CareOregon Advantage Plus (HMO-POS D-SNP)

Oregon Medicare-Medicaid Dual Eligible D-SNP Plan (2024 Plan)


Monthly Premium

Your Cost
$0
by CareOregon Advantage

Additional Coverage

HearingVisionDental

Overall Government Star Rating

 3.5
out of 5 stars

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Plan Name
CareOregon Advantage Plus (HMO-POS D-SNP)
Insurance Carrier
CareOregon Advantage
Plan Type
Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP)
Network Type
HMO

CareOregon Advantage Plus (HMO-POS D-SNP) is a Medicare-Medicaid Dual Eligible Medicare Advantage Plan (D-SNP), which is available in Oregon and offered by the health insurance company CareOregon Advantage. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.

Monthly Premium
$0
Annual Deductible
$0
Max Out-of-Pocket
$8,850
Primary doctor visit
$0 copay
Specialist visit
$0 copay
ER visit
$0 copay
Ambulance
$0 copay

CareOregon Advantage Plus (HMO-POS D-SNP) has a monthly premium cost of $0 per month, with an annual deductible of $0 and a maximum out of pocket cost sharing of $13,300 In and Out-of-network $8,850 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 CareOregon Advantage Plus (HMO-POS D-SNP) are defined below.

Yes
Part D Prescription Drug Coverage
Yes
Dental
Yes
Vision
Yes
Hearing

CareOregon Advantage Plus (HMO-POS D-SNP) 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. CareOregon Advantage Plus (HMO-POS D-SNP) includes coverage for hearing, vision, dental.

Medicare Advantage health plans can offer even more additional benefits. CareOregon Advantage Plus (HMO-POS D-SNP) includes coverage for the following additional benefits:

Other benefits

Fitness benefit
Limited coverage
Over the counter drug benefits
Limited coverage
In-home support services
Limited coverage
Home and bathroom safety devices
Not covered
Meals for short duration
Limited coverage
Annual physical exams
Limited coverage
Telehealth
Limited coverage

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, CareOregon Advantage Plus (HMO-POS D-SNP) received an overall government quality rating of 3.5 stars out of 5 stars.

CareOregon Advantage Plus (HMO-POS D-SNP) performed better than Oregon’s State average overall quality score of 3.2 stars.

This Plan’s 5-star Gov’t Quality Score
Oregon State Average Score
Overall Government 5 Star Quality Rating
 3.5
 3.2
Summary rating of health plan quality
 3.5
 3.2
Staying healthy: screenings, tests, & vaccines
 3
 3.0
Managing chronic (long term) conditions
 4
 3.0
Member experience with health plan
 3
 3.0
Member complaints & changes in the health plan's performance
 5
 4.3
Health plan customer service
 2
 3.0
Summary rating of drug plan quality
 3.5
 3.3
Drug plan customer service
 3
 2.5
Member complaints & changes in the drug plan's performance
 4
 4.1
Member experience with the drug plan
 3
 2.8
Drug safety & accuracy of drug pricing
 3
 2.8

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.

CareOregon Advantage Plus (HMO-POS D-SNP) received 3.5 stars for its health plan quality score which is better than the Oregon State average health plan quality score of 3.2 stars.

CareOregon Advantage Plus (HMO-POS D-SNP) received 3.5 stars for its drug plan quality score which is better than the Oregon State average drug plan quality score of 3.3 stars.


Monthly Premium
$0
Health Portion of Premium
$0
Drug Portion of Premium
$0
Health Plan Deductible
$0
Health Plan Max Out-of-Pocket
$13,300 In and Out-of-network
$8,850 In-network
Nationwide Coverage included
No
Hearing Coverage included
Yes
Vision Coverage included
Yes
Dental Coverage included
Yes

Doctor Services

Primary doctor visit
In-network: $0 copay
Out-of-network: 20% coinsurance per visit
Specialist visit
In-network: $0 copay
Out-of-network: 20% coinsurance per visit

Tests, labs, & imaging

Diagnostic tests & procedures
In-network: $0 copay
Out-of-network: No Data
Lab services
In-network: $0 copay
Out-of-network: No Data
Diagnostic radiology services (like MRI)
In-network: $0 copay
Out-of-network: No Data
Outpatient x-rays
In-network: $0 copay
Out-of-network: No Data
Emergency care
$0 copay
Urgent care
$0 copay

Hospital Services

Inpatient hospital coverage
In-network: $0 copay
Out-of-network: Not Applicable
Outpatient hospital coverage
In-network: $0 copay
Out-of-network: No Data

Skilled nursing facility

Skilled nursing facility
In-network: $0 copay
Out-of-network: Not Applicable

Preventive services

Preventive services
In-network: $0 copay
Out-of-network: No Data

Ambulance

Ground ambulance
In-network: $0 copay
Out-of-network: No Data

Therapy services

Occupational therapy visit
In-network: $0 copay
Out-of-network: No Data
Physical therapy & speech & language therapy visit
In-network: $0 copay
Out-of-network: No Data

Mental health services

Outpatient group therapy with a psychiatrist
In-network: $0 copay
Out-of-network: No Data
Outpatient individual therapy with a psychiatrist
In-network: $0 copay
Out-of-network: No Data
Outpatient group therapy visit
In-network: $0 copay
Out-of-network: 20% coinsurance
Outpatient individual therapy visit
In-network: $0 copay
Out-of-network: 20% coinsurance

Opioid treatment services

Opioid treatment services
Covered

Other services

Durable medical equipment (like wheelchairs & oxygen)
In-network: $0 copay
Out-of-network: No Data
Prosthetics (like braces, artificial limbs)
In-network: $0 copay
Out-of-network: No Data
Diabetes supplies
In-network: $0 copay
Out-of-network: No Data

Tier drug costs for: Standard retail pharmacy drug cost for 1-month

TiersInitial coverage phaseGap coverage phaseCatastrophic coverage phase
Preferred Generic


Generic drugs :
25%

Brand-name drugs :
25%


Generic drugs :
$0 copay

Brand-name drugs :
$0 copay

Generic25%
Preferred Brand25%
Non-Preferred Drug
Specialty Tier25%

Part B Drugs

Chemotherapy drugs
In-network: $0 copay
Out-of-network: No Data
Other Part B drugs
In-network: $0 copay
Out-of-network: No Data

Hearing

Hearing exam
In-network: $0 copay
Out-of-network: No Data
Fitting/evaluation
Not covered
Hearing aids - Inner ear
Not covered
Hearing aids - Outer ear
Not covered
Hearing aids - Over the ear
Not covered

Preventive Dental

Oral exam
In-network: $0 copay
Out-of-network: No Data
Cleaning
In-network: $0 copay
Out-of-network: No Data
Fluoride treatment
In-network: $0 copay
Out-of-network: No Data
Dental x-rays
In-network: $0 copay
Out-of-network: No Data

Comprehensive dental

Non-routine services
In-network: $0 copay
Out-of-network: No Data
Diagnostic services
In-network: $0 copay
Out-of-network: No Data
Restorative services
In-network: $0 copay
Out-of-network: No Data
Endodontics
In-network: $0 copay
Out-of-network: No Data
Periodontics
In-network: $0 copay
Out-of-network: No Data
Extractions
In-network: $0 copay
Out-of-network: No Data
Prosthodontics, other oral/maxillofacial surgery, other services
In-network: $0 copay
Out-of-network: No Data

Vision

Routine eye exam
In-network: $0 copay
Out-of-network: No Data
Contact lenses
In-network: $0 copay
Out-of-network: No Data
Eyeglasses (frames & lenses)
In-network: $0 copay
Out-of-network: No Data
Eyeglass frames (only)
Not covered
Eyeglass lenses (only)
Not covered
Upgrades
In-network: $0 copay
Out-of-network: No Data

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