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2025 Provider Directory guidance for
Individual Health Plans
ASKING THE RIGHT QUESTION
One of the toughest part of evaluating an insurance plan is understanding the provider network. My best advice is to get the exact name of your plan's network an confirm with your providers that they accept it. For example, if you have a PacificSource plan, ask the office specifically if they accept the 'PacificSource Navigator Network'. If they hesitate, call the business office to confirm. PacificSource offers 12 networks, and the medical office may only accept a few. This can help you avoid out-of-network charges.
I have updated the network information for 2025 by company to help you find contracted providers. If you need assistance I am happy to help you.
KAISER PERMANENTE
PROVIDER NETWORK: In-network providers with Kaiser include all of the Kaiser providers in Oregon and nationwide.
Click Here to search Kaiser Providers
MODA HEALTH PLAN
PROVIDER NETWORK:
Moda uses a broad network of providers called the Beacon Network in the Portland area. When you travel outside of Oregon, they use a national network called the Aetna PPO Network for Emergency and Urgent Care.
Click Here to search Moda Providers
CONTRACTED HOSPITALS:
Moda only contracts with OHSU, Portland Adventist, and Tuality Community Hospitals in the Portland area. (not Providence or Legacy Hospitals)
PROVIDENCE HEALTH PLANS
MEDICAL HOME REQUIREMENT:
When you enroll in a Providence Plan you are required to select a Medical Home Primary Care Clinic, not a specific primary care provider. A Medical Home Clinic is where you go for Primary Care. You can your MHC selection anytime through your myProvidence portal or by calling Customer Service. For 2025 a referral to a Specialist physician is no longer required. Just verify that they are in the same provider network. Emergency Room and Urgent Care visits are the only services covered outside of your network nationwide. However, you will pay more if you do not go to an In-Network Urgent Care.
3 DIFFERENT PROVIDER NETWORKS:
Providence plans for 2025 will use one of 3 different provider networks: The Connect, Choice, or Signature Network. The plan name will indicate what Network the plan uses. The Connect Network is the generally the smallest of the 3, but may be appropriate for your needs. The Signature Network offers a national network of providers. Make sure the doctors you want to use accept the plan network you are a part of by using the search tool below:
Click Here to search Providence Providers
CONTRACTED HOSPITALS:
In the Portland area the in-network hospitals include Providence Glisan Street. St. Vincent, Milwaukie Community, Willamette Falls, and Newberg Hospital.
PACIFICSOURCE
The PacificSource Navigator Network includes Oregon, Washington, Idaho and Montana. When you travel outside of those 4 states you can use provider in the Aetna Signature Administrators Network (case of a child in college out of state).
CONTRACTED HOSPITALS:
You are not required to select a Primary Care Doctor (PCP) when you enroll, and referrals are not required. Legacy Meridian Park, Good Samaritan, Emmanuel, and Mt. Hood Medical are covered in the Portland area, as well as Tuality, OHSU and Adventist Hospitals. (Not Providence) Silverton and Salem are also in the network.
REGENCE INDIVIDUAL PLANS
PROVIDER NETWORKS:
The Regence plans are either the Legacy or Individual & Family Network.
Click Here to search Regence Providers
LEGACY NETWORK: The Legacy Network plans work only with the Legacy Hospitals: Emanuel, Good Samaritan, Meridian Park, Mt. Hood Medical, and Silverton.
INDIVIDUAL & FAMILY NETWORK: This is the larger network of contracted doctors which includes both Adventist, OHSU and Tuality hospitals in addition to the 5 Legacy Hospitals.
NEED HELP?
I recognize that looking for doctors that match up with your plans network can be a challenging thing to do. I've been using these provider directories for 20 years now and I can be of assistance if you need help or are having problems. Send me an email of the problem are having or doctor type you are looking for and I'll try to help.
If you want to email me a list of doctors (first and last names) to danneils@gmail.com, I'd be happy to help you look them up in any of the provider search engines. You can also give me a call at 503-740-0535
UPDATED 02/24/2025
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