Regence BlueAdvantage HMO (HMO)
Available to residents of Snohomish County, WA for 2027. Contract H1997, plan 014, segment 0.
2027 drug-by-drug coverage is not published by CMS yet. The drug lookup covers 2026, whose formulary is live.
New for 2027. This plan has no 2026 predecessor in the CMS crosswalk.
Plan details
| Monthly premium (Part C + D) | $188.00 |
|---|---|
| — medical (Part C) part | $136.00 |
| — drug (Part D) part | $52.00 |
| In-network out-of-pocket maximum | $5,900.00 |
| Drug deductible | $400.00Tier 1 and 2 exempt |
| Drug out-of-pocket threshold | $2,400.00 |
| Plan type | HMO |
| Contract / plan | H1997-014-0 |
| Offered by | Regence BlueShield |
| Parent organization | Cambia Health Solutions, Inc. |
| Formulary tiers | 5 |
| Member services | (888)369-3171TTY 711 |
CMS star ratings
- Overall
- —
- Health plan (Part C)
- —
- Drug plan (Part D)
- 4 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H1997 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 · Preferred Generic | $0.00 |
| Tier 2 · Generic | $3.00 |
| Tier 3 · Preferred Brand | 20% |
| Tier 4 · Non-Preferred Drug | 32% |
| Tier 5 · Specialty Tier | 29% |
Star rating measures
| Measure | 2027 | 2026 |
|---|---|---|
| Staying Healthy: Screenings, Tests and Vaccines | ||
| Breast Cancer Screening · C01 | 3 out of 5 stars for Breast Cancer Screening | 3 out of 5 stars for Breast Cancer Screening |
| Colorectal Cancer Screening · C02 | 5 out of 5 stars for Colorectal Cancer Screening | 4 out of 5 stars for Colorectal Cancer Screening |
| Improving or Maintaining Physical Health · C04 | not enough data | 3 out of 5 stars for Improving or Maintaining Physical Health |
| Improving or Maintaining Mental Health · C05 | not enough data | 3 out of 5 stars for Improving or Maintaining Mental Health |
| Monitoring Physical Activity · C06 | 5 out of 5 stars for Monitoring Physical Activity | 4 out of 5 stars for Monitoring Physical Activity |
| Managing Chronic (Long Term) Conditions | ||
| Diabetes Care – Eye Exam · C11 | 4 out of 5 stars for Diabetes Care – Eye Exam | 3 out of 5 stars for Diabetes Care – Eye Exam |
| Diabetes Care – Blood Sugar Controlled · C12 | 5 out of 5 stars for Diabetes Care – Blood Sugar Controlled | 3 out of 5 stars for Diabetes Care – Blood Sugar Controlled |
| Kidney Health Evaluation for Patients with Diabetes · C13 | 3 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes | 3 out of 5 stars for Kidney Health Evaluation for Patients with Diabetes |
| Controlling High Blood Pressure · C14 | 3 out of 5 stars for Controlling High Blood Pressure | 3 out of 5 stars for Controlling High Blood Pressure |
| Reducing the Risk of Falling · C15 | not enough data | 1 out of 5 stars for Reducing the Risk of Falling |
| Improving Bladder Control · C16 | not enough data | 2 out of 5 stars for Improving Bladder Control |
| Plan All-Cause Readmissions · C17 | no data | 5 out of 5 stars for Plan All-Cause Readmissions |
| Statin Therapy for Patients with Cardiovascular Disease · C18 | not enough data | 3 out of 5 stars for Statin Therapy for Patients with Cardiovascular Disease |
| Transitions of Care · C19 | 5 out of 5 stars for Transitions of Care | 5 out of 5 stars for Transitions of Care |
| Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions · C20 | 3 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions | 3 out of 5 stars for Follow-up after Emergency Department Visit for People with Multiple High-Risk Chronic Conditions |
| Member Complaints and Changes in the Health Plan's Performance | ||
| Complaints about the Health Plan · C27 | not enough data | 5 out of 5 stars for Complaints about the Health Plan |
| Members Choosing to Leave the Plan · C28 | not enough data | 5 out of 5 stars for Members Choosing to Leave the Plan |
| Health Plan Quality Improvement · C29 | not enough data | 4 out of 5 stars for Health Plan Quality Improvement |
| Health Plan Customer Service | ||
| Plan Makes Timely Decisions about Appeals · C30 | 5 out of 5 stars for Plan Makes Timely Decisions about Appeals | 5 out of 5 stars for Plan Makes Timely Decisions about Appeals |
| Reviewing Appeals Decisions · C31 | 5 out of 5 stars for Reviewing Appeals Decisions | 5 out of 5 stars for Reviewing Appeals Decisions |
| Call Center – Foreign Language Interpreter and TTY Availability · C32 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD1: Drug Plan Customer Service | ||
| Call Center – Foreign Language Interpreter and TTY Availability · D01 | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability | 5 out of 5 stars for Call Center – Foreign Language Interpreter and TTY Availability |
| DD2: Member Complaints and Changes in the Drug Plan’s Performance | ||
| Complaints about the Drug Plan · D02 | not enough data | 5 out of 5 stars for Complaints about the Drug Plan |
| Members Choosing to Leave the Plan · D03 | not enough data | 5 out of 5 stars for Members Choosing to Leave the Plan |
| Drug Plan Quality Improvement · D04 | 3 out of 5 stars for Drug Plan Quality Improvement | 3 out of 5 stars for Drug Plan Quality Improvement |
| DD4: Drug Safety and Accuracy of Drug Pricing | ||
| MPF Price Accuracy · D07 | 5 out of 5 stars for MPF Price Accuracy | 5 out of 5 stars for MPF Price Accuracy |
| Medication Adherence for Diabetes Medications · D08 | 3 out of 5 stars for Medication Adherence for Diabetes Medications | 3 out of 5 stars for Medication Adherence for Diabetes Medications |
| Medication Adherence for Hypertension (RAS antagonists) · D09 | 4 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) | 3 out of 5 stars for Medication Adherence for Hypertension (RAS antagonists) |
| Medication Adherence for Cholesterol (Statins) · D10 | 4 out of 5 stars for Medication Adherence for Cholesterol (Statins) | 4 out of 5 stars for Medication Adherence for Cholesterol (Statins) |
| Statin Use in Persons with Diabetes (SUPD) · D11 | 3 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) | 3 out of 5 stars for Statin Use in Persons with Diabetes (SUPD) |
| Concurrent Use of Opioids and Benzodiazepines (COB) · D12 | 5 out of 5 stars for Concurrent Use of Opioids and Benzodiazepines (COB) | new measure |
| Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) · D13 | 3 out of 5 stars for Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (Poly-ACH) | new measure |
Measures are paired between the two years by name, not by the C/D number: CMS reuses those numbers, and in 2027 nineteen of them refer to a different measure than they did in 2026. A measure introduced for 2027 has no 2026 score to show. Published per contract — every plan under H1997 shares it.
Also available in 1 other WA county
Plan facts come from the CMS plan Landscape file and the CMS plan benefit package (PBP) files.