Health Plan RadarIn this article we rank Utah Medicare Advantage plans based on our evaluation of government 5-star quality scores.
Read more →Regence MedAdvantage + Rx Classic (PPO)
by Regence BlueCross BlueShield of Utah
2026 Medicare Advantage plan available in Utah
Plan ID H4605-002-0
Additional coverage:
RxHearingVisionDental
Medicare Advantage PPO 3.5 Overall
Monthly plan premium $46 / mo
Annual deductible $0 / yr
Max out-of-pocket · in-network $6,200 / yr
Drug deductible $495 / yr
3.5 Overall Government Star Rating 2026 · out of 5 stars
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Plan Overview
Regence MedAdvantage + Rx Classic (PPO) is a Medicare Advantage Plan With Part D Prescription Drug Coverage, which is available in Utah and offered by the health insurance company Regence BlueCross BlueShield of Utah. This plan's network type is PPO, which determines the in-network doctors who accept the plan and whether a referral is needed.
Plan Name Regence MedAdvantage + Rx Classic (PPO)
Insurance Carrier Regence BlueCross BlueShield of Utah
Plan Type Medicare Advantage Plan With Part D Prescription Drug Coverage
Network Type PPO
Cost Summary
Regence MedAdvantage + Rx Classic (PPO) has a monthly premium cost of $46 per month, with an annual deductible of $0 and a maximum out-of-pocket cost sharing of $6,200. The most common costs people evaluate when choosing a plan are listed here; a full list of benefit costs is defined below.
Monthly Premium $46 / mo
Health portion of premium $11
Drug portion of premium $35
Annual Deductible $0 / yr
Max Out-of-Pocket · in-network $6,200 / yr
Primary doctor visit $0 copay
Specialist visit $40 copay
ER visit $130 copay
Ambulance $300 copay
Additional Benefits and Coverage
Regence MedAdvantage + Rx Classic (PPO) is a Medicare Advantage plan which includes Medicare Part D prescription drug coverage. Other common benefits included with Medicare Advantage plans are coverage for dental, vision, and hearing. Regence MedAdvantage + Rx Classic (PPO) includes coverage for hearing, vision, dental.
Part D Prescription Drug Coverage Yes
Dental Yes
Vision Yes
Hearing Yes
Nationwide Coverage No
Other benefits
Fitness benefit Limited coverage
Over-the-counter drug benefits Limited coverage
In-home support services Not covered
Home & bathroom safety devices Limited coverage
Meals for short duration Not covered
Annual physical exams Limited coverage
Telehealth Limited coverage
Medical Benefits
Doctor Services
Primary doctor visit In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Specialist visit In-network: $40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Tests, labs & imaging
Diagnostic tests & procedures In-network: $5 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Lab services In-network: $0-$5 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Diagnostic radiology services (like MRI) In-network: $0-$300 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient x-rays In-network: $10 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Emergency care $130 copay
Urgent care $50 copay
Hospital Services
Inpatient hospital coverage In-network:
Tier 1
$350 per day for days 1-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
50% per day for days 1-999
0% per stay
Tier 1
$350 per day for days 1-4
$0 per day for days 5-90
$0 per stay
Out-of-network:
50% per day for days 1-999
0% per stay
Outpatient hospital coverage In-network: $40 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Skilled nursing facility
Skilled nursing facility In-network:
Tier 1
$10 per day for days 1-20
$218 per day for days 21-48
$0 per day for days 49-100
Out-of-network:
50% per day for days 1-100
0% per stay
Tier 1
$10 per day for days 1-20
$218 per day for days 21-48
$0 per day for days 49-100
Out-of-network:
50% per day for days 1-100
0% per stay
Preventive services
Preventive services In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Ambulance
Ground ambulance In-network: $300 copay
Out-of-network: $300 copay
Out-of-network: $300 copay
Therapy services
Occupational therapy visit In-network: $35 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Physical therapy & speech & language therapy visit In-network: $35 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Mental health services
Outpatient group therapy with a psychiatrist In-network: $30 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient individual therapy with a psychiatrist In-network: $30 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient group therapy visit In-network: $30 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Outpatient individual therapy visit In-network: $30 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Opioid treatment services
Opioid treatment services Covered
Other services
Durable medical equipment (like wheelchairs & oxygen) In-network: 30% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthetics (like braces, artificial limbs) In-network: 20% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Diabetes supplies In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prescription drugs (Part D benefits)
Drug tier standard retail · 1-month supply Initial coverage Catastrophic
Preferred Generic $3.00 copay $0 copay
Generic $10.00 copay $0 copay
Preferred Brand 22% coinsurance $0 copay
Non-Preferred Drug 38% coinsurance $0 copay
Specialty Tier 25% coinsurance $0 copay
Part B drugs
Chemotherapy drugs In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Other Part B drugs In-network: 0%-20% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Medicare star rating
Each year the federal government rates Medicare Advantage and Part D plans on a 5-star system covering quality of care, chronic-condition management, member experience, and customer service. For 2026, Regence MedAdvantage + Rx Classic (PPO) earned an overall rating of 3.5 stars — worse than Utah's state average of 4.0 stars.
Rating category This plan State average
Overall star rating ★ 3.5 4.0
Health plan quality
Summary rating of health plan quality ★ 3.5 4.0
Staying healthy: screenings, tests & vaccines ★ 3.0 3.8
Managing chronic (long-term) conditions ★ 3.0 3.4
Member experience with health plan ★ 4.0 4.1
Member complaints & changes in performance ★ 4.0 4.2
Health plan customer service ★ 4.0 4.2
Drug plan quality
Summary rating of drug plan quality ★ 3.5 3.7
Drug plan customer service ★ 5.0 4.8
Member complaints & changes in performance ★ 5.0 4.2
Member experience with the drug plan ★ 4.0 3.7
Drug safety & accuracy of drug pricing ★ 3.0 3.5
Extra Benefits
Hearing
Hearing exam In-network: $0 copay
Out-of-network: $150 copay
Out-of-network: $150 copay
Fitting/evaluation In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Hearing aids - prescription In-network: $499-$999 copay
Out-of-network: $499-$999 copay
Out-of-network: $499-$999 copay
Hearing aids - over the counter Not covered
Preventive dental
Oral exam In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Cleaning In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Fluoride treatment In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Dental x-rays In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Comprehensive dental
Restorative services In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Endodontics In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Periodontics In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, removable In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Prosthodontics, fixed Not covered
Maxillofacial prosthetics Not covered
Implant services Not covered
Oral and maxillofacial surgery In-network: 50% coinsurance
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Orthodontics Not covered
Adjunctive general services Not covered
Vision
Routine eye exam In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Contact lenses In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglasses (frames & lenses) Not covered
Eyeglass frames (only) In-network: $0 copay
Out-of-network: $0 copay
Out-of-network: $0 copay
Eyeglass lenses (only) In-network: $0 copay
Out-of-network: 50% coinsurance
Out-of-network: 50% coinsurance
Upgrades Not covered
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