Sold outside the marketplace. This plan is bought directly from the insurer, so it is not eligible for a premium tax credit. If your income qualifies you for savings, a marketplace plan at the same price will usually cost you less.
Connect 1500 Gold
Providence Health Plan · 2026 plan year
Gold
- Ind. deductible
- $1,500
- Family deductible
- $3,000
- Ind. OOP max
- $9,000
- Family OOP max
- $18,000
Other cost-sharing reduction variants for this plan:
More Providence Health Plan plans in OR
Monthly premiums by age
Rating Area 1 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.
| Age | Individual | Individual + tobacco |
|---|---|---|
| Under 15 | $302 | $302 |
| 21 | $476 | $523 |
| 30 | $540 | $594 |
| 40 | $608 | $669 |
| 50 | $850 | $935 |
| 60 | $1,291 | $1,420 |
| 64 and over | $1,427 | $1,570 |
Live premium estimate
Benefits & cost sharing
Primary Care
| Benefit | In-network |
|---|---|
| Preventive Care/Screening/Immunization | No charge |
| Primary Care Visit to Treat an Injury or Illness | $30.00 |
Specialist
| Benefit | In-network |
|---|---|
| Specialist Visit | $50.00 |
Hospital
| Benefit | In-network |
|---|---|
| Emergency Room Services | $250.00 Copay after deductible + 20.00% Coinsurance after deductible |
| Inpatient Hospital Services (e.g., Hospital Stay) | 20.00% Coinsurance after deductible |
| Outpatient Surgery Physician/Surgical Services | 20.00% Coinsurance after deductible |
| Urgent Care Centers or Facilities | $50.00 |
Pharmacy
| Benefit | In-network |
|---|---|
| Generic Drugs | $10.00 |
| Medical Service Drugs | Not covered |
| Non-Preferred Brand Drugs | 50.00% Coinsurance after deductible |
| Preferred Brand Drugs | $50.00 |
| Specialty Drugs | 50.00% Coinsurance after deductible |
| Zero Cost Share Preventive Drugs | No charge |
Mental Health
| Benefit | In-network |
|---|---|
| Mental/Behavioral Health Inpatient Services | 20.00% Coinsurance after deductible |
| Mental/Behavioral Health Outpatient Services | $30.00 |
Other
| Benefit | In-network |
|---|---|
| Abortion for Which Public Funding is Prohibited | Not covered |
| Accidental Dental | 20.00% Coinsurance after deductible |
| Acupuncture | $30.00 |
| Allergy Testing | 20.00% Coinsurance after deductible |
| Bariatric Surgery | Not covered |
| Basic Dental Care - Adult | Not covered |
| Basic Dental Care - Child | 50.00% Coinsurance after deductible |
| Chemotherapy | 20.00% Coinsurance after deductible |
| Chiropractic Care | $30.00 |
| Cosmetic Surgery | 20.00% Coinsurance after deductible |
| Delivery and All Inpatient Services for Maternity Care | 20.00% Coinsurance after deductible |
| Dental Check-Up for Children | No charge |
| Diabetes Education | No charge |
| Dialysis | 20.00% Coinsurance after deductible |
| Durable Medical Equipment | 20.00% Coinsurance after deductible |
| Emergency Transportation/Ambulance | 20.00% Coinsurance after deductible |
| Eye Glasses for Children | No charge |
| Gender Affirming Care | See plan details |
| Habilitation Services | 20.00% Coinsurance after deductible |
| Hearing Aids | 20.00% |
| Home Health Care Services | 20.00% Coinsurance after deductible |
| Hormone Therapy | See plan details |
| Hospice Services | No charge |
| Imaging (CT/PET Scans, MRIs) | 20.00% Coinsurance after deductible |
| Infertility Treatment | Not covered |
| Infusion Therapy | 20.00% Coinsurance after deductible |
| Inpatient Physician and Surgical Services | 20.00% Coinsurance after deductible |
| Laboratory Outpatient and Professional Services | 20.00% |
| Long-Term/Custodial Nursing Home Care | Not covered |
| Major Dental Care - Adult | Not covered |
| Major Dental Care - Child | 50.00% Coinsurance after deductible |
| Routine Eye Exam for Children | No charge |
| Non-Preferred Generic | $50.00 |
| Nutritional Counseling | No charge |
| Orthodontia - Adult | 20.00% Coinsurance after deductible |
| Orthodontia - Child | 20.00% Coinsurance after deductible |
| Other Practitioner Office Visit (Nurse, Physician Assistant) | $50.00 |
| Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 20.00% Coinsurance after deductible |
| Outpatient Rehabilitation Services | 20.00% Coinsurance after deductible |
| Preferred Generic | $10.00 |
| Prenatal and Postnatal Care | 20.00% Coinsurance after deductible |
| Private-Duty Nursing | Not covered |
| Prosthetic Devices | 20.00% Coinsurance after deductible |
| Radiation | 20.00% Coinsurance after deductible |
| Reconstructive Surgery | 20.00% Coinsurance after deductible |
| Rehabilitative Occupational and Rehabilitative Physical Therapy | 20.00% Coinsurance after deductible |
| Rehabilitative Speech Therapy | 20.00% Coinsurance after deductible |
| Routine Dental Services (Adult) | Not covered |
| Routine Eye Exam (Adult) | $25.00 |
| Routine Foot Care | 20.00% Coinsurance after deductible |
| Skilled Nursing Facility | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Inpatient Services | 20.00% Coinsurance after deductible |
| Substance Abuse Disorder Outpatient Services | $30.00 |
| Telehealth - Primary Care | $10.00 |
| Telehealth - Specialist | $50.00 |
| Transplant | 20.00% Coinsurance after deductible |
| Treatment for Temporomandibular Joint Disorders | Not covered |
| Weight Loss Programs | Not covered |
| Well Baby Visits and Care | No charge |
| X-rays and Diagnostic Imaging | 20.00% |
Service area
This plan covers 6 geographic areas. 2 of them are covered only in part, meaning specific ZIP codes rather than the whole county. The filing does not list which, so confirm with the insurer or on HealthCare.gov before enrolling.
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