ATRIO Health Silver Rx Local Enhanced Jackson Plans (Rogue) (PPO) H6743 016 PPO No Alternative $67.20 $13.50 $22.30 ATRIO Health Gold Rx Local Enhanced Jackson Plans (Rogue) (PPO) 017 PPO No Alternative $100.50 $29.00 $35.50 Special Needs Defined ATRIO Health Plan (Rogue) Standard Jackson Plans (HMO SNP) H3814 029 HMO Yes Benefit $0.00 $34.80 $0.00 CareOregon Defined CareOregon Advantage Plus Standard Jackson Advantage (HMO-POS SNP) H5859 001 HMOPOS Yes Benefit $0.00 $34.80 $0.00 Humana Medical Humana Gold Plus Enhanced Jefferson Plan, Inc. H1036-219 (HMO) H1036 219 HMO No Alternative $47.60 $16.10 $7.30 Moda Health Plan, Moda Health Local Enhanced Jefferson Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 PacificSource Medicare PacificSource Essentials Rx 6 Enhanced Jefferson Medicare (HMO) H3864 006 HMO No Alternative $134.80 $50.30 $35.40 PacificSource Medicare PacificSource Essentials Choice Enhanced Jefferson Medicare Rx 14 (HMO-POS) H3864 014 HMOPOS No Alternative $73.80 $34.00 $19.20 PacificSource Medicare PacificSource Essentials Rx 27 Basic Jefferson Medicare (HMO) H3864 027 HMO No Alternative $67.70 $54.30 $19.50 Humana Insurance HumanaChoice Local Enhanced Jefferson Company H6609-013 (PPO) H6609 013 PPO No Alternative $66.40 $31.50 $4.10 Humana Insurance HumanaChoice Local Jefferson Company H6609-073 (PPO) H6609 073 PPO No Alternative $168.90 $32.10 $0.00 Providence Providence Health Medicare Latitude Enhanced Jefferson Assurance + RX (HMO-POS) 038 HMOPOS No Alternative $111.60 $46.40 $22.60
Jackson ATRIO Health Plans Silver Rx (Rogue) (PPO) H6743 016 Local PPO No Enhanced Alternative $67.20 $13.50 $22.30 Jackson ATRIO Health Plans Gold Rx (Rogue) (PPO) 017 Local PPO No Enhanced Alternative $100.50 $29.00 $35.50 Jackson ATRIO Health Plans Special Needs Plan (Rogue) (HMO SNP) H3814 029 HMO Yes Defined Standard Benefit $0.00 $34.80 $0.00 Jackson CareOregon Advantage CareOregon Advantage Plus (HMO-POS SNP) H5859 001 HMOPOS Yes Defined Standard Benefit $0.00 $34.80 $0.00 Jefferson Humana Medical Plan, Inc. Humana Gold Plus H1036-219 (HMO) H1036 219 HMO No Enhanced Alternative $47.60 $16.10 $7.30 Jefferson Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Jefferson PacificSource Medicare PacificSource Medicare Essentials Rx 6 (HMO) H3864 006 HMO No Enhanced Alternative $134.80 $50.30 $35.40 Jefferson PacificSource Medicare PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) H3864 014 HMOPOS No Enhanced Alternative $73.80 $34.00 $19.20 Jefferson PacificSource Medicare PacificSource Medicare Essentials Rx 27 (HMO) H3864 027 HMO No Basic Alternative $67.70 $54.30 $19.50 Jefferson Humana Insurance Company HumanaChoice H6609-013 (PPO) H6609 013 Local PPO No Enhanced Alternative $66.40 $31.50 $4.10 Jefferson Humana Insurance Company HumanaChoice H6609-073 (PPO) H6609 073 Local PPO No Alternative $168.90 $32.10 $0.00 Jefferson Providence Health Assurance Providence Medicare Latitude + RX (HMO-POS) 038 HMOPOS No Enhanced Alternative $111.60 $46.40 $22.60
2017%20Medicare%20Advantage%20Prescription%20Drug%20Plan%20List.docx