Www.dhs.state.or.us



CountyOrganization NamePlan NameContract IDPlan IDPlan TypeSpecial Needs PlanSpecial Needs Plan TypeBenefit TypePart C Premium2Part D Basic Premium3Part D Premium Obligation with Full Premium AssistanceBakerModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60BakerModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20BentonUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805007HMONo?Enhanced Alternative$24.80$21.20$0.00BentonUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805013HMONo?Enhanced Alternative$0.00$0.00$0.00BentonSamaritan Advantage Health PlanSamaritan Advantage Premier Plan (HMO)H3811002HMONo?Enhanced Alternative$56.60$53.40$18.60BentonSamaritan Advantage Health PlanSamaritan Advantage Premier Plan Plus (HMO)H3811009HMONo?Enhanced Alternative$70.90$69.10$34.30BentonModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60BentonRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70BentonRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80BentonHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90BentonHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$24.00$0.00BentonHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00BentonHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00BentonKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20BentonKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00BentonUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00BentonUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00BentonSamaritan Advantage Health PlanSamaritan Advantage Special Needs Plan (HMO SNP)H3811003HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00BentonHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00ClackamasHumana Medical Plan, Inc.Humana Gold Plus H1036-153 (HMO)H1036153HMONo?Enhanced Alternative$0.00$0.00$0.00ClackamasUnitedHealthcareAARP MedicareComplete Choice (PPO)H2228029Local PPONo?Enhanced Alternative$2.50$29.50$0.00ClackamasUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805001HMONo?Enhanced Alternative$40.50$26.50$0.00ClackamasUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805012HMONo?Enhanced Alternative$0.00$0.00$0.00ClackamasProvidence ElderPlace PortlandProvidence ElderPlace Portland (dual eligible) (PACE)H3809001National PACENo???$161.70$0.00ClackamasProvidence ElderPlace PortlandProvidence ElderPlace Portland (private pay) (PACE)H3809002National PACENo???$125.50$498.80ClackamasModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60ClackamasRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$2.00$41.00$6.20ClackamasRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$106.40$66.90$55.80ClackamasFamilyCare HealthFamilyCare Advantage Rx (HMO)H3818003HMONo?Enhanced Alternative$0.00$0.00$0.00ClackamasPacificSource MedicarePacificSource Medicare MyCare Rx 22 (HMO)H3864022HMONo?Enhanced Alternative$48.80$29.20$0.00ClackamasHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90ClackamasHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$19.00$0.00ClackamasCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00ClackamasRegence BlueCross BlueShield of OregonRegence BlueAdvantage HMO (HMO)H6237003HMONo?Enhanced Alternative$0.00$0.00$0.00ClackamasHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00ClackamasHumana Insurance CompanyHumana Gold Choice H8145-093 (PFFS)H8145093PFFSNo?Enhanced Alternative$47.60$34.90$4.60ClackamasKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20ClackamasKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00ClackamasProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10ClackamasProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30ClackamasProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70ClackamasProvidence Health AssuranceProvidence Medicare Prime + RX (HMO-POS)H9047037HMOPOSNo?Enhanced Alternative$0.00$0.00$0.00ClackamasAgeRight Advantage Health Plan (HMO SNP)AgeRight Advantage Health Plan (HMO SNP) (HMO SNP)H1372001HMOYesInstitutionalDefined Standard Benefit$0.00$30.40$0.00ClackamasUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00ClackamasUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00ClackamasFamilyCare HealthFamilyCare Community (HMO SNP)H3818002HMOYesDual-EligibleEnhanced Alternative$0.00$31.40$0.00ClackamasCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00ClackamasHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00ClackamasProvidence Health AssuranceProvidence Medicare Dual Plus (HMO SNP)H9047043HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00ClatsopProvidence ElderPlace PortlandProvidence ElderPlace Portland (dual eligible) (PACE)H3809001National PACENo???$161.70$0.00ClatsopProvidence ElderPlace PortlandProvidence ElderPlace Portland (private pay) (PACE)H3809002National PACENo???$125.50$498.80ClatsopModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60ClatsopFamilyCare HealthFamilyCare Advantage Rx (HMO)H3818003HMONo?Enhanced Alternative$0.00$0.00$0.00ClatsopCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00ClatsopFamilyCare HealthFamilyCare Community (HMO SNP)H3818002HMOYesDual-EligibleEnhanced Alternative$0.00$31.40$0.00ClatsopCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00ColumbiaModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60ColumbiaRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70ColumbiaRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80ColumbiaCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00ColumbiaHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00ColumbiaKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20ColumbiaKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00ColumbiaProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10ColumbiaProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30ColumbiaProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70ColumbiaCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00CoosModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60CoosRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70CoosRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80CoosPacificSource MedicarePacificSource Medicare Essentials Rx 26 (HMO)H3864026HMONo?Enhanced Alternative$55.00$31.00$0.00CoosPacificSource MedicarePacificSource Medicare Explorer Rx 7 (PPO)H4754007Local PPONo?Enhanced Alternative$74.40$29.60$16.00CrookModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60CrookPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40CrookPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20CrookPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50CrookHumana Insurance CompanyHumanaChoice H6609-013 (PPO)H6609013Local PPONo?Enhanced Alternative$66.40$31.50$4.10CrookHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00CrookProvidence Health AssuranceProvidence Medicare Latitude + RX (HMO-POS)H9047038HMOPOSNo?Enhanced Alternative$111.60$46.40$22.60CrookProvidence Health AssuranceProvidence Medicare Compass + RX (HMO-POS)H9047039HMOPOSNo?Enhanced Alternative$59.70$39.30$4.50CurryModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60CurryRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70CurryRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80CurryPacificSource MedicarePacificSource Medicare Essentials Rx 26 (HMO)H3864026HMONo?Enhanced Alternative$55.00$31.00$0.00CurryPacificSource MedicarePacificSource Medicare Explorer Rx 7 (PPO)H4754007Local PPONo?Enhanced Alternative$74.40$29.60$16.00DeschutesHumana Medical Plan, Inc.Humana Gold Plus H1036-219 (HMO)H1036219HMONo?Enhanced Alternative$47.60$16.10$7.30DeschutesModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60DeschutesPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40DeschutesPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20DeschutesPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50DeschutesHumana Insurance CompanyHumanaChoice H6609-013 (PPO)H6609013Local PPONo?Enhanced Alternative$66.40$31.50$4.10DeschutesHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00DeschutesProvidence Health AssuranceProvidence Medicare Latitude + RX (HMO-POS)H9047038HMOPOSNo?Enhanced Alternative$111.60$46.40$22.60DeschutesProvidence Health AssuranceProvidence Medicare Compass + RX (HMO-POS)H9047039HMOPOSNo?Enhanced Alternative$59.70$39.30$4.50DouglasAllCare AdvantageAllCare Advantage Gold Plus Rx (HMO)H3810003HMONo?Enhanced Alternative$90.60$50.90$16.10DouglasModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60DouglasRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70DouglasRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80DouglasHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520004Local PPONo?Enhanced Alternative$71.10$33.90$0.00DouglasHealth Net Life Insurance CompanyHealth Net Violet Option 3 (PPO)H5520014Local PPONo?Enhanced Alternative$0.00$0.00$0.00DouglasHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520015Local PPONo?Basic Alternative$0.00$25.00$0.00DouglasATRIO Health PlansATRIO Silver Rx (PPO)H6743003Local PPONo?Enhanced Alternative$80.40$32.60$0.00DouglasATRIO Health PlansATRIO Gold Rx (PPO)H6743004Local PPONo?Enhanced Alternative$132.60$32.60$14.80DouglasATRIO Health PlansATRIO Bronze Rx (Umpqua) (PPO)H6743007Local PPONo?Enhanced Alternative$0.00$0.00$0.00DouglasATRIO Health PlansATRIO Special Needs Plan (HMO SNP)H3814007HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00GilliamModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60GilliamModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20GrantModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60GrantPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40GrantPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20GrantPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50GrantModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20HarneyModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60HarneyModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20Hood RiverModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60Hood RiverPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40Hood RiverPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20Hood RiverPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50Hood RiverHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00Hood RiverProvidence Health AssuranceProvidence Medicare Latitude + RX (HMO-POS)H9047038HMOPOSNo?Enhanced Alternative$111.60$46.40$22.60Hood RiverProvidence Health AssuranceProvidence Medicare Compass + RX (HMO-POS)H9047039HMOPOSNo?Enhanced Alternative$59.70$39.30$4.50JacksonAllCare AdvantageAllCare Advantage Gold Plus Rx (HMO)H3810003HMONo?Enhanced Alternative$90.60$50.90$16.10JacksonModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60JacksonRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70JacksonRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80JacksonHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520004Local PPONo?Enhanced Alternative$71.10$33.90$0.00JacksonHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520015Local PPONo?Basic Alternative$0.00$25.00$0.00JacksonATRIO Health PlansATRIO Bronze Rx (Rogue) (PPO)H6743014Local PPONo?Enhanced Alternative$0.00$0.00$0.00JacksonATRIO Health PlansATRIO Silver Rx (Rogue) (PPO)H6743016Local PPONo?Enhanced Alternative$67.20$13.50$22.30JacksonATRIO Health PlansATRIO Gold Rx (Rogue) (PPO)H6743017Local PPONo?Enhanced Alternative$100.50$29.00$35.50JacksonATRIO Health PlansATRIO Special Needs Plan (Rogue) (HMO SNP)H3814029HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00JacksonCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00JeffersonHumana Medical Plan, Inc.Humana Gold Plus H1036-219 (HMO)H1036219HMONo?Enhanced Alternative$47.60$16.10$7.30JeffersonModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60JeffersonPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40JeffersonPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20JeffersonPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50JeffersonHumana Insurance CompanyHumanaChoice H6609-013 (PPO)H6609013Local PPONo?Enhanced Alternative$66.40$31.50$4.10JeffersonHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00JeffersonProvidence Health AssuranceProvidence Medicare Latitude + RX (HMO-POS)H9047038HMOPOSNo?Enhanced Alternative$111.60$46.40$22.60JeffersonProvidence Health AssuranceProvidence Medicare Compass + RX (HMO-POS)H9047039HMOPOSNo?Enhanced Alternative$59.70$39.30$4.50JosephineAllCare AdvantageAllCare Advantage Gold Plus Rx (HMO)H3810003HMONo?Enhanced Alternative$90.60$50.90$16.10JosephineModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60JosephineRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70JosephineRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80JosephineHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520004Local PPONo?Enhanced Alternative$71.10$33.90$0.00JosephineHealth Net Life Insurance CompanyHealth Net Violet Option 3 (PPO)H5520014Local PPONo?Enhanced Alternative$0.00$0.00$0.00JosephineHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520015Local PPONo?Basic Alternative$0.00$25.00$0.00JosephineATRIO Health PlansATRIO Bronze Rx (Rogue) (PPO)H6743014Local PPONo?Enhanced Alternative$0.00$0.00$0.00JosephineATRIO Health PlansATRIO Silver Rx (Rogue) (PPO)H6743016Local PPONo?Enhanced Alternative$67.20$13.50$22.30JosephineATRIO Health PlansATRIO Gold Rx (Rogue) (PPO)H6743017Local PPONo?Enhanced Alternative$100.50$29.00$35.50JosephineATRIO Health PlansATRIO Special Needs Plan (Rogue) (HMO SNP)H3814029HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00JosephineCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00KlamathModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60KlamathPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40KlamathPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20KlamathPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50KlamathATRIO Health PlansATRIO Bronze Rx (Basin) (PPO)H6743001Local PPONo?Enhanced Alternative$0.00$21.00$0.00KlamathATRIO Health PlansATRIO Silver Rx (PPO)H6743003Local PPONo?Enhanced Alternative$80.40$32.60$0.00KlamathATRIO Health PlansATRIO Gold Rx (PPO)H6743004Local PPONo?Enhanced Alternative$132.60$32.60$14.80KlamathAgeRight Advantage Health Plan (HMO SNP)AgeRight Advantage Health Plan (HMO SNP) (HMO SNP)H1372001HMOYesInstitutionalDefined Standard Benefit$0.00$30.40$0.00KlamathATRIO Health PlansATRIO Special Needs Plan (HMO SNP)H3814007HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00LakeModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60LakePacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40LakePacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20LakePacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50LakeModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20LaneUnitedHealthcareAARP MedicareComplete Choice (PPO)H2228029Local PPONo?Enhanced Alternative$2.50$29.50$0.00LaneUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805007HMONo?Enhanced Alternative$24.80$21.20$0.00LaneUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805013HMONo?Enhanced Alternative$0.00$0.00$0.00LaneModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60LaneRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$2.00$41.00$6.20LaneRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$106.40$66.90$55.80LanePacificSource MedicarePacificSource Medicare Essentials Rx 26 (HMO)H3864026HMONo?Enhanced Alternative$38.00$31.00$0.00LanePacificSource MedicarePacificSource Medicare Explorer Rx 4 (PPO)H4754004Local PPONo?Enhanced Alternative$95.50$46.50$31.70LaneHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90LaneHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$19.00$0.00LaneHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00LaneTrillium Medicare AdvantageTrillium Advantage Pioneer Rx (PPO)H6951002Local PPONo?Enhanced Alternative$25.60$64.40$29.60LaneProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10LaneProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30LaneProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70LaneTrillium Medicare AdvantageTrillium Advantage Dual (HMO SNP)H2174001HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00LaneTrillium Medicare AdvantageTrillium Advantage TLC ISNP (HMO SNP)H2174003HMOYesInstitutionalDefined Standard Benefit$0.00$34.80$0.00LaneTrillium Medicare AdvantageTrillium Advantage TLC Community ISNP (HMO SNP)H2174005HMOYesInstitutionalDefined Standard Benefit$0.00$34.80$0.00LaneUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00LaneUnitedHealthcareUnitedHealthcare Assisted Living Plan (HMO SNP)H3113008HMOYesInstitutionalBasic Alternative$0.00$34.80$0.00LaneHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00LincolnSamaritan Advantage Health PlanSamaritan Advantage Premier Plan (HMO)H3811002HMONo?Enhanced Alternative$56.60$53.40$18.60LincolnSamaritan Advantage Health PlanSamaritan Advantage Premier Plan Plus (HMO)H3811009HMONo?Enhanced Alternative$70.90$69.10$34.30LincolnModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60LincolnHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00LincolnSamaritan Advantage Health PlanSamaritan Advantage Special Needs Plan (HMO SNP)H3811003HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00LinnUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805007HMONo?Enhanced Alternative$24.80$21.20$0.00LinnUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805013HMONo?Enhanced Alternative$0.00$0.00$0.00LinnSamaritan Advantage Health PlanSamaritan Advantage Premier Plan (HMO)H3811002HMONo?Enhanced Alternative$56.60$53.40$18.60LinnSamaritan Advantage Health PlanSamaritan Advantage Premier Plan Plus (HMO)H3811009HMONo?Enhanced Alternative$70.90$69.10$34.30LinnModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60LinnRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70LinnRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80LinnHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90LinnHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$24.00$0.00LinnHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00LinnHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00LinnKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20LinnKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00LinnUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00LinnUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00LinnSamaritan Advantage Health PlanSamaritan Advantage Special Needs Plan (HMO SNP)H3811003HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00LinnHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00MalheurModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60MalheurHumana Insurance CompanyHumanaChoice H6609-009 (PPO)H6609009Local PPONo?Enhanced Alternative$34.70$15.10$6.20MalheurHumana Insurance CompanyHumanaChoice H6609-073 (PPO)H6609073Local PPONo?Basic Alternative$168.90$32.10$0.00MalheurModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20MarionUnitedHealthcareAARP MedicareComplete Choice (PPO)H2228029Local PPONo?Enhanced Alternative$2.50$29.50$0.00MarionUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805001HMONo?Enhanced Alternative$40.50$26.50$0.00MarionUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805012HMONo?Enhanced Alternative$0.00$0.00$0.00MarionModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60MarionRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70MarionRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80MarionHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90MarionHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$32.00$0.00MarionRegence BlueCross BlueShield of OregonRegence BlueAdvantage HMO (HMO)H6237003HMONo?Enhanced Alternative$0.00$0.00$0.00MarionHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00MarionATRIO Health PlansATRIO Gold Rx (Willamette) (PPO)H7006001Local PPONo?Enhanced Alternative$139.50$45.50$10.70MarionATRIO Health PlansATRIO Silver Rx (Willamette) (PPO)H7006003Local PPONo?Enhanced Alternative$54.10$12.90$0.00MarionKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20MarionKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00MarionProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10MarionProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30MarionProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70MarionUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00MarionUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00MarionATRIO Health PlansATRIO Special Needs Plan (Willamette) (HMO SNP)H5995001HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00MorrowModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60MorrowModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20MultnomahHumana Medical Plan, Inc.Humana Gold Plus H1036-153 (HMO)H1036153HMONo?Enhanced Alternative$0.00$0.00$0.00MultnomahUnitedHealthcareAARP MedicareComplete Choice (PPO)H2228029Local PPONo?Enhanced Alternative$2.50$29.50$0.00MultnomahUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805001HMONo?Enhanced Alternative$40.50$26.50$0.00MultnomahUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805012HMONo?Enhanced Alternative$0.00$0.00$0.00MultnomahProvidence ElderPlace PortlandProvidence ElderPlace Portland (dual eligible) (PACE)H3809001National PACENo???$161.70$0.00MultnomahProvidence ElderPlace PortlandProvidence ElderPlace Portland (private pay) (PACE)H3809002National PACENo???$125.50$498.80MultnomahModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60MultnomahRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$2.00$41.00$6.20MultnomahRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$106.40$66.90$55.80MultnomahFamilyCare HealthFamilyCare Advantage Rx (HMO)H3818003HMONo?Enhanced Alternative$0.00$0.00$0.00MultnomahPacificSource MedicarePacificSource Medicare MyCare Rx 22 (HMO)H3864022HMONo?Enhanced Alternative$48.80$29.20$0.00MultnomahHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90MultnomahHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$19.00$0.00MultnomahCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00MultnomahRegence BlueCross BlueShield of OregonRegence BlueAdvantage HMO (HMO)H6237003HMONo?Enhanced Alternative$0.00$0.00$0.00MultnomahHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00MultnomahHumana Insurance CompanyHumana Gold Choice H8145-093 (PFFS)H8145093PFFSNo?Enhanced Alternative$47.60$34.90$4.60MultnomahKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20MultnomahKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00MultnomahProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10MultnomahProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30MultnomahProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70MultnomahProvidence Health AssuranceProvidence Medicare Prime + RX (HMO-POS)H9047037HMOPOSNo?Enhanced Alternative$0.00$0.00$0.00MultnomahAgeRight Advantage Health Plan (HMO SNP)AgeRight Advantage Health Plan (HMO SNP) (HMO SNP)H1372001HMOYesInstitutionalDefined Standard Benefit$0.00$30.40$0.00MultnomahUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00MultnomahUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00MultnomahFamilyCare HealthFamilyCare Community (HMO SNP)H3818002HMOYesDual-EligibleEnhanced Alternative$0.00$31.40$0.00MultnomahCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00MultnomahHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00MultnomahProvidence Health AssuranceProvidence Medicare Dual Plus (HMO SNP)H9047043HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00PolkUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805001HMONo?Enhanced Alternative$40.50$26.50$0.00PolkUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805012HMONo?Enhanced Alternative$0.00$0.00$0.00PolkModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60PolkRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70PolkRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80PolkHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90PolkHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$32.00$0.00PolkRegence BlueCross BlueShield of OregonRegence BlueAdvantage HMO (HMO)H6237003HMONo?Enhanced Alternative$0.00$0.00$0.00PolkHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00PolkATRIO Health PlansATRIO Gold Rx (Willamette) (PPO)H7006001Local PPONo?Enhanced Alternative$139.50$45.50$10.70PolkATRIO Health PlansATRIO Silver Rx (Willamette) (PPO)H7006003Local PPONo?Enhanced Alternative$54.10$12.90$0.00PolkKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20PolkKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00PolkProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10PolkProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30PolkProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70PolkATRIO Health PlansATRIO Special Needs Plan (Willamette) (HMO SNP)H5995001HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00ShermanModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60ShermanPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40ShermanPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20ShermanPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50ShermanModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20TillamookProvidence ElderPlace PortlandProvidence ElderPlace Portland (dual eligible) (PACE)H3809001National PACENo???$161.70$0.00TillamookProvidence ElderPlace PortlandProvidence ElderPlace Portland (private pay) (PACE)H3809002National PACENo???$125.50$498.80TillamookModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60TillamookCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00TillamookCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00UmatillaModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60UmatillaModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20UnionModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60UnionModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20WallowaModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60WallowaModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20WascoModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60WascoPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40WascoPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20WascoPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50WashingtonHumana Medical Plan, Inc.Humana Gold Plus H1036-153 (HMO)H1036153HMONo?Enhanced Alternative$0.00$0.00$0.00WashingtonUnitedHealthcareAARP MedicareComplete Choice (PPO)H2228029Local PPONo?Enhanced Alternative$2.50$29.50$0.00WashingtonUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805001HMONo?Enhanced Alternative$40.50$26.50$0.00WashingtonUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805012HMONo?Enhanced Alternative$0.00$0.00$0.00WashingtonProvidence ElderPlace PortlandProvidence ElderPlace Portland (dual eligible) (PACE)H3809001National PACENo???$161.70$0.00WashingtonProvidence ElderPlace PortlandProvidence ElderPlace Portland (private pay) (PACE)H3809002National PACENo???$125.50$498.80WashingtonModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60WashingtonRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$2.00$41.00$6.20WashingtonRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$106.40$66.90$55.80WashingtonFamilyCare HealthFamilyCare Advantage Rx (HMO)H3818003HMONo?Enhanced Alternative$0.00$0.00$0.00WashingtonPacificSource MedicarePacificSource Medicare MyCare Rx 22 (HMO)H3864022HMONo?Enhanced Alternative$48.80$29.20$0.00WashingtonHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90WashingtonHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$19.00$0.00WashingtonCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00WashingtonRegence BlueCross BlueShield of OregonRegence BlueAdvantage HMO (HMO)H6237003HMONo?Enhanced Alternative$0.00$0.00$0.00WashingtonHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00WashingtonHumana Insurance CompanyHumana Gold Choice H8145-093 (PFFS)H8145093PFFSNo?Enhanced Alternative$47.60$34.90$4.60WashingtonKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20WashingtonKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00WashingtonProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10WashingtonProvidence Health AssuranceProvidence Medicare Extra Part B Only + RX (HMO)H9047013HMONo?Enhanced Alternative$375.60$42.10$7.30WashingtonProvidence Health AssuranceProvidence Medicare Choice + RX (HMO-POS)H9047024HMOPOSNo?Enhanced Alternative$39.50$48.50$13.70WashingtonProvidence Health AssuranceProvidence Medicare Prime + RX (HMO-POS)H9047037HMOPOSNo?Enhanced Alternative$0.00$0.00$0.00WashingtonAgeRight Advantage Health Plan (HMO SNP)AgeRight Advantage Health Plan (HMO SNP) (HMO SNP)H1372001HMOYesInstitutionalDefined Standard Benefit$0.00$30.40$0.00WashingtonUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00WashingtonUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00WashingtonFamilyCare HealthFamilyCare Community (HMO SNP)H3818002HMOYesDual-EligibleEnhanced Alternative$0.00$31.40$0.00WashingtonCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00WashingtonHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00WashingtonProvidence Health AssuranceProvidence Medicare Dual Plus (HMO SNP)H9047043HMOYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00WheelerModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60WheelerPacificSource MedicarePacificSource Medicare Essentials Rx 6 (HMO)H3864006HMONo?Enhanced Alternative$134.80$50.30$35.40WheelerPacificSource MedicarePacificSource Medicare Essentials Choice Rx 14 (HMO-POS)H3864014HMOPOSNo?Enhanced Alternative$73.80$34.00$19.20WheelerPacificSource MedicarePacificSource Medicare Essentials Rx 27 (HMO)H3864027HMONo?Basic Alternative$67.70$54.30$19.50WheelerModa Health Plan, Inc.Moda Health HMO (HMO-POS)H8506001HMOPOSNo?Enhanced Alternative$0.00$63.00$28.20WheelerProvidence Health AssuranceProvidence Medicare Latitude + RX (HMO-POS)H9047038HMOPOSNo?Enhanced Alternative$111.60$46.40$22.60WheelerProvidence Health AssuranceProvidence Medicare Compass + RX (HMO-POS)H9047039HMOPOSNo?Enhanced Alternative$59.70$39.30$4.50YamhillUnitedHealthcareAARP MedicareComplete Choice (PPO)H2228029Local PPONo?Enhanced Alternative$2.50$29.50$0.00YamhillUnitedHealthcareAARP MedicareComplete Plan 1 (HMO)H3805001HMONo?Enhanced Alternative$40.50$26.50$0.00YamhillUnitedHealthcareAARP MedicareComplete Plan 2 (HMO)H3805012HMONo?Enhanced Alternative$0.00$0.00$0.00YamhillModa Health Plan, Inc.Moda Health PPORX (PPO)H3813006Local PPONo?Enhanced Alternative$40.60$57.40$22.60YamhillRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Classic (PPO)H3817008Local PPONo?Basic Alternative$51.50$49.50$14.70YamhillRegence BlueCross BlueShield of OregonRegence MedAdvantage + Rx Enhanced (PPO)H3817009Local PPONo?Enhanced Alternative$147.40$66.90$55.80YamhillHealth Net Life Insurance CompanyHealth Net Violet Option 1 (PPO)H5520002Local PPONo?Enhanced Alternative$76.30$39.70$4.90YamhillHealth Net Life Insurance CompanyHealth Net Violet Option 2 (PPO)H5520012Local PPONo?Basic Alternative$0.00$24.00$0.00YamhillCareOregon AdvantageCareOregon Advantage Star (HMO-POS)H5859003HMOPOSNo?Enhanced Alternative$0.00$34.80$0.00YamhillHealth Net Health Plan of Oregon, Inc.Health Net Ruby (HMO)H6815003HMONo?Enhanced Alternative$0.00$0.00$0.00YamhillKaiser PermanenteKaiser Permanente Senior Advantage (HMO)H9003001HMONo?Enhanced Alternative$61.00$41.50$31.20YamhillKaiser PermanenteKaiser Permanente Senior Advantage Basic (HMO)H9003006HMONo?Enhanced Alternative$14.70$29.30$0.00YamhillProvidence Health AssuranceProvidence Medicare Extra + RX (HMO)H9047001HMONo?Enhanced Alternative$109.10$52.50$18.10YamhillAgeRight Advantage Health Plan (HMO SNP)AgeRight Advantage Health Plan (HMO SNP) (HMO SNP)H1372001HMOYesInstitutionalDefined Standard Benefit$0.00$30.40$0.00YamhillUnitedHealthcareUnitedHealthcare Nursing Home Plan (PPO SNP)H2228016Local PPOYesInstitutionalDefined Standard Benefit$0.00$28.70$0.00YamhillUnitedHealthcareUnitedHealthcare Assisted Living Plan (PPO SNP)H2228017Local PPOYesInstitutionalBasic Alternative$0.00$24.90$0.00YamhillCareOregon AdvantageCareOregon Advantage Plus (HMO-POS SNP)H5859001HMOPOSYesDual-EligibleDefined Standard Benefit$0.00$34.80$0.00YamhillHealth Net Health Plan of Oregon, Inc.Health Net Jade (HMO SNP)H6815004HMOYesChronic or Disabling ConditionEnhanced Alternative$0.00$0.00$0.00 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download