You have a prepaid debit card you can use to pay for certain dental, vision, hearing and over-the-counter items.
Earn a bonus card for seeing your primary care provider and staying current on preventive health services. It looks similar to your Benefits Mastercard but is used differently. You can use this card at many retailers or to pay for other expenses.
Feel safe and secure with Samaritan Advantage Health Plan’s Personal Emergency Response Systems or PERS. A PERS device is a wearable electronic device with a button used to call for help during any emergency. When pressed, a 24/7 monitoring center is alerted.
As of Jan. 1, 2024, members can ask for the Mini Guardian, MGMinilite or the MGMove PERS devices by calling our service provider, Medical Guardian at 800-914-5531.
Learn more about this exciting benefit and the Personal Emergency Response System devices you can choose:
Product InformationFrequently Asked Questions
If you need additional copies of your member materials, please contact Customer Service.
Download the Summary of Benefits to review details about your plan’s medical, dental and prescription drug benefits, copays, coinsurance and more:
2025 Summary of Benefits – Valor, Premier & Premier Plus Plans (last updated 8/16/2024)2025 Summary of Benefits – Dual Advantage (last updated 8/16/2024)
For detailed plan information including how to use the plan’s coverage to obtain medical services, your rights and responsibilities as a member, important phone numbers and other resources, see your plan’s Evidence of Coverage:
2025 Evidence of Coverage – Valor (last updated 10/1/2024)2025 Evidence of Coverage – Premier Plan (last updated 10/1/2024)2025 Evidence of Coverage – Premier Plan Plus (last updated 10/1/2024)2025 Evidence of Coverage – Dual Advantage (English) (last updated 10/1/2024)2025 Evidence of Coverage – Dual Advantage (Spanish) (last updated 10/15/2024)
To learn how your plan benefits have changed from year to year, see your plan’s Annual Notice of Changes:
2025 Annual Notice of Changes – Valor (last updated 9/18/2024)2025 Annual Notice of Changes – Premier Plan (last updated 9/18/2024)2025 Annual Notice of Changes – Premier Plan Plus (last updated 9/18/2024)2025 Annual Notice of Changes – Dual Advantage (last updated 9/18/2024)
Learn which medical services, procedures, supplies and equipment require our written authorization before being performed or supplied. Review the Prior Authorization List:
2025 Prior Authorization List (last updated 5/30/2024)
If you get Extra Help from Medicare to help pay for your Medicare prescription drug plan costs, review the Low Income Subsidy Premium Summary to see your monthly premium.
2025 Low Income Subsidy Premium Summary (last updated 10/1/2024)
2024 Summary of Benefits – Premier & Premier Plus Plans (last updated 10/1/2024)2024 Summary of Benefits – Valor (last updated 10/12/2023)2024 Summary of Benefits – Dual Advantage (last updated 11/1/2023)
2024 Evidence of Coverage – Valor (last updated 9/26/2023)2024 Evidence of Coverage – Premier Plan (last updated 9/25/2023)2024 Evidence of Coverage – Premier Plan Plus (last updated 9/25/2023)2024 Evidence of Coverage – Dual Advantage (last updated 10/27/2023)
2024 Annual Notice of Changes – Valor (last updated 8/29/2023)2024 Annual Notice of Changes – Premier Plan (last updated 8/29/2023)2024 Annual Notice of Changes – Premier Plan Plus (last updated 8/30/2023)2024 Annual Notice of Changes – Dual Advantage (last updated 11/3/2023)
2024 Prior Authorization List (last updated 7/18/2023)
2024 Low Income Subsidy Premium Summary (last updated 9/7/2023).
Take advantage of this annual opportunity to have a one-on-one with your medical provider to discuss your health. Medicare fully covers your wellness visit.
The visit includes:
(This phone number is only for scheduling Medicare annual wellness visits.)
As a Samaritan Advantage Health Plan member, you can schedule a ride to your doctor, pharmacy or any health-related location with Cascades West Ride Line. Rides can be scheduled 365 days a year, 24 hours a day. Some restrictions may apply.
Find rules and policies for how we cover medical services.
Medical Coverage policies are developed to communicate Samaritan Health Plans decisions about coverage and benefits for various medical services. Determinations are made after careful consideration of evidence, insurance plan factors, Medicare rules, community standards, service availability and other applicable factors.
For Samaritan’s Medicare Advantage Health Plans, we use applicable content from Medicare National Coverage Determinations, Local Coverage Determinations and the Medicare Benefit Policy Manual.
CMS Medicare National Coverage DeterminationsCMS Medicare Local Coverage DeterminationsMedicare Benefit Policy Manual
If there is not a Medicare Guideline (NCD/LCD) available, Samaritan Health Plans will use nationally recognized evidence-based guidelines from MCG Health. Care guidelines from MCG provide evidence-based medicine’s best practices and care plan tools across all areas of treatment, providing clinical decision support and documentation which enables effective transfers between different care settings.
On the rare occasion that no appropriate guideline exists from the sources above, Samaritan Health Plans uses a small number of internally developed Samaritan Health Plans medical coverage policies, listed below:
Our Customer Service Team is happy to help! We are here to serve you.
Call us at 541-768-7866 or toll free 866-207-3182, (TTY 800-735-2900 or 711). Our service hours are:
*Samaritan Advantage cannot pay for services rendered by providers who have opted-out of Medicare.
Page Updated 10-15-2024
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