Home Members Medicare Advantage Members Your Advantage Member Benefits
Starting in 2026, Samaritan Advantage Health Plans will offer one Medicare plan: Samaritan Dual Advantage (HMO D-SNP). This plan is designed for people who have both Medicare and Medicaid (Oregon Health Plan) coverage.
Below you will find coverage information for this plan. These materials are important documents that describe your health insurance benefits in detail.
To understand the complete details and documentation about what is covered under the 2026 Samaritan Dual Advantage plan, download the Evidence of Coverage. This legal document explains your benefits and rights:
To review a summary of the plan’s medical, dental and prescription drug benefits, copays, coinsurance and more, download the Summary of Benefits:
To learn how the plan’s benefits have changed from year to year, see the Annual Notice of Changes:
To learn which medical services, procedures, supplies and equipment require our written authorization before being performed or supplied, review the Prior Authorization List:
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.)
You have a prepaid debit card you can use to pay for certain dental, vision and hearing items.
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.
There are three PERS options available: the Mini Guardian, MGMinilite or the MGMove. Call our service provider, Medical Guardian at 800-914-5531 to request the PERS device that works for you!
Learn more about this exciting benefit and the Personal Emergency Response System devices you can choose:
Product Information (English)Frequently Asked Questions (English)
Learn how you can earn rewards for seeing your primary care provider and staying current on preventative health services. You can use this card at many retailers or to pay for other expenses.
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 10/12/2026
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