ATRIO Choice Rx (PPO)
Oregon Medicare Advantage Plan (2024 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
2.5Ready to Enroll Online?
Plan Overview
ATRIO Choice Rx (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Oregon and offered by the health insurance company ATRIO Health Plans. This plan’s network type is PPO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
ATRIO Choice Rx (PPO) has a monthly premium cost of $20 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $6,500 In and Out-of-network $4,950 In-network. The most common benefit costs which people evaluate when choosing a plan are costs for a primary doctor visit, specialist doctor visit, emergency room visit, and ambulance. These costs are listed in this summary section and a full list of benefit costs for ATRIO Choice Rx (PPO) are defined below.
Additional Benefits and Coverage
ATRIO Choice Rx (PPO) is a Medicare Advantage plan which does include Medicare Part D Prescription Drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. ATRIO Choice Rx (PPO) includes coverage for hearing, vision, dental.
Medicare Advantage health plans can offer even more additional benefits. ATRIO Choice Rx (PPO) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of ATRIO Choice Rx (PPO) to Other Plans in Oregon
Each year the federal government evaluates the quality of Medicare Advantage and Part D Prescription Drug plans based on a 5-star scoring system. For 2024, ATRIO Choice Rx (PPO) received an overall government quality rating of 2.5 stars out of 5 stars.
ATRIO Choice Rx (PPO) performed worse than Oregon’s State average overall quality score of 3.4 stars.
The government calculates an “Overall star rating” based on ratings for sub components including “Health plan star rating” and “Drug plan star rating”, which includes further subcomponents of each.
ATRIO Choice Rx (PPO) received 3 stars for its health plan quality score which is worse than the Oregon State average health plan quality score of 3.4 stars.
ATRIO Choice Rx (PPO) received 3 stars for its drug plan quality score which is worse than the Oregon State average drug plan quality score of 3.4 stars.
Plan Benefits and Coverage Details
$4,950 In-network
Medical Benefits
Doctor Services
Out-of-network: $50 copay per visit
Out-of-network: $65 copay per visit
Tests, labs, & imaging
Out-of-network: 30% coinsurance
Out-of-network: 15% coinsurance
Out-of-network: 30% coinsurance
Out-of-network: 30% coinsurance
Hospital Services
$0 per day for days 6 through 90
Out-of-network: $600 per day for days 1 through 5
$0 per day for days 6 through 90
Out-of-network: $600 copay per visit
Skilled nursing facility
$203 per day for days 21 through 100
Out-of-network: $203 per day for days 1 through 100
Preventive services
Out-of-network: $0 copay
Ambulance
Out-of-network: $350 copay
Therapy services
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Mental health services
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Opioid treatment services
Other services
Out-of-network: 30% coinsurance per item
Out-of-network: 30% coinsurance per item
Out-of-network: 20% coinsurance per item
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $7.00 copay |
Brand-name drugs :
|
Brand-name drugs :
|
| Generic | $20.00 copay | ||
| Preferred Brand | $45.00 copay | ||
| Non-Preferred Drug | $95.00 copay | ||
| Specialty Tier | 28% |
Part B Drugs
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Extra Benefits
Hearing
Out-of-network: $50 copay
Out-of-network: $0 copay
Out-of-network: $699-999 copay
Preventive Dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Comprehensive dental
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Vision
Out-of-network: 0-50% coinsurance
Out-of-network: 0-50% coinsurance
Out-of-network: 0-50% coinsurance
Out-of-network: 0-50% coinsurance
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