2020 Medicare Advantage Plan Details | |||||
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Medicare Plan Name: | Regence MedAdvantage + Rx Classic (PPO) | ||||
Location: | Ada, Idaho Click to see other locations | ||||
Plan ID: | H1304 - 012 - 0 Click to see other plans | ||||
Member Services: | |||||
— This plan information is for research purposes only. — Click here to see plans for the current plan year | |||||
Medicare Contact Information: | Please go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to get information on all of your options. TTY users 1-877-486-2048 or contact your local SHIP for assistance |
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Email a copy of the Regence MedAdvantage + Rx Classic (PPO) benefit details | |||||
— Medicare Plan Features — | |||||
Monthly Premium: | $48.00 | ||||
Annual Deductible: | $250 | ||||
Annual Initial Coverage Limit (ICL): | $4,020 | ||||
Health Plan Type: | Local PPO | ||||
Maximum Out-of-Pocket Limit for Parts A & B (MOOP): | $6,700 | ||||
Additional Gap Coverage? | No additional gap coverage, only the Donut Hole Discount | ||||
Total Number of Formulary Drugs: | 3,651 drugs | Browse the Regence MedAdvantage + Rx Classic (PPO) Formulary | |||
This plan has 5 drug tiers. See cost-sharing for all pharmacies and tiers. | |||||
Formulary Drug Details: | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 5 |
• Preferred Pharmacy Cost-Sharing during initial coverage phase: | $3.00 | $13.00 | $40.00 | 40% | 28% |
• Number of Drugs per Tier: | 373 | 1272 | 392 | 855 | 759 |
Plan Offers Mail Order? | Yes | ||||
Medicare Plan Pharmacy Numbers: | BIN: 610623 PCN: 2100000 See BIN/PCNs for all plans | ||||
Number of Members enrolled in this plan in Ada, Idaho: | 397 members | ||||
Number of Members enrolled in this plan in (H1304 - 012): | 3,210 members | ||||
Plan’s Summary Star Rating: | 4 out of 5 Stars. | ||||
• Customer Service Rating: | 5 out of 5 Stars. | ||||
• Member Experience Rating: | 3 out of 5 Stars. | ||||
• Drug Cost Accuracy Rating: | 4 out of 5 Stars. |
— Plan Health Benefits — |