Welcome to PacificSource Health Plans

We are pleased to be your health plan. For us, healthcare goes far beyond insurance. It means providing top-notch customer service and programs that help you stay well so you can live well.

We're Here to Help

 

At PacificSource, everything we do revolves around taking care of people. You are welcome to call us toll-free. Our customers enjoy average on-hold times of less than 20 seconds, and phone contact with a live person—not automated response systems. Or e-mail us at cs@pacificsource.com. One of our friendly, professional Customer Service Representatives will be happy to assist you.

Using PacificSource.com

 

Check out the For Members section of PacificSource.com to find a wealth of information designed to help you navigate your plan.

Here's what you'll find:

Welcome: Find out what's new at PacificSource. This page is regularly updated with our most current news.

Need an ID card?: If you need to access healthcare services like seeing a doctor or filling a prescription, and your PacificSource ID card has not arrived yet, you can print a temporary ID card from our website and use it until your actual card arrives. (Each family member should make their own temporary ID card.)

Note about the temporary ID card: Your temporary ID card will only show your eligibility in effect on the day you print your card. If your plan has not started yet, you will only be able to print a temporary card after the plan’s effective date. If you are a renewing member, your new eligibility will show on your temporary card only after your plan’s renewal date.

Health and Wellness Programs: Check out the health and wellness programs we offer to help you improve or maintain your health.

PacificSource Extras: Take a look at the extra benefits and services that are available to you as part of your medical coverage.

Forms and Materials: Download administrative forms, member materials, and view InTouch tutorials in this section.

Preauthorization: Learn about the our preauthorization requirements.

Prescription Drug Information: Access our PacificSource Drug List, view information about our mail order program, and check out recent drug news from WebMD.

Cost and Quality: Find information on the cost and quality of hospital care.

Member Newsletters: Access current issues of our Member Bulletin newsletters.

Provider Directory: Find a provider or create your own personalized provider directory to download and print. You can search for a provider by specialty, name, location, or other details.

Using InTouch for Members

 
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View our online demo.

InTouch, our secure Web portal at PacificSource.com, allows you to easily and conveniently manage your insurance coverage and health 24/7.

To register, click the "Login" button in the upper-right area of this page and follow the easy instructions. 

Log in to InTouch to:

  • Look up coverage information and review benefit summaries in your Member Handbook
  • Look up claims
  • Review your family's enrollment history
  • Check your plan's deductible
  • Check your out-of-pocket status
  • Track preauthorization
  • Track referral requests
  • Look up your share of your family's healthcare expenses
  • Change your address
  • Order replacement ID cards

Register or login now.

Health Manager

The Health Manager is your personal online health and wellness center. Powered by WebMD®, our site includes personalized wellness information and a variety of helpful, easy-to-use online tools designed to help you maximize your health. Log in to InTouch and click Health Manager to:

  • Assess your health with the HealthQuotient health risk assessment
  • Research health topics
  • Subscribe to health and wellness newsletters
  • Participate in programs to improve your health
  • Keep medical record dates
  • Make goals and track your progress
 

Top Ten Questions Asked by Members

 
1. When will I receive my ID cards?
2. How do I submit a claim?
3. What should I do if I need help when you're closed?
4. How can I get a copy of my policy?
5. How can I get a summary of my plan benefits?
6. How can I update my mailing address, phone number, e-mail address, or name?
7. Why aren't all my covered family members listed on my ID card?
8. Do you have a list of preferred drugs?
9. Do you have a list of participating providers?
10. Can I see any provider I want?

When will I receive my ID cards?

Your ID cards will be mailed directly to your home. You should receive your cards within a few weeks after enrollment. If you need to access healthcare services like seeing a doctor or filling a prescription, and your PacificSource ID card has not arrived yet, you can print a temporary ID card from our website and use it until your actual card arrives. 

Note about the temporary ID card: Your temporary ID card will only show your eligibility in effect on the day you print your card. If your plan has not started yet, you will only be able to print a temporary card after the plan’s effective date. If you are a renewing member, your new eligibility will show on your temporary card only after your plan’s renewal date.

Please begin using the new cards as soon as you receive them, and discard any old cards. The next time you visit your doctor or pharmacy, be sure to present your new card so they have the correct insurance information.

How do I submit a claim?

Usually, your provider or pharmacy will submit claims for you. If you need to fill a covered prescription or see a provider for a covered service before you receive your new ID card, you can pay and then submit a copy of the provider’s itemized receipt or statement for reimbursement. It needs to include:

  • Your full name and the name of the patient
  • The name of the pharmacy or provider and their tax ID number 
  • The date your prescription was filled or the service was provided
  • The medication name, strength, and quantity dispensed
  • The billed charges with the CPT and diagnosis billing codes

Please add your employer's name and group number (if known). If the treatment was for an accidental injury, please include details.

For dental or pharmacy claims, please include our Dental Claim Form or Prescription Drug Claim Form.

  • Mail your claim to PacificSource Health Plans, Claims Department, PO Box 7068, Springfield OR 97475.
  • Or fax: medical and vision (541) 225-3632, pharmacy (541) 225-3665, or dental (541) 225-3655. 

What should I do if I need help when you're closed?

If you have a true medical emergency, always go directly to the nearest emergency room or call 911 for help. In other cases, you're welcome to use the Contact Us form to send us an inquiry online and we'll respond the next business day. You can also access personalized information about your PacificSource coverage online 24/7 through InTouch for Members. Register or log in now.

How can I get a copy of my policy?

  • If you're covered under a group health plan, your employer is the policyholder. Contact your employer to request a copy of the insurance policy or a Member Benefit Handbook.
  • If you're covered under a PacificSource individual and family plan, you received the policy when you enrolled or changed plans. You can request a replacement copy from our Individual Sales Department: phone (888) 684-5585 or e-mail individual@pacificsource.com.

How can I get a summary of my plan benefits?

Your summary of benefits is available online in InTouch for Members, our secure member Web site. Register or log in now. If you're covered under a group health plan, you'll find a copy in your Member Benefit Handbook, or you can request one from your employer. The Summary of Benefits is included in your policy document if you have a PacificSource individual and family plan.

How can I update my mailing address, phone number, e-mail address, or name?

You can update your contact information any time by logging into InTouch for Members, our secure member Web site. Register or log in now. You're also welcome to use the Contact Us form any time, or call our Customer Service staff at (888) 977-9299 during business hours.

Why aren't all my covered family members listed on my ID card?

This is most often due to custody arrangements. For dependent children, the insurance ID card is issued only to the custodial parent. This is true even if the noncustodial parent is the primary policyholder. The child's name will not appear on a noncustodial parent's ID card. If this circumstance doesn't apply to you and you believe there's an error on your ID card, please contact our Customer Service staff at (888) 977-9299.

Do you have a list of preferred drugs?

Your prescription plan uses one of two PacificSource drug lists: our PDL (Preferred Drug List) or our VDL (Value Drug List). Your Summary of Benefits—available online through your InTouch account—will tell you which list applies to your plan. Both lists are available online at PacificSource.com/PDL. They are a guide to excellent values on brand name prescription drugs. Your drug list will help your doctor identify medications that can provide the best clinical results at the lowest cost.

Do you have a list of participating providers?

Yes. We have an online Provider Directory to help you find providers in your area, or create a printable directory of providers based on your criteria. The online directory is updated frequently.

Can I see any provider I want?

Yes, although you'll receive your plan's highest level of benefits when you use participating providers. Unless it's a medical emergency, your benefits are lower when you seek treatment from a nonparticipating provider. If you're on a PacificSource Prime or Choice plan, you also need a referral from your PCP to get the highest level of benefits. See your plan's Summary of Benefits (available in InTouch for Members—register or log in now), or contact our Customer Service staff at (888) 977-9299 or cs@pacificsource.com for specific information on your coverage for nonparticipating providers.

Still have questions?

 

Check out our general FAQ or contact us.

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Last updated 11/18/2013