Regence BlueCross Regence BlueShield of BlueAdvantage Enhanced Polk Oregon HMO (HMO) H6237 003 HMO No Alternative $0.00 $0.00 $0.00 Health Net Health Health Net Ruby Enhanced Polk Plan of Oregon, Inc. (HMO) H6815 003 HMO No Alternative $0.00 $0.00 $0.00 ATRIO Health ATRIO Gold Rx Local Enhanced Polk Plans (Willamette) (PPO) H7006 001 PPO No Alternative $139.50 $45.50 $10.70 ATRIO Health ATRIO Silver Rx Local Enhanced Polk Plans (Willamette) (PPO) 003 PPO No Alternative $54.10 $12.90 $0.00 Kaiser Permanente Senior Advantage Enhanced Polk Kaiser Permanente (HMO) H9003 001 HMO No Alternative $61.00 $41.50 $31.20 Kaiser Permanente Senior Advantage Enhanced Polk Kaiser Permanente Basic (HMO) 006 HMO No Alternative $14.70 $29.30 $0.00 Providence Providence Health Medicare Extra + Enhanced Polk Assurance RX (HMO) H9047 001 HMO No Alternative $109.10 $52.50 $18.10 Providence Medicare Part Providence Health B Only + RX Enhanced Polk Assurance (HMO) H9047 013 HMO No Alternative $375.60 $42.10 $7.30 Providence Providence Health Medicare Choice + Enhanced Polk Assurance RX (HMO-POS) 024 HMOPOS No Alternative $39.50 $48.50 $13.70 ATRIO Special Needs Plan Defined (Willamette) (HMO Standard Polk Health Plans SNP) H5995 001 HMO Yes Benefit $0.00 $34.80 $0.00 Moda Health Plan, Moda Health Local Enhanced Sherman Inc. PPORX (PPO) H3813 006 PPO No Alternative $40.60 $57.40 $22.60 PacificSource Medicare PacificSource Essentials Rx 6 Enhanced Sherman Medicare (HMO) 006 HMO No Alternative $134.80 $50.30 $35.40
Polk Regence BlueCross BlueShield of Oregon Regence BlueAdvantage HMO (HMO) H6237 003 HMO No Enhanced Alternative $0.00 $0.00 $0.00 Polk Health Net Health Plan of Oregon, Inc. Health Net Ruby (HMO) H6815 003 HMO No Enhanced Alternative $0.00 $0.00 $0.00 Polk ATRIO Health Plans ATRIO Gold Rx (Willamette) (PPO) H7006 001 Local PPO No Enhanced Alternative $139.50 $45.50 $10.70 Polk ATRIO Health Plans ATRIO Silver Rx (Willamette) (PPO) 003 Local PPO No Enhanced Alternative $54.10 $12.90 $0.00 Polk Kaiser Permanente Kaiser Permanente Senior Advantage (HMO) H9003 001 HMO No Enhanced Alternative $61.00 $41.50 $31.20 Polk Kaiser Permanente Kaiser Permanente Senior Advantage Basic (HMO) 006 HMO No Enhanced Alternative $14.70 $29.30 $0.00 Polk Providence Health Assurance Providence Medicare Extra + RX (HMO) H9047 001 HMO No Enhanced Alternative $109.10 $52.50 $18.10 Polk Providence Health Assurance Providence Medicare Part B Only + RX (HMO) H9047 013 HMO No Enhanced Alternative $375.60 $42.10 $7.30 Polk Providence Health Assurance Providence Medicare Choice + RX (HMO-POS) 024 HMOPOS No Enhanced Alternative $39.50 $48.50 $13.70 Polk Health Plans ATRIO Special Needs Plan (Willamette) (HMO SNP) H5995 001 HMO Yes Defined Standard Benefit $0.00 $34.80 $0.00 Sherman Moda Health Plan, Inc. Moda Health PPORX (PPO) H3813 006 Local PPO No Enhanced Alternative $40.60 $57.40 $22.60 Sherman PacificSource Medicare PacificSource Medicare Essentials Rx 6 (HMO) 006 HMO No Enhanced Alternative $134.80 $50.30 $35.40
2017%20Medicare%20Advantage%20Prescription%20Drug%20Plan%20List.docx