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Information Memorandum TransmittalAging and People with DisabilitiesKevin NygrenAuthorized signatureNumber: APD-IM-19-013Issue date: 3/4/2019Topic: OtherDue date:Subject: Oregon's 2019 Medicare Advantage PlansApplies to (check all that apply):All DHS employeesArea Agencies on Aging: Types A and BAging and People with DisabilitiesSelf Sufficiency ProgramsCounty DD program managersODDS Children’s Residential ServicesChild Welfare ProgramsCounty Mental Health DirectorsHealth ServicesOffice of DevelopmentalDisabilities Services (ODDS)ODDS Children’s Intensive InHome ServicesStabilization and Crisis Unit (SACU)Other (please specify):Message:Recently, the Centers for Medicare and Medicaid Services (CMS) announced the 2019Medicare Advantage and Medicare Advantage Prescription Drug Plans (MA-PDs).MA-PD plans are Medicare Advantage plans that offer Medicare Prescription Drugcoverage along with Part A and Part B benefits in one Plans. When a consumer isenrolled in a Medicare Advantage Plan the Medicare services are paid through theplans and are not paid through Original Medicare.MA-PDs Special Needs Plans (SNP) are plans specifically designed to provide targetcare to special needs individuals. A special needs individual could be any one of thefollowing: An institutionalized individual, a dual eligible, or an individual with a severeor disabling chronic condition, as specified by CMS. There are three different types ofSpecial Needs Plans: Chronic Condition SNP (C-SNP), Dual Eligible SNP (D-SNP),Institutional SNP (I-SNP).MSC 0080 (rev. 11/17)
The 1st attached document is the “2019” MA-PDs” plan list. The MA-PDs arealphabetically arranged by county. MA-PDs Special Needs Plans (SNP) arehighlighted in yellow.The 2nd attached document is the CCO Affiliated Medicare Advantage list.The 3rd attached document is the Medicare Advantage Health Plan enrollment contactlist.4th attached document is the Medicare Advantage FAQ’s for Dual Eligibles.sdfIf you have any questions about this information, contact:Contact(s): Kesha BaxterPhone: 503-945-6082Email: Kesha.L.Baxter@state.or.usFax: 503-945-6606MSC 0080 (rev. 11/17)
2019 Medicare Advantage Prescription Drug Plan ListCountyOrganization NamePlan NameBakerModa Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.Moda Health PPORX(PPO)Moda Health HMO(HMO)Moda Health HMOEnhanced RX entonUnitedHealthcareBentonSamaritan AdvantageHealth maritan AdvantageHealth PlanSamaritan AdvantageHealth PlanModa Health Plan,Inc.Regence BlueCrossBlueShield ealthcare NursingHome Plan 2 (PPO SNP)UnitedHealthcareAssisted Living Plan 2(PPO SNP)UnitedHealthcareAssisted Living Plan 1(PPO SNP)Samaritan AdvantageSpecial Needs Plan (HMOSNP)AARP MedicareCompletePlan 1 (HMO)AARP MedicareCompletePlan 2 (HMO)Samaritan AdvantagePremier Plan (HMO)Samaritan AdvantagePremier Plan Plus (HMO)Moda Health PPORX(PPO)Regence MedAdvantage Rx Classic (PPO)ContractIDPlanIDPlan TypeSpecialNeedsPlanSpecialNeeds PlanTypeBenefitTypeH3813006Local PPONoH8506001HMONoH8506003HMONoH0710036Local 710037Local l 813006Local ocal PPONoEnhancedAlternativePart CPremium2Part DBasicPremium3Part DPremiumObligation withFull PremiumAssistance 79.90 52.10 18.30 91.30 17.70 0.00 120.30 68.20 48.90 0.00 33.80 0.00 0.00 25.70 0.00 0.00 27.80 0.00 0.00 33.80 0.00 36.10 18.90 0.00 0.00 0.00 0.00 49.80 50.20 16.40 74.50 54.50 20.70 79.90 52.10 18.30 33.00 43.00 9.20
2019 Medicare Advantage Prescription Drug Plan ListBentonBentonBentonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence MedAdvantage Rx Enhanced (PPO)009Local PPONoH3817011Local PPONoH5216048Local PPONoHealth Net Violet 1 (PPO)H5439011Local PPONoHealth Net Violet 2 (PPO)H5439014Local PPONoHealth Net Ruby (HMO)Kaiser Permanente SeniorAdvantage (HMO)Kaiser Permanente SeniorAdvantage Basic (HMO)Providence MedicareEnrich RX 45HMONoH0710036Local PPOYesInstitutionalH0710037Local 8016Local PPOYesInstitutionalH2228017Local egence MedAdvantage Rx Primary (PPO)HumanaChoice H5216048 (PPO)BentonHumanaHealth Net LifeInsurance CompanyHealth Net LifeInsurance CompanyHealth Net HealthPlan of Oregon, Inc.BentonKaiser PermanenteBentonBentonKaiser PermanenteProvidence lackamasUnitedHealthcareAgeRight AdvantageHealth Plan althcareUnitedHealthcare NursingHome Plan 1 (PPO SNP)UnitedHealthcareAssisted Living Plan 1(PPO SNP)ClackamasCareOregonAdvantageCareOregon AdvantagePlus (HMO-POS lthcare NursingHome Plan 2 (PPO SNP)UnitedHealthcareAssisted Living Plan 2(PPO SNP)AgeRight AdvantageHealth Plan (HMO tiveDefinedStandardBenefit 117.10 58.10 44.10 0.00 19.00 0.00 166.40 34.60 0.60 74.60 45.40 11.60 0.00 24.00 0.00 0.00 0.00 0.00 73.40 39.50 19.80 15.40 28.60 0.00 94.40 52.60 18.80 0.00 33.80 0.00 0.00 25.70 0.00 0.00 33.80 0.00 0.00 33.80 0.00 0.00 27.80 0.00 0.00 33.80 0.00
2019 Medicare Advantage Prescription Drug Plan ListClackamasProvidence hcareClackamasProvidenceElderPlace rovidenceElderPlace PortlandModa Health Plan,Inc.Moda Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield HumanaHealth Net LifeInsurance CompanyProvidence MedicareDual Plus (HMO SNP)Humana Gold PlusH1036-153 (HMO)AARP MedicareCompleteChoice (PPO)AARP MedicareCompletePlan 1 (HMO)AARP MedicareCompletePlan 2 (HMO)Providence ElderPlacePortland (dual eligible)(PACE)Providence ElderPlacePortland (private pay)(PACE)Moda Health PPORX(PPO)Moda Health PPORXEnhanced (PPO)H9047043HMOYesH1036153HMONoH2228029Local PPONoH3805001HMONoH3805012HMONoH3809001National PACENoH3809002National hancedAlternative 0.00 33.80 0.00 0.00 0.00 0.00 11.70 23.30 0.00 52.10 21.90 0.00 0.00 0.00 0.00 220.00 0.00 159.20 661.40H3813006Local PPONoH3813009Local PPONoEnhancedAlternativeEnhancedAlternativeRegence MedAdvantage Rx Classic (PPO)H3817008Local PPONoEnhancedAlternative 5.00 43.00 9.20Regence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoEnhancedAlternative 106.60 52.70 34.60H3817011Local PPONo 0.10 18.90 0.00H3864039HMONo 19.40 48.60 14.80H3864040HMONo 0.00 0.00 0.00H5216048Local PPONo 166.40 34.60 0.60H5439011Local PPONo 74.60 45.40 11.60Regence MedAdvantage Rx Primary (PPO)PacificSource MedicareMyCare Rx 39 (HMO)PacificSource MedicareMyCare Rx 40 (HMO)HumanaChoice H5216048 (PPO)Health Net Violet 1 dAlternativeBasicAlternativeEnhancedAlternative 79.90 52.10 18.30 122.80 60.30 38.40
2019 Medicare Advantage Prescription Drug Plan ListClackamasHealth Net LifeInsurance CompanyRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonHealth Net HealthPlan of Oregon, Inc.ClackamasKaiser PermanenteClackamasKaiser PermanenteProvidence HealthAssuranceClackamasClackamasClackamasHealth Net Violet 2 (PPO)H5439014Local PPONoEnhancedAlternative 0.00 19.00 0.00Regence BlueAdvantageHMO (HMO)H6237004HMONoEnhancedAlternative 0.00 0.00 0.00Regence BlueAdvantageHMO Plus (HMO)H6237005HMONo 6.90 28.10 0.00H6815003HMONo 0.00 0.00 0.00H9003001HMONo 73.40 39.50 19.80H9003006HMONo 15.40 28.60 0.00H9047001HMONo 123.40 49.60 15.80H9047024HMOPOSNo 41.60 46.40 12.60H9047037HMONo 0.00 0.00 0.00H9431005Local PPONo 3.80 13.20 0.00H9431008Local PPONo 33.10 13.90 0.00H3809001National PACENo 220.00 0.00H3809002National PACENo 159.20 661.40H3813006Local PPONo 79.90 52.10 18.30H3813008Local PPONo 131.80 52.20 29.40H5859001HMOPOSYes 0.00 33.80 0.00ClatsopProvidenceElderPlace PortlandModa Health Plan,Inc.Moda Health Plan,Inc.Health Net Ruby (HMO)Kaiser Permanente SeniorAdvantage (HMO)Kaiser Permanente SeniorAdvantage Basic (HMO)Providence MedicareExtra RX (HMO)Providence MedicareChoice RX (HMOPOS)Providence MedicarePrime RX (HMO)Aetna Medicare ChoicePlan (PPO)Aetna Medicare SelectPlan (PPO)Providence ElderPlacePortland (dual eligible)(PACE)Providence ElderPlacePortland (private pay)(PACE)Moda Health PPORX(PPO)Moda Health PPORXEnhanced (PPO)ColumbiaCareOregonAdvantageCareOregon AdvantagePlus (HMO-POS SNP)ClackamasClackamasProvidence HealthAssuranceProvidence HealthAssuranceClackamasAetna MedicareClackamasAetna MedicareClatsopProvidenceElderPlace tiveDefinedStandardBenefit
2019 Medicare Advantage Prescription Drug Plan ListColumbiaModa Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonColumbiaHumanaColumbiaKaiser PermanenteColumbiaKaiser PermanenteProvidence umbiaCoosCoosCoosCoosCoosCoos5Providence HealthAssuranceModa Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield Moda Health PPORX(PPO)H3813006Local PPONoEnhancedAlternative 79.90 52.10 18.30Regence MedAdvantage Rx Classic (PPO)H3817008Local PPONoEnhancedAlternative 33.00 43.00 9.20Regence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoEnhancedAlternative 117.10 58.10 44.10H3817011Local PPONo 0.00 19.00 0.00H5216048Local PPONo 166.40 34.60 0.60H9003001HMONo 73.40 39.50 19.80H9003006HMONo 15.40 28.60 0.00H9047001HMONo 123.40 49.60 15.80H9047024HMOPOSNo 41.60 46.40 12.60H3813006Local PPONoEnhancedAlternativeEnhancedAlternative 79.90 52.10 18.30Regence MedAdvantage Rx Classic (PPO)H3817008Local PPONoEnhancedAlternative 33.00 43.00 9.20Regence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoEnhancedAlternative 117.10 58.10 44.10H3817011Local PPONo 0.00 19.00 0.00H3864026HMONo 13.30 49.70 15.90H4754007Local PPONo 59.00 46.20 36.20Regence MedAdvantage Rx Primary (PPO)HumanaChoice H5216048 (PPO)Kaiser Permanente SeniorAdvantage (HMO)Kaiser Permanente SeniorAdvantage Basic (HMO)Providence MedicareExtra RX (HMO)Providence MedicareChoice RX (HMOPOS)Moda Health PPORX(PPO)Regence MedAdvantage Rx Primary (PPO)PacificSource MedicareEssentials Rx 26 (HMO)PacificSource MedicareExplorer Rx 7 tive
2019 Medicare Advantage Prescription Drug Plan ListCoosCrookCrookHealth Net HealthPlan of Oregon, Inc.Moda Health rookCrookHumanaHealth Net HealthPlan of Oregon, Inc.CrookProvidence 6Providence HealthAssuranceModa Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield hancedAlternativeEnhancedAlternativeHealth Net Ruby (HMO)Moda Health PPORX(PPO)PacificSource MedicareEssentials Rx 6 (HMO)PacificSource MedicareEssentials Choice Rx 14(HMO-POS)PacificSource MedicareEssentials Rx 27 (HMO)HumanaChoice H5216044 (PPO)HumanaChoice H5216047 (PPO)HumanaChoice H5216048 (PPO)H6815006HMONoH3813006Local 16044Local PPONoH5216047Local PPONoH5216048Local PPONoHealth Net Ruby (HMO)Providence MedicareLatitude RX (HMOPOS)Providence MedicareCompass RX (HMOPOS)Moda Health EnhancedAlternativeH9047039HMOPOSNoH3813006Local PPONoEnhancedAlternativeEnhancedAlternativeRegence MedAdvantage Rx Classic (PPO)H3817008Local PPONoRegence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoH3817011Local PPONoH3864026HMONoRegence MedAdvantage Rx Primary (PPO)PacificSource MedicareEssentials Rx 26 (HMO) 55.10 28.90 0.00 79.90 52.10 18.30 138.30 56.20 44.90 67.60 48.40 14.60 0.10 66.90 33.10 24.70 24.30 0.00 54.90 39.40 13.30 166.40 34.60 0.60 55.10 28.90 0.00 143.50 51.50 17.70 64.00 35.00 1.20 79.90 52.10 18.30EnhancedAlternative 33.00 43.00 9.20EnhancedAlternative 117.10 58.10 44.10 0.00 19.00 0.00 13.30 49.70 15.90EnhancedAlternativeEnhancedAlternative
2019 Medicare Advantage Prescription Drug Plan edicareHumanaModa Health Plan,Inc.PacificSourceMedicarePacificSource MedicareExplorer Rx 7 (PPO)Humana Gold PlusH1036-219 (HMO)Moda Health PPORX(PPO)PacificSource MedicareEssentials Rx 6 (HMO)PacificSource MedicareEssentials Choice Rx 14(HMO-POS)PacificSource MedicareEssentials Rx 27 (HMO)HumanaChoice H5216044 (PPO)HumanaChoice H5216047 (PPO)HumanaChoice H5216048 utesHumanaHealth Net HealthPlan of Oregon, Inc.DeschutesProvidence HealthAssuranceDeschutesProvidence HealthAssuranceDouglasATRIO Health PlansDouglasAllCare AdvantageATRIO Special NeedsPlan (HMO SNP)AllCare Advantage GoldPlus Rx (HMO)DouglasAllCare AdvantageModa Health Plan,Inc.AllCare AdvantagePreferred Rx (HMO)Moda Health PPORX(PPO)DeschutesDouglas7Health Net Ruby (HMO)Providence MedicareLatitude RX (HMOPOS)Providence MedicareCompass RX ncedAlternativeEnhancedAlternativeH4754007Local PPONoH1036219HMONoH3813006Local 16044Local PPONoH5216047Local PPONoH5216048Local 03HMONoH3810020HMONoH3813006Local EnhancedAlternative 59.00 46.20 36.20 69.00 0.00 0.00 79.90 52.10 18.30 138.30 56.20 44.90 67.60 48.40 14.60 0.10 66.90 33.10 24.70 24.30 0.00 54.90 39.40 13.30 166.40 34.60 0.60 55.10 28.90 0.00 143.50 51.50 17.70 64.00 35.00 1.20 0.00 33.80 0.00 64.60 56.80 40.60 0.00 33.80 0.00 79.90 52.10 18.30
2019 Medicare Advantage Prescription Drug Plan ListDouglasRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonHealth Net LifeInsurance CompanyHealth Net LifeInsurance CompanyHealth Net LifeInsurance CompanyDouglasATRIO Health PlansATRIO Silver Rx (PPO)H6743003Local PPONoDouglasATRIO Health PlansH6743004Local PPONoDouglasH6743007Local PPONo005HMONoH3813006Local PPONoH8506001HMONoH8506003HMONoH3813006Local PPONoH3864006HMONoGrantPacificSourceMedicareHealth Net Ruby (HMO)Moda Health PPORX(PPO)Moda Health HMO(HMO)Moda Health HMOEnhanced RX (HMO)Moda Health PPORX(PPO)PacificSource MedicareEssentials Rx 6 (HMO)PacificSource MedicareEssentials Choice Rx 14(HMO-POS)H6815GrantATRIO Health PlansHealth Net HealthPlan of Oregon, Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.PacificSourceMedicareATRIO Gold Rx (PPO)ATRIO Bronze Rx(Umpqua) Grant8Regence MedAdvantage Rx Classic (PPO)H3817008Local PPONoEnhancedAlternative 33.00 43.00 9.20Regence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoEnhancedAlternative 117.10 58.10 44.10Regence MedAdvantage Rx Primary (PPO)H3817011Local PPONo 0.00 19.00 0.00Health Net Violet 1 (PPO)H5439013Local PPONo 72.80 32.20 0.00Health Net Violet 3 (PPO)H5439015Local PPONo 0.00 0.00 0.00Health Net Violet 2 (PPO)H5439016Local PPONo 0.00 25.00 0.00 79.50 44.00 18.70 123.20 45.30 42.00 0.00 0.00 0.00 0.00 29.00 0.00 79.90 52.10 18.30 91.30 17.70 0.00 120.30 68.20 48.90 79.90 52.10 18.30 138.30 56.20 44.90 67.60 48.40 14.60
2019 Medicare Advantage Prescription Drug Plan ListGrantGrantGrantHarneyHarneyHarneyHood RiverHood RiverPacificSourceMedicareModa Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.Moda Health Plan,Inc.PacificSourceMedicarePacificSource MedicareEssentials Rx 27 (HMO)Moda Health HMO(HMO)Moda Health HMOEnhanced RX (HMO)Moda Health PPORX(PPO)Moda Health HMO(HMO)Moda Health HMOEnhanced RX (HMO)Moda Health PPORX(PPO)PacificSource MedicareEssentials Rx 6 (HMO)PacificSource MedicareEssentials Choice Rx 14(HMO-POS)PacificSource MedicareEssentials Rx 27 (HMO)HumanaChoice H5216048 (PPO)Providence MedicareLatitude RX (HMOPOS)Providence MedicareCompass RX (HMOPOS)Hood d RiverHumanaHood RiverProvidence HealthAssuranceHood RiverProvidence lCare AdvantageCareOregon AdvantagePlus (HMO-POS SNP)AllCare Advantage GoldPlus Rx (HMO)JacksonAllCare AdvantageAllCare AdvantagePreferred Rx (HMO)Hood 006Local PPONoH8506001HMONoH8506003HMONoH3813006Local 16048Local nhancedAlternative 0.10 66.90 33.10 91.30 17.70 0.00 120.30 68.20 48.90 79.90 52.10 18.30 91.30 17.70 0.00 120.30 68.20 48.90 79.90 52.10 18.30 138.30 56.20 44.90 67.60 48.40 14.60 0.10 66.90 Alternative 166.40 34.60 0.60HMOPOSNoEnhancedAlternative 143.50 51.50 17.70039HMOPOSNo 64.00 35.00 1.20H5859001HMOPOSYes 0.00 33.80 0.00H3810003HMONo 64.60 56.80 40.60H3810020HMONo 0.00 33.80 dBenefitEnhancedAlternativeDefinedStandardBenefit
2019 Medicare Advantage Prescription Drug Plan ListJacksonModa Health Plan,Inc.Moda Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonHealth Net LifeInsurance CompanyHealth Net LifeInsurance CompanyJacksonATRIO Health PlansJacksonJacksonATRIO Health PlansHealth Net HealthPlan of Oregon, Inc.JacksonAetna MedicareJacksonAetna MedicareJeffersonJeffersonHumanaModa Health onJefferson10Moda Health PPORX(PPO)Moda Health PPORXEnhanced (PPO) 79.90 52.10 18.30NoEnhancedAlternativeEnhancedAlternative 112.40 70.80 48.80Local PPONoEnhancedAlternative 33.00 43.00 9.20009Local PPONoEnhancedAlternative 117.10 58.10 44.10H3817011Local PPONo 0.00 19.00 0.00Health Net Violet 1 (PPO)H5439013Local PPONo 72.80 32.20 0.00Health Net Violet 2 (PPO)ATRIO Silver Rx (Rogue)(PPO)ATRIO Bronze Rx(Rogue) (PPO)H5439016Local PPONo 0.00 25.00 0.00H6743016Local PPONo 72.90 45.70 22.30H6743018Local PPONo 0.00 15.00 0.00Health Net Ruby (HMO)Aetna Medicare ChoicePlan (PPO)Aetna Medicare SelectPlan (PPO)Humana Gold PlusH1036-219 (HMO)Moda Health PPORX(PPO)PacificSource MedicareEssentials Rx 6 (HMO)PacificSource MedicareEssentials Choice Rx 14(HMO-POS)H6815005HMONo 0.00 29.00 0.00H9431004Local PPONo 23.50 13.50 0.00H9431007Local PPONo 54.00 13.00 0.00H1036219HMONo 69.00 0.00 0.00H3813006Local PPONoH3864006HMOH3864014HMOPOSH3813006Local PPONoH3813007Local PPORegence MedAdvantage Rx Classic (PPO)H3817008Regence MedAdvantage Rx Enhanced (PPO)H3817Regence MedAdvantage Rx Primary (PPO) 79.90 52.10 ancedAlternative 138.30 56.20 44.90NoEnhancedAlternative 67.60 48.40 14.60
2019 Medicare Advantage Prescription Drug Plan effersonHumanaJeffersonJeffersonHumanaHealth Net HealthPlan of Oregon, Inc.JeffersonProvidence HealthAssuranceJeffersonProvidence HealthAssuranceJosephineAllCare AdvantageJosephineAllCare AdvantageModa Health Plan,Inc.Moda Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonHealth Net LifeInsurance CompanyHealth Net LifeInsurance neJosephineJosephine11PacificSource MedicareEssentials Rx 27 (HMO)HumanaChoice H5216044 (PPO)HumanaChoice H5216047 (PPO)HumanaChoice H5216048 (PPO)H3864027HMONoH5216044Local PPONoH5216047Local PPONoH5216048Local 039HMOPOSNoH3810003HMONoH3810020HMONoH3813006Local PPONoH3813007Local PPORegence MedAdvantage Rx Classic (PPO)H3817008Regence MedAdvantage Rx Enhanced (PPO)H3817Regence MedAdvantage Rx Primary (PPO)Health Net Ruby (HMO)Providence MedicareLatitude RX (HMOPOS)Providence MedicareCompass RX (HMOPOS)AllCare Advantage GoldPlus Rx (HMO) 0.10 66.90 33.10 24.70 24.30 0.00 54.90 39.40 13.30 166.40 34.60 0.60 55.10 28.90 0.00 143.50 51.50 17.70 64.00 35.00 1.20 64.60 56.80 40.60 0.00 33.80 0.00 79.90 52.10 ative 112.40 70.80 48.80Local PPONoEnhancedAlternative 33.00 43.00 9.20009Local PPONoEnhancedAlternative 117.10 58.10 44.10H3817011Local PPONo 0.00 19.00 0.00Health Net Violet 1 (PPO)H5439013Local PPONo 72.80 32.20 0.00Health Net Violet 3 (PPO)H5439015Local PPONo 0.00 0.00 0.00AllCare AdvantagePreferred Rx (HMO)Moda Health PPORX(PPO)Moda Health PPORXEnhanced dAlternative
2019 Medicare Advantage Prescription Drug Plan ListJosephineHealth Net LifeInsurance CompanyJosephineATRIO Health PlansJosephineJosephineATRIO Health PlansHealth Net HealthPlan of Oregon, Inc.JosephineAetna MedicareJosephineAetna MedicareAgeRight AdvantageHealth Plan (HMOSNP)KlamathHealth Net Violet 2 (PPO)ATRIO Silver Rx (Rogue)(PPO)ATRIO Bronze Rx(Rogue) (PPO)H5439016Local PPONoH6743016Local PPONoH6743018Local PPONoHealth Net Ruby (HMO)Aetna Medicare ChoicePlan (PPO)Aetna Medicare SelectPlan (PPO)H6815005HMONoH9431004Local PPONoH9431007Local -EligibleH3813006Local PPONoH6743001Local PPONoAgeRight AdvantageHealth Plan (HMO SNP)KlamathATRIO Health PlansModa Health Plan,Inc.KlamathATRIO Health PlansATRIO Special NeedsPlan (HMO SNP)Moda Health PPORX(PPO)ATRIO Bronze Rx(Basin) (PPO)KlamathATRIO Health PlansATRIO Silver Rx (PPO)H6743003Local PPONoKlamathATRIO Gold Rx (PPO)Moda Health PPORX(PPO)Moda Health HMO(HMO)Moda Health HMOEnhanced RX (HMO)H6743004Local PPONoH3813006Local PPONoH8506001HMONoLakeATRIO Health PlansModa Health Plan,Inc.Moda Health Plan,Inc.Moda Health althcare NursingHome Plan 2 (PPO SNP)H0710036Local ernativeEnhancedAlternativeDefinedStandardBenefit 0.00 25.00 0.00 72.90 45.70 22.30 0.00 13.00 0.00 0.00 29.00 0.00 23.50 13.50 0.00 54.00 13.00 0.00 0.00 33.80 0.00 0.00 33.80 0.00 79.90 52.10 18.30 0.00 31.00 0.00 79.50 44.00 18.70 123.20 45.30 42.00 79.90 52.10 18.30 91.30 17.70 0.00 120.30 68.20 48.90 0.00 33.80 0.00
2019 Medicare Advantage Prescription Drug Plan ListLaneAgeRight AdvantageHealth Plan (HMOSNP)AgeRight AdvantageHealth Plan (HMO SNP)H1372001HMOYesInstitutionalLaneTrillium MedicareAdvantageTrillium Advantage Dual(HMO a Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield PacificSourceMedicareHealth Net LifeInsurance lthcare NursingHome Plan 1 (PPO SNP)UnitedHealthcareAssisted Living Plan(HMO SNP)AARP MedicareCompleteChoice (PPO)AARP MedicareCompletePlan 1 (HMO)AARP MedicareCompletePlan 2 (HMO)Moda Health PPORX(PPO) 0.00 33.80 0.00 0.00 33.80 0.00 0.00 33.80 0.00 0.00 12.80 0.00 11.70 23.30 0.00 36.10 18.90 0.00 0.00 0.00 0.00 79.90 52.10 18.30H2228016Local 8029Local PPONoH3805007HMONoH3805013HMONoH3813006Local Regence MedAdvantage Rx Classic (PPO)H3817008Local PPONoEnhancedAlternative 5.00 43.00 9.20Regence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoEnhancedAlternative 106.60 52.70 34.60H3817011Local PPONo 0.10 18.90 0.00H3864026HMONo 19.30 49.70 15.90H3864036HMONo 0.00 39.00 5.20H4754004Local PPONo 48.00 61.00 27.20H5439011Local PPONo 74.60 45.40 11.60Regence MedAdvantage Rx Primary (PPO)PacificSource MedicareEssentials Rx 26 (HMO)PacificSource MedicareEssentials Rx 36 (HMO)PacificSource MedicareExplorer Rx 4 (PPO)Health Net Violet 1 dAlternativeEnhancedAlternativeEnhancedAlternative
2019 Medicare Advantage Prescription Drug Plan ListLaneLaneLaneLaneLaneHealth Net LifeInsurance CompanyHealth Net HealthPlan of Oregon, Inc.Providence HealthAssuranceProvidence HealthAssuranceProvidence HealthAssuranceLincolnSamaritan AdvantageHealth PlanSamaritan AdvantageHealth PlanSamaritan AdvantageHealth PlanModa Health Plan,Inc.Moda Health eEnhancedAlternativeEnhancedAlternativeHealth Net Violet 2 (PPO)H5439014Local PPONoHealth Net Ruby (HMO)Providence MedicareExtra RX (HMO)Providence MedicareChoice RX (HMOPOS)Providence MedicareTimber RX (HMO)Samaritan AdvantageSpecial Needs Plan (HMOSNP)Samaritan AdvantagePremier Plan (HMO)Samaritan AdvantagePremier Plan Plus (HMO)Moda Health PPORX(PPO)Moda Health PPORXEnhanced (PPO)HumanaChoice H5216048 H3813006Local PPONoH3813008Local PPONoH5216048Local PPONoH0710036Local PPOYesInstitutionalH0710037Local PPOYesInstitutionalH2228016Local ardBenefitH2228017Local care NursingHome Plan 2 (PPO SNP)UnitedHealthcareAssisted Living Plan 2(PPO SNP)UnitedHealthcare NursingHome Plan 1 (PPO SNP)UnitedHealthcareAssisted Living Plan 1(PPO iveBasicAlternativeDefinedStandardBenefit 0.00 19.00 0.00 0.00 0.00 0.00 123.40 49.60 15.80 41.60 46.40 12.60 0.00 0.00 0.00 0.00 33.80 0.00 49.80 50.20 16.40 74.50 54.50 20.70 79.90 52.10 18.30 131.80 52.20 29.40 166.40 34.60 0.60 0.00 33.80 0.00 0.00 25.70 0.00 0.00 33.80 0.00 0.00 27.80 0.00
2019 Medicare Advantage Prescription Drug Plan ListLinnSamaritan AdvantageHealth tan AdvantageHealth PlanSamaritan AdvantageHealth PlanModa Health Plan,Inc.Regence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield ofOregonRegence BlueCrossBlueShield th Net LifeInsurance CompanyHealth Net LifeInsurance CompanyHealth Net HealthPlan of Oregon, Inc.LinnKaiser PermanenteLinnKaiser PermanenteProvidence HealthAssuranceLinnLinnLinn15Samaritan AdvantageSpecial Needs Plan (HMOSNP)AARP MedicareCompletePlan 1 (HMO)AARP MedicareCompletePlan 2 (HMO)Samaritan AdvantagePremier Plan (HMO)Samaritan AdvantagePremier Plan Plus (HMO)Moda Health H3811002HMONoH3811009HMONoH3813006Local iveEnhancedAlternativeRegence MedAdvantage Rx Classic (PPO)H3817008Local PPONoRegence MedAdvantage Rx Enhanced (PPO)H3817009Local PPONoH3817011Local PPONoH5216048Local PPONoHealth Net Violet 1 (PPO)H5439011Local PPONoH
MSC 0080 (rev. 11/17) The 1st attached document is the "2019" MA-PDs" plan list. The MA-PDs are alphabetically arranged by county. MA-PDs Special Needs Plans (SNP) are highlighted in yellow. The 2nd attached document is the CCO Affiliated Medicare Advantage list. The 3rd attached document is the Medicare Advantage Health Plan enrollment contact .
