Medicare Advantage (MA) Plans, also known as Medicare Part C, replace your Medicare Parts A and B benefits with those of the plan you join. An MA plan has an annually renewable contract with Medicare to provide at least the same benefits as Original Medicare, but not necessarily at the same payment rates. Plans can also offer additional benefits, such as routine annual physicals, vision and hearing exams and hardware, dental coverage, and even gym memberships. Most MA plans include prescription drug coverage (Medicare Part D). In Oregon, only HMO and PPO plans are available:
Health Maintenance Organization (HMO) plans: In most HMOs, you can only go to doctors, other health care providers, or hospitals in the plan’s network, except in an urgent or emergency situation. You may also need to get a referral from your primary care doctor for tests or to see other doctors or specialists.
HMO Point-of-Service (HMO-POS) plans: These are HMO plans that may allow you to get some services out-of-network for a higher copayment or coinsurance.
Preferred Provider Organization (PPO) plans: In a PPO, you pay less if you use doctors, hospitals, and other health care providers that belong to the plan’s network. You usually pay more if you use doctors, hospitals, and providers outside of the network.
We are contracted to offer all plans available in Central Oregon (Deschutes, Crook, and Jefferson counties) as well as others elsewhere in Oregon, Idaho, Washington, and Arizona.