2018 Providence Medicare Extra Part B Only + RX (HMO) H9047-13-0 in OR from Providence | HealthPocket
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Providence Medicare Extra Part B Only + RX (HMO)

$8/mo
Summary of BenefitsCovered Drugs

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Zip Code97229
Applicant3/26/1984 Male
Coverage Start3/27/2019
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Benefits & Coverage

Insurance TypeMedicare Advantage Plan (Part C w/ RX)
Insurance ProviderProvidence
Plan IDH9047-13-0
Plan Year2018
CMS Rating
Plan TypeHMO
Annual Deductible$0.00
What To Know About This Plan
  • This plan has health and drug coverage
  • This plan is available for 2019. see plan
Why We Like This Plan
  • has both Health and Drug Coverage
  • has been rated 5 stars by CMS

Costs and Other Important Information

Plan Year2018
Prescription Drugs Covered?Yes
Health Plan Deductible$0
Monthly Drug Plan Premium$8.3
Monthly Health Plan Premium$0

Coverage Area for Providence Medicare Extra Part B Only + RX (HMO)

StateOregon
CountyMultnomah

All cost-sharing assumes in-network healthcare providers.
Prescription Drug Copay/Coninsurance Details - Initial Coverage Limit

30 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$6 copay$12 copayNot offered
Tier 2: Non-Preferred Generic$15 copay$20 copayNot offered
Tier 3: Preferred Brand Name$45 copay$45 copayNot offered
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsuranceNot offered
Tier 5: Specialty Tier33% coinsurance33% coinsuranceNot offered
60 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$12 copay$24 copayNot offered
Tier 2: Non-Preferred Generic$30 copay$40 copayNot offered
Tier 3: Preferred Brand Name$90 copay$90 copayNot offered
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsuranceNot offered
Tier 5: Specialty Tier
90 Day SupplyPreferred Retail PharmaciesNon-Preferred Retail PharmaciesMail-Order Pharmacies
Tier 1: Preferred Generic$14.4 copay$36 copayNot offered
Tier 2: Non-Preferred Generic$36 copay$60 copayNot offered
Tier 3: Preferred Brand Name$108 copay$135 copayNot offered
Tier 4: Non-Preferred Brand Name25% coinsurance25% coinsuranceNot offered
Tier 5: Specialty Tier

Staying healthy - screenings, tests and vaccines

Breast cancer screening
Colorectal cancer screening
Annual flu vaccine
Improving or maintaining physical health
Improving or maintaining mental health
Monitoring physical ability
Adult BMI assessment

Managing Chronic Conditions

Special needs plan care managementNot Rated
Care for older adults – medication reviewNot Rated
Care for older adults – functional status assessmentNot Rated
Care for older adults – Pain screeningNot Rated
Osteoporosis management in women who had a fracture
Diabetes care – eye exam
Diabetes care – kidney disease monitoring
Diabetes care – blood sugar controlled
Controlling blood pressure
Rheumatoid arthritis management
Reducing the risk of falling
Plan all-cause readmissions

Member Experience with Health Plan

Getting needed care
Getting appointments and care quickly
Customer service
Overall rating of health care quality
Overall rating of plan
Care Coordination

Member Complaints, and Changes in Health Plan's Performance

Complaints about the health plan
Members choosing to leave the health plan
Beneficiary access and performance problems
Health plan quality improvement

Health Plan Customer Service

Plan makes timely decision about appeals
Reviewing appeals decisions
Call center – foreign language interpreter and TTY/TDD availability - Medical

Drug Plan Customer Service

Call center – foreign language interpreter and TTY/TDD availability - Drugs
Appeals auto-forward
Appeals upheld

Member Complaints, and Changes in Drug Plan's Performance

Complaints about the drug plan
Members choosing to leave the drug plan
Beneficiary access and performance problems
Drug plan quality improvement

Member Experience with Drug Plan

Rating of drug plan
Getting needed prescription drugs

Drug Pricing and Patient Safety

MPF Price Accuracy
High risk medication
Part D medication adherence for diabetes
Part D medication adherence for hypertension
Part D medication adherence for cholesterol
Medication Therapy Management program completion rate

Physicians that accept Providence Medicare Extra Part B Only + RX (HMO) for Oregon

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Hardebeck, Laura
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Blievernicht, Matthew
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Lowenstein, Keith
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Romero, Cynthia
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Ji, Dong
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Chiang, Lydia
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Barich, Frank
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Kakodkar, Swati
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Dorrington, Michael
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Pena, Angeles
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Mcilraith, Marlo
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Paskowski, Brian
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Samagh, Gunjeet
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Barry, Harold
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Geddes, Gary
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Doshi, Heena
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Krisciunas, Vic
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Losli, Steve
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Gillingham, Todd
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Crihfield, Kimberly
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Hankenson, Lori
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Lutfi, Eman
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Takahashi, Gary
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Koppula, Sandhya
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Laura Hardebeck, PT
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  • Phone Number
    (503) 819-7477
  • Office Locations
    13520 Nw Pettygrove St
    Portland, OR 97229
13520 Nw Pettygrove St Portland OR, 97229
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HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.

Medicare Plans Found

 

HealthPocket is a free information source designed to help consumers find medical coverage. Whether you are looking for Medicare, Medicaid or an individual health insurance plan, we will help you find the right healthcare option and save on your out of pocket healthcare costs. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. If you select a plan presented on our site, you will be directed (via a click or a call) to one of our partners who can help you with your application. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan.