Your Guide to Medicare Advantage in Douglas County, OR
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In Douglas County, Oregon, there are 12 Medicare Advantage Plans available for the 2025. From basics to specialized care, each of the 12 plans caters to distinct health needs and priorities. Our guide will help you weigh your options so you can make an informed decision.
Compare Medicare Advantage Plans in Douglas County
Below is a complete list of Medicare Advantage Plans available in Douglas County. Click on any plan to view full details, including benefits, coverage, and costs.
Douglas County, Oregon Medicare Advantage Plans
| Plan Name | Type | Premium | MOOP | Rx Ded. | Rating |
|---|---|---|---|---|---|
| Regence MedAdvantage + Rx Enhanced | PPO | $179 | $5,000 | $0 | |
| Regence MedAdvantage + Rx Primary | PPO | $14 | $6,200 | $100 | |
| Regence Valiance | PPO | $0 | $5,000 | N/A | |
| ATRIO Choice Rx | PPO | $0 | $4,150 | $100 | |
| ATRIO Freedom | PPO | $0 | $4,500 | N/A | |
| ATRIO Prime Rx | PPO | $96 | $4,150 | $0 | |
| Wellcare Giveback Open | PPO | $0 | $8,850 | $420 | |
| Wellcare Low Premium Open | PPO | $38 | $6,800 | $420 | |
| Wellcare Patriot Giveback Open | PPO | $0 | $5,000 | N/A | |
| Wellcare Premium Ultra Open | PPO | $146 | $4,000 | $420 | |
| Wellcare Simple Open | PPO | $0 | $3,450 | $420 | |
| Wellcare Simple Value | HMO-POS | $0 | $6,600 | $420 | |
| **Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages. | |||||
Understanding Your Medicare Advantage Options
Medicare Advantage Plans, also known as Medicare Part C, are private health plans that provide all-in-one coverage, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). On top of the core benefits, many of the plans in Douglas County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Mohave County looking for something more than Original Medicare.
- Health Maintenance Organization (HMO): Members must use the plan's network of doctors and hospitals in Douglas County, and typically need a referral to see a specialist. Some Medicare Advantage HMO Plans may have lower costs but offer less flexibility in choosing healthcare providers.
- Preferred Provider Organization (PPO): Offers more provider flexibility, allowing members to see any doctor or specialist without a referral, often at a higher cost. Medicare Advantage PPO Plans generally have higher premiums and out-of-pocket expenses compared to HMOs.
- Private Fee-for-Service (PFFS): With a PFFS plan, members can visit any Medicare-approved doctor or hospital in Douglas County that agrees to the plan’s terms and payment rates. PFFS plans provide more freedom in provider choice but can come with higher costs.
- Medicare Savings Account (MSA): Combines a high-deductible Medicare Advantage plan with a tax-advantaged savings account. The plan deposits money into the account each year, which you can use for healthcare expenses before your deductible is met. MSAs offer control over healthcare spending, with the potential to save on future costs if the savings account funds are not fully used.
Another option you might encounter is the HMO-POS plan, a type of Medicare Advantage plan that provides more flexibility compared to a standard HMO. While it still requires members to use a network of doctors and hospitals and typically requires referrals to see specialists, an HMO-POS plan stands out by allowing members to access certain healthcare services outside of the network, though at a higher cost.
Why Choose a Medicare Advantage Plan?
Many Medicare Advantage Plans offer extra benefits that go beyond Original Medicare, making them an attractive option for some people. These plans provide comprehensive coverage, often including additional services like prescription drug coverage, dental, vision, and wellness programs, all bundled into one plan. By choosing a Medicare Advantage Plan, you can simplify your healthcare and potentially save on costs.
Take a look at the main benefits provided by Medicare Advantage Plans in Douglas County:
- Coordinated Care: Plans often include care coordination services, which helps you manage your healthcare across different providers and services.
- Cost Savings: Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.
- Comprehensive Coverage: Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.
- Wellness Programs: Many Douglas County plans offer free gym memberships, wellness programs, and preventive care services. You need to stay healthy, right?
Tips for Selecting a Medicare Advantage Plan
Choosing the right Medicare Advantage Plan out of the 12 plans available in Douglas County requires careful consideration of several key factors:
- Provider Network: Verify that your current doctors and preferred hospitals are included in the plan's network. Access to your healthcare providers can significantly impact your care experience.
- Prescription Drug Coverage: Make sure the plan covers your medications, particularly if you have specific prescriptions you rely on regularly.
- Costs: Examine the plan's premiums, copayments, and out-of-pocket limits. Compare these costs against your budget to avoid unexpected expenses.
- Additional Benefits: Consider what extra services, such as dental, vision, or wellness programs, are important to you, and check if the plan offers them.
- Plan Ratings: Look into the plan's star ratings, which provide insight into the plan's overall quality and member satisfaction.
Learn more about the basics of comparing Medicare Advantage Plans.
Getting Enrolled in a Douglas County Medicare Advantage Plan: Know Your Enrollment Periods
Making sense of Medicare Advantage enrollment periods can seem overwhelming, but it's worth the effort for better health coverage. Missing these key dates could delay your coverage or limit your plan choices for 2025 in Douglas County.
- Initial Enrollment Period (IEP): This initial enrollment window starts three months before and ends three months after your 65th birthday, offering a total of seven months to enroll in a Medicare Advantage Plan.
- Annual Enrollment Period (AEP): Every year from October 15 to December 7, you have the option to change, enroll, or disenroll from a Medicare Advantage Plan.
- Open Enrollment Period (OEP): Running from January 1 to March 31, this period allows changes to your Medicare Advantage Plan if you’re already enrolled or lets you switch back to Original Medicare.
For comprehensive details on how to enroll, visit our detailed guide on Medicare Enrollment.
Plan Availability
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in and all other areas of Douglas County, Oregon.
Plans Offered
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
Citations & References
- CMS.gov, "2024 Medicare Part C Landscape Source Files", Last Accessed October 14, 2023
- CMS.gov, "2024 Part C and D Performance Data", Last Accessed October 14, 2023
- Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 18 June, 2023
- CMS.gov, "Special Needs Plans (SNP)", Last Accessed 24 May, 2024
- Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", Last Accessed 22 May, 2024