PacificSource Materials for Oregon in Spanish

You're welcome to download the following materials, or contact your regional marketing office to request hard copies. Looking for plan benefit summaries in Spanish? You'll find them here.

AccordantCare Rare Disease Program

Address/Name Change Form

AlternaCare Savings Program flier

Average Cost of Care flier

Care Coordination Request form

COBRA Initial Notice

Continuation Election Form - Federal

Continuation Election Form - State

Diabetes Benefits

Dual Choice Provider Network (for Portland metro only)

Expectations Prenatal Care Program

First Health Network - for members outside the service area

Free & Clear Tobacco Cessation Program

Global Emergency Services - Assist America flier

Group Medical/Dental Enrollment Form

Health Management with PacificSource - clients with 2-50 employees

Health Management with PacificSource - clients with 50+ employees

Health Resources for Your Family

Healthy Returns Care Management Program - clients with 51+ employees

Hospital-Based Health Education Classes flier

Informed Healthcare Consumer flier

International Travel/Emergency Care Outside the U.S.
Mail Order Pharmacy Options for Prescription Drugs
Maternity Benefits

Preferred Drug List (PDL)

Privacy Policy

Prescription Discount Program flier - plans with pharmacy coverage

Prescription Discount Program flier - plans without pharmacy coverage

Prescription Drug List - Alternatives for Nonpreferred Drugs

Rising Healthcare Costs: Information and Tips

Third Party Recovery

Travel Benefits

Using Your PacificSource Group Health Plan

Using Your Tiered Prescription Drug Plan flier - mac B

Using Your Tiered Prescription Drug Plan flier - no mac

Using Your Tiered Prescription Drug Plan flier - value

Value-Added Programs and Services - clients with 2-50 employees

Value-Added Programs and Services - clients with 51+ employees

Vision Benefits

Waiver of Coverage Form

Unless otherwise stated, all text and images © 2006 PacificSource. All rights reserved.