Moda Health Plan, Moda Health Local Enhanced Wallowa Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 Moda Health Plan, Moda Health HMO Enhanced Wallowa Inc. (HMO-POS) 001 HMOPOS No Alternative $0.00 $63.00 $28.20 Moda Health Plan, Moda Health Local Enhanced Inc. (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 PacificSource Medicare PacificSource Essentials Rx 6 Enhanced Wasco Medicare (HMO) H3864 006 HMO No Alternative $134.80 $50.30 $35.40 PacificSource Medicare PacificSource Essentials Choice Enhanced Wasco Medicare Rx 14 (HMO-POS) H3864 014 HMOPOS No Alternative $73.80 $34.00 $19.20 PacificSource Medicare PacificSource Essentials Rx 27 Basic Wasco Medicare (HMO) 027 HMO No Alternative $67.70 $54.30 $19.50 Humana Medical Humana Gold Plus Enhanced Washington Plan, Inc. H1036-153 (HMO) H1036 153 HMO No Alternative $0.00 $0.00 $0.00 AARP MedicareComplete Enhanced Washington UnitedHealthcare Choice (PPO) H2228 029 PPO No Alternative $2.50 $29.50 $0.00 AARP MedicareComplete Enhanced Washington UnitedHealthcare Plan 1 (HMO) H3805 001 HMO No Alternative $40.50 $26.50 $0.00 AARP MedicareComplete Enhanced Washington UnitedHealthcare Plan 2 (HMO) H3805 012 HMO No Alternative $0.00 $0.00 $0.00 Providence ElderPlace Providence Portland (dual National Washington ElderPlace Portland eligible) (PACE) H3809 001 PACE No $161.70 $0.00
Wallowa Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Wallowa Moda Health Plan, Inc. Moda Health HMO (HMO-POS) 001 HMOPOS No Enhanced Alternative $0.00 $63.00 $28.20 Moda Health Plan, Inc. Moda Health (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Wasco PacificSource Medicare PacificSource Medicare Essentials Rx 6 (HMO) H3864 006 HMO No Enhanced Alternative $134.80 $50.30 $35.40 Wasco PacificSource Medicare PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) H3864 014 HMOPOS No Enhanced Alternative $73.80 $34.00 $19.20 Wasco PacificSource Medicare PacificSource Medicare Essentials Rx 27 (HMO) 027 HMO No Basic Alternative $67.70 $54.30 $19.50 Washington Humana Medical Plan, Inc. Humana Gold Plus H1036-153 (HMO) H1036 153 HMO No Enhanced Alternative $0.00 $0.00 $0.00 Washington UnitedHealthcare AARP MedicareComplete Choice (PPO) H2228 029 PPO No Enhanced Alternative $2.50 $29.50 $0.00 Washington UnitedHealthcare AARP MedicareComplete Plan 1 (HMO) H3805 001 HMO No Enhanced Alternative $40.50 $26.50 $0.00 Washington UnitedHealthcare AARP MedicareComplete Plan 2 (HMO) H3805 012 HMO No Enhanced Alternative $0.00 $0.00 $0.00 Washington Providence ElderPlace Portland Providence ElderPlace Portland (dual eligible) (PACE) H3809 001 National PACE No $161.70 $0.00
2017%20Medicare%20Advantage%20Prescription%20Drug%20Plan%20List.docx