You have a prepaid debit card you can use to pay for certain dental, vision, hearing and over-the-counter items.
Earn rewards for seeing your primary care provider and staying current on preventive health services.
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.
Click on the link below to download our Summary of Benefits and review details about your plan’s medical, dental and prescription drug benefits, copays, coinsurance and more.
2024 Summary of Benefits – Premier and Premier Plus Plans2024 Summary of Benefits – Valor 2024 Summary of Benefits – Dual Advantage
For more 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.
2024 Evidence of Coverage – Valor2024 Evidence of Coverage – Premier Plan2024 Evidence of Coverage – Premier Plan Plus2024 Evidence of Coverage – Dual Advantage
To see how your plan benefits have changed from year to year, see your plan’s Annual Notice of Changes.
2024 Annual Notice of Changes – Valor2024 Annual Notice of Changes – Premier Plan2024 Annual Notice of Changes – Premier Plan Plus 2024 Annual Notice of Changes – Dual Advantage
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:
Advanced Care Planning PolicyApplied Behavioral AnalysisComputer Assisted Surgical Navigational ProcedureCosmetic and Reconstructive Procedures PolicyCoverage of Routine Care for Members Enrolled in Qualifying Clinical Trials PolicyDrug Testing in the Outpatient SettingEvaluation of New and Existing TechnologiesGenetic TestingProprietary Laboratory AnalysesPsychiatric Sub-Acute AdmissionWireless Gastrointestinal Monitoring System
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.
Our Customer Service Team is happy to help. Call us at 541-768-4550 or toll free 800-832-4580, (TTY 800-735-2900). We are here to serve you.Customer Service is available:
*Samaritan Advantage cannot pay for services rendered by providers who have opted-out of Medicare.
Please note: The Albany SamFit location is temporarily closed. Visit the SamFit website for other locations.
Page Updated 3-25-2024
Select “Leave Site” to go to the external website.