PacificSource Dual Care (HMO D-SNP)
Oregon Medicare-Medicaid Dual Eligible D-SNP Plan (2024 Plan)
Monthly Premium
Additional Coverage
Overall Government Star Rating
3.5Ready to Enroll Online?
Plan Overview
PacificSource Dual Care (HMO 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 PacificSource Medicare. This plan’s network type is HMO which determines in-network doctors who accept the health plan and whether a referral is needed.
Cost Summary
PacificSource Dual Care (HMO 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 $8,300 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 PacificSource Dual Care (HMO D-SNP) are defined below.
Additional Benefits and Coverage
PacificSource Dual Care (HMO 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. PacificSource Dual Care (HMO D-SNP) includes coverage for hearing, vision.
Medicare Advantage health plans can offer even more additional benefits. PacificSource Dual Care (HMO D-SNP) includes coverage for the following additional benefits:
Other benefits
Comparing the Quality Score of PacificSource Dual Care (HMO D-SNP) 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, PacificSource Dual Care (HMO D-SNP) received an overall government quality rating of 3.5 stars out of 5 stars.
PacificSource Dual Care (HMO D-SNP) performed better than Oregon’s State average overall quality score of 3.2 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.
PacificSource Dual Care (HMO 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.
PacificSource Dual Care (HMO 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.
Plan Benefits and Coverage Details
Medical Benefits
Doctor Services
Tests, labs, & imaging
Hospital Services
Skilled nursing facility
Preventive services
Ambulance
Therapy services
Mental health services
Opioid treatment services
Other services
Prescription Drug Benefits
Tier drug costs for: Standard retail pharmacy drug cost for 1-month
| Tiers | Initial coverage phase | Gap coverage phase1 | Catastrophic coverage phase |
|---|---|---|---|
| Preferred Generic | $0.00 copay |
Brand-name drugs :
| |
| Generic | $20.00 copay | ||
| Preferred Brand | $47.00 copay | ||
| Non-Preferred Drug | 34% | ||
| Specialty Tier | 25% | ||
| 1 For all other drugs, you pay 25% for generic drugs and 25% for brand-name drugs. | |||
Part B Drugs
Extra Benefits
Hearing
Preventive Dental
Comprehensive dental
Vision
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