ATRIO Special Defined ATRIO Health Needs Plan (HMO Standard Douglas Plans SNP) H3814 007 HMO Yes Benefit $0.00 $34.80 $0.00 Moda Health Plan, Moda Health Enhanced Gilliam Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 Moda Health Plan, Moda Health HMO Enhanced Gilliam Inc. (HMO-POS) 001 HMOPOS No Alternative $0.00 $63.00 $28.20 Moda Health Plan, Moda Health Local Enhanced Grant Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 PacificSource Medicare PacificSource Essentials Rx 6 Enhanced Grant Medicare (HMO) H3864 006 HMO No Alternative $134.80 $50.30 $35.40 PacificSource Medicare PacificSource Essentials Choice Enhanced Medicare Rx 14 (HMO-POS) H3864 014 HMOPOS No Alternative $73.80 $34.00 $19.20 PacificSource Medicare PacificSource Essentials Rx 27 Basic Grant Medicare (HMO) 027 HMO No Alternative $67.70 $54.30 $19.50 Moda Health Plan, Moda Health HMO Enhanced Inc. (HMO-POS) H8506 001 HMOPOS No Alternative $0.00 $63.00 $28.20 Moda Health Plan, Moda Health Local Enhanced Harney Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 Moda Health Plan, Moda Health HMO Enhanced Harney Inc. (HMO-POS) H8506 001 HMOPOS No Alternative $0.00 $63.00 $28.20 Moda Health Plan, Moda Health Local Enhanced Hood Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 PacificSource Medicare PacificSource Essentials Rx 6 Enhanced Hood River Medicare (HMO) H3864 006 HMO No Alternative $134.80 $50.30 $35.40
Douglas ATRIO Health Plans ATRIO Special Needs Plan (HMO SNP) H3814 007 HMO Yes Defined Standard Benefit $0.00 $34.80 $0.00 Gilliam Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 PPO No Enhanced Alternative $40.60 $57.40 $22.60 Gilliam Moda Health Plan, Inc. Moda Health HMO (HMO-POS) 001 HMOPOS No Enhanced Alternative $0.00 $63.00 $28.20 Grant Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Grant PacificSource Medicare PacificSource Medicare Essentials Rx 6 (HMO) H3864 006 HMO No Enhanced Alternative $134.80 $50.30 $35.40 PacificSource Medicare PacificSource Medicare Essentials Choice Rx 14 (HMO-POS) H3864 014 HMOPOS No Enhanced Alternative $73.80 $34.00 $19.20 Grant PacificSource Medicare PacificSource Medicare Essentials Rx 27 (HMO) 027 HMO No Basic Alternative $67.70 $54.30 $19.50 Moda Health Plan, Inc. Moda Health HMO (HMO-POS) H8506 001 HMOPOS No Enhanced Alternative $0.00 $63.00 $28.20 Harney Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Harney Moda Health Plan, Inc. Moda Health HMO (HMO-POS) H8506 001 HMOPOS No Enhanced Alternative $0.00 $63.00 $28.20 Hood Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Hood River PacificSource Medicare PacificSource Medicare Essentials Rx 6 (HMO) H3864 006 HMO No Enhanced Alternative $134.80 $50.30 $35.40
2017%20Medicare%20Advantage%20Prescription%20Drug%20Plan%20List.docx