural Injection, and submit the paperwork to Providence for consideration.
Dec 28th: Pain Dr's office calls me to say the procedure was denied due to lack of institutional PT appointment(s). The office states they are appealing.
Since the initial diagnosis on Nov 12th, I have performed the PT suggested by the handout provided by my GP, limited only by the pain of the disc bulge. I have also been performing a variety of Yoga moves to supplement the PT suggested by my GP.
February 3: Providence denies appeal. Denial mentions about 6 possible reasons for the denial, but does not elaborate, nor does it mention any path for further treatment.
Unethical, uncaring, expensive is the beginning, February, 2016
Few physicians accepting new patients. Nickeled and died to death with referral to referral to referral all with copays and additional charges. I might add that each referral was to a provider who did not treat my condition. Approval takes days to weeks. Example: Discuss it with your surgeon. Surgeon referral arrived 6 weeks later - he was booked up for the next two months. Back to the referral system, contact the originating Dr, another wait on approval or disapproval by administration. Multiple tests with normal results for the same item - apparently no one can read chart notes or lab values. Chaos and confusion in addition to uninterested, rude, arrogant, negative Drs and employees. In less than 5 months, the referrals and copays with the added expense of speciality reviews of CT, X-rays I am out of pocket approximately $1,000.00. The first week of Nov 2015 a CT showed that major abdominal surgery was required in the near future due to the possibility of infection and sepsis. It is mid Feb 2016 with no surgery date in site because of the bureaucracy and profit motives of Providence. Still more referrals coming, proposed additional procedure medically unfounded in view of prior multiple CT results, more copays and referrals and fees. I sincerely doubt that surgery will be scheduled until after my piggy bank is empty and/or I am disabled or near terminal. Thankfully, I have taken pages of extensive notes - who, what, when, where, why with quotations, et. useful to attorneys after my death which I believe will occur due to negligence, incompetence, et al if I stay with Providence - lack of interest in anything other than profits. I have literally seen animals led to slaughter with more respect and care than has been given to this Providence patient and others. If you choose Providence 'Health Care: start taking detailed notes at first contact and leave your heirs with volumes of facts and a good attorney.
awful, January, 2018
Awful, depressing, run-down, prison-like facilities (like think neon-lit windowless rooms in gross strip malls, where they couldn't even bother to get like, $1 Goodwill art for the walls, not even a place for little kids to play), impossible to get anyone on the phone, you wait months for an appointment even with PCP, it's just awful, literally the worst. Then nothing is covered. Hope you like their hold music. You'll hear it a lot.
customer, February, 2016
Terrible customer service! Unwilling to help client(s) with their billing statements. They add additional medical costs to the patient by calling it "our contracted durable medical equipment supplier"!
terrible, June, 2016
i would give all zero stars if that was an option. They do not cover anything! Even doctors on the list are not covered. Beware!!!!!!!!!
The contractual agreement from an outside carrier , June, 2016
I switched from United Health Care because everything I use is providence so I felt Providence insurance would be a better coverage. I was wrong. The contractual agreement was better thru United Health and cost less if under the deductiable.
TERRIBLE INSURANCE COMPANY, May, 2018
I don't even know where to start. Our company was told that medical facilities like OHSU would be covered but they are NOT. They are out of network and instead of a copay, you will have a co-insurance. THIS IS NOT OHSU'S FAULT, THIS IS PROVIDENCE NOT PLAYING NICE. They want to force their subscribers to use their facilities. I HIGHLY RECOMMEND NOT BUYING INTO THIS INSURANCE.
Make it difficult to see a doctor, April, 2016
Providence Insurance sets up their plan so that it is very difficult to actually see a doctor. First it is hard to find a doctor in your area and verify he is in your plan. Then, you need to get a referral to see doctor for every visit even if you are receiving continuing treatment for one problem. Their customer support is worse than awful. Their answers are often contradictory or just plain wrong. This is the worst insurance I have ever had. If you have any choice at all, avoid it like the plague which if you do get, Providence insurance will make sure you die before you get treatment.
UNETHICAL, May, 2018
I had an individual plan. This is not a plan for young hard working people trying to take care of their family. The payment each month was more than a car payment for a nice car. They pay for nothing. I took my 3-year old son to the ER for a bowel at Providence Newberg Hospital. They were unable to care for him there and told me I had to take him to Providence St. Vincent Hospital which I did. The entire bill went to the deductible.
In March, I tried to use their payment portal to make my payment. The little wheel on the computer went round & round. I was not able to get on. I then forgot about it until a week later. I was able to get on and made my payment which they accepted. A couple of weeks later I got an email that made absolutely no sense. I called Customer Service (or so they call it) and was told my policy was cancelled for being 2 days late. I was told there was nothing that could be done about it. I was told to contact Healthcare.gov where I was told I would have to wait and apply during open enrollment. If you were cancelled for non-payment, they could not help you. They could only help you if you were getting a government subsidy. So much for health insurance for everyone. I'm particularly upset with an insurance plan who touts that they are a caring, compassionate, Christian organization. They couldn't be more the opposite. They've left my 3-year old son uninsured. I'm not concerned for myself, but why punish a 3-year old little boy?
Terrible, October, 2016
1) They created a fake user account for me through healthcare.gov, which intercepted all communications with Obamacare - all without my permission.
2) You have to get a referral from your primary to see a specialist - even if all you need to see is a specialist, which means an extra $50 visit.
3) They denied coverage for tests that I needed for a freaking peripheral neuropathy, saying it wasn't necessary.
4) They're jacking up the prices.
5) The deductible is high already and I still end up paying $100 per specialist visit.
Terrible Company, February, 2019
They continue to raise their rates for individual customers and give less benefits. I have stayed with them because of our doctor, but I am not sure I will continue. I am shocked by the rate increase in 2019 on individual plans which was also questioned by OSPIRIG ( Health Insurance Rate Watch) In June 2018. Providence offers no converage for Emergency care. Not a thing. What you pay goes toward your deductible. SO you are victim to excessive EMergency Room costs if an urgent care isn't open. And even with Urgent care you have to pay. I find that absolutely shocking. Aren't Emergencies MEdical Care too????? And when they deny a claim, then you are NOT allowed to discuss it with the dept that denied it. They keep you away from the Greivances Dept. You cannot talk to them or have it explained. The idea that a silver plan which has a $2850 ded and then you pay 30% until you reach your max cost$1880 a month is INSANE!!! That is $22,560 a year just for the premium! WTF? Plus what you pay for many things until you reach your deductible. $5,700 for a family of two, therefore $28,260 a year plus the 30% charge after you meet your deductible which raises it to who knows what. It's financial rape. I was looking at an ad on Glass Door to see if I could find out what a salary for a Senior Director of Marketing would be ( NOT that I was interested. Hah - I would NEVER work for an insurance company-) Providence was offering $254K to $272K a year plus additional pay of $42-$46K. Ha Ha Ha!!! They'll pay someone for all the BS "branding" talk and tell us our doctors are in our"medical homes" - HOMES! Really?! What a sick joke. but they do not pay for the care they should. DIsgusting.
A huge, Uncaring Bureaucracy, September, 2018
I will not bore people with a detailed timeline of my grievances. It must suffice for me to state simply that Providence throws up an impenetrable wall of bureaucracy that denies customers/consumers/patients - however we may be characterized - the opportunity to express concerns, obtain information, or obtain written responses to items of importance to me.
I am left feeling siempowered, frustrated, and victimized. I am interested in knowing what, if any, collective action or complaints are being mustered. Simply put: who is actively pursuing collective remedies for this organization's incompetence and callous disregard for its customers.
Dishonest and Abusive Billing Practices, August, 2018
I had a lapse in coverage of 2 months as I transitioned from one branch of a company to another. I called Providence to make certain I had no lapse in coverage. They assured me I did not. 5 months after the fact, I started receiving notices that the pharmacy had overpaid because I in fact did have a lapse in coverage. I received multiple letters asking for different amounts, from "Financial Transactions at Providence Health Plans", which is staffed by a 3rd party, Capital Billing: 10200 SW Eastridge St Ste 201, Portland, OR, 97225. I attempted to call, clarify the amount owing and pay my bill. I left 5 voicemails over 4 months. I also called Providence Health Plans directly as I did not receive a call back. I called each month. Providence assured me they would help, but no one called me back from them either. Each day I was routed to up to 6 representatives, each of whom had no idea how to help me or who Capital Billing even was, and continued to either transfer me or drop the call. One week ago, I received a collections notice. I called Providence again, understandably angered. I finally reached Rachel in the Pharmacy Billing Department. Her team contacted Capital Billing on my behalf, stating "We have had problems with them". On the next day, a man named Thomas from Capital Billing returned my call (he can be reached at 503-296-8424). I paid my small bill. I asked why it had taken 4-5 months, multiple harassing letters and a collections notice to simply take my 200$ payment over the phone. He replied "We've been busy" and offered no apology. I have filed a complaint with Providence, The Better Business Bureau, and am now posting this review. I have cancelled my overpriced medical insurance and have switched to Pacific Health Plans. I strongly advised, both as a member and a healthcare provider myself, avoid this company.
unorganized, May, 2018
My premium statements were different amounts each month. The Accounting Department and Customer Service are inept. Letters are rude and make no sense. This the the only invoice that we have trouble with on the banks auto pay. Unfortunately there is not any way to rate less than one star...
Horrible. Can't choose less stars for them., October, 2017
They don't care if you do with out medicine regardless of what a doctor prescribes. They, not your doc, will determine your care.
Pays very little after coinsurance copay, July, 2016
Very poor coverage for $800 a month type 1 diabetic after copay and coinsurance pays 70%.
Only allows testing of my blood sugar 5 times a day
The best, May, 2016
Don't understand how anyone would rate Providence low. Unless.....
Anyway I've heard from many many others who are also completely satisfied. They are one of the biggest players in the NW.
Worst insurance ever, February, 2018
Have paid three months of premiums, and Providence has told physicians I have no coverage. I'm trying to get anyone to help with the problem, with no one assisting at all. Thanks Obama for screwing it to hard working Americans
Terrible coverage and terrible customer service., January, 2019
Providence refused to reimburse me for time/money after they failed to fix an issue they said they did. They wouldn’t cover a prescription because they thought i still had another insurance. I called to tell them I did not. They said they fixed it. 3 days later I tried to pick up the medication. Still would not cover it. Called again and said the person who helped last time did not follow through and fix it. I asked for the copay to be waived due to my wasted time and having to wait an additional week to receive my medication. They refused. Counting the weeks until I can switch insurance.
Do your homework, January, 2019
Do your homework as you can sign up and choose a doctor and they can switch on you. I signed up for a doctor with providence based on her great reviews and it said she was taking new patients. I enrolled with her name and was given a medical card that had her as my primary doctor.
I tried to make a appointment with her and I was told no she is not my doctor and pulled a switch on me. Now I have someone who looks to be new and has only three reviews and one if pretty bad.
Do you homework before you choose Providence and a doctor. Just to add injury to insult, it took 6 calls to customer service to find out the details and in two of them they said they would call back and I still had to follow up...not happy.
Awful, September, 2018
I can't imagine worse health insurance. Now that they don't cover anything out of network, you might as well not have health insurance. They don't cover any local pediatricians and if you have a serious ailment you will likely have to pay out of pocket anyways if you want the best doctor that specializes in what you have. They say they wouldn't even cover my children if their pediatrician referred them to an in network doctor. Very hopeful that we will have another option in Lincoln County next year. I can't imagine a worse company. Sad to see them building in Newport.
best plan i have ever seen, July, 2018
this plan has really help me and my family, not only do i get the coverage I need the customer serve is amazing
Nightmare!, May, 2018
Getting urgently needed CT scans requires preapproval through AIM. They delay, delay, delay. My mom was assaulted and ended up having a 10 hour surgery (which was delayed by a couple weeks thanks to Providence because no in-network services handle trauma), and now she was serious, life altering complications which may have resulted from the delay). A week later, my mom's quick appointment turned into a 10 hour ordeal and multiple phone calls for a CT scan which she ended up having to go to one hospital for half the CT and a Providence facility for the other half (both films were of one area) because that's what this health plan mamdated. A representative hung up on me while I was pleading with them on behalf of my mother.
Shoddy customer service and won't pay, March, 2018
This insurance company is shady af. They deny claims and make insured folks jump through time consuming hoops which are both obnoxious and unnecessary. Sometimes multiple times. I've been stuck with them for years now and STILL calling them over the same old problems. There pattern is to blame others: the doctor, another insurance company, random uninvolved entities. Zero accountability. When you push them they'll tell you to file a grievance (thanks, Travis, super helpful!) but still not make an attempt to fix the problems that originate with them. They seem to bank on the fact that you won't bother and they can get away with shade. So frustrating to pay them every month for such poor quality coverage.