New health plans from PacificSource Health Plans coming in 2020
Beginning in 2020, there will be a greater variety of health plans from PacificSource in the market and the plans will have new names. One of the key distinctions between the different plans is the level of network flexibility that they offer for referrals, so it will be important to understand the differences between each plan.
In the Portland metro area and Clark County, PacificSource will have three different commercial plans:
- Navigator is the narrow network health plan that leverages the Legacy Health Partners network. Members of the PacificSource Navigator plan will only have services from LHP providers covered at the in-network level.
- Voyager is PacificSource’s preferred provider organization (PPO) plan, which offers members a broad choice of providers covered at the in-network level.
- Pathfinder, the new health plan announced in May, leverages a broader set of providers that will be covered at the in-network level than the PacificSource Navigator plan. It includes Legacy Health and its affiliated network of providers and OHSU and its affiliated provider network. We still encourage providers to refer internally to LHP providers for this product. This plan is only available to employers in Clackamas, Multnomah, and Washington counties.
PacificSource also offers Medicare Advantage plans in the Portland metro area and Clark County that only cover services from the Legacy Health Partners network at the in-network level. For Medicaid in Clackamas, Multnomah, and Washington Counties only, PacificSource is the health plan administrator for patients enrolled with Health Share and assigned to Legacy Medical Group for primary care.
In Marion and Polk counties, PacificSource will offer the Voyager PPO, as well as the SmartChoice plan, which includes Legacy Health and its partner providers among several in-network options for coordinated care. In this region, PacificSource is also the health plan administrator for all Medicaid-insured patients.
In addition, PacificSource will continue to administer the Legacy Employee Health Plan, which only reimburses for services from providers and facilities in the Legacy + Network.
If you have any questions about any of the PacificSource health plans, please contact your field operations adviser.
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