Regence Medicare Plans

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General Medicare Information

This page replaces the separate Medicare Advantage and Medicare Advantage + Rx/Part D pages, please bookmark this new page.

Regence is proud to offer:

Regence MedAdvantage + Rx Enhanced (PPO), Regence MedAdvantage + Rx Classic (PPO) and Regence MedAdvantage Basic (PPO)
Regence MedAdvantage Basic(PPO) for medical coverage only. Regence MedAdvantage + Rx Enhanced (PPO) and Regence MedAdvantage + Rx Classic (PPO) for medical coverage plus Part D prescription drug coverage.
Medicare Script™ Enhanced (PDP) and Medicare Script^TM Basic (PDP)
Need a separate plan for Medicare Part D prescription drug coverage? Learn more about our plans, Medicare Script Enhanced (PDP) and Medicare Script Basic (PDP).
Regence Bridge Medigap Plans
We offer four standard Medigap (Medicare Supplement) plans

Regence MedAdvantage + Rx Enhanced, Regence MedAdvantage + Rx Classic and Regence MedAdvantage Basic

Key Dates

Enrollment October 15 – December 7
Plans effective January 1

2012 Highlights

Members can choose their own doctor—no referrals are required to see specialists
Large PPO network of doctors, specialists and hospitals to choose from
$10 copay for each in-network primary doctor visit for Regence MedAdvantage + Rx Enhanced. A $15 copay applies to Regence MedAdvantage + Rx Classic and Regence MedAdvantage Basic.
No copays for many preventive services.
No deductible for medical services for Regence MedAdvantage + Rx Enhanced. $50 deductible for Regence MedAdvantage Basic. A $100 medical deductible for Regence MedAdvantage + Rx Classic.
Easy to use with virtually no paperwork
Predictable expenses with out-of-pocket maximums
Routine, preventive dental services, up to $500 per year with 20% member coinsurance.
Routine eye exams covered, along with up to $100 every year for vision hardware with our Regence MedAdvantage and Regence MedAdvantage + Rx Classic plans, and up to $200 every year for vision hardware with our Regence MedAdvantage + Rx Enhanced Plan.
Nurse health-advice hotline available 24-hours a day
Great customer service

Include Part D Prescription Drug Coverage with Regence MedAdvantage + Rx Enhanced or Regence MedAdvantage + Rx Classic. Members can choose from nationwide pharmacies, or use convenient mail order service, and have copays as low as $5 for Tier 1 generic medications.

2012 Regence MedAdvantage + Rx Enhanced	2012 Regence MedAdvantage + Rx Classic	2012 Regence MedAdvantage Basic
Monthly premium: $211 Annual medical deductible: $0 Lower copays for many in-network medical services Annual pharmacy deductible: $0 Tiered pharmacy benefit with $5 copay for Tier 1 generic medications, even throughout the coverage gap	Monthly premium: $119 Annual medical deductible: $100 Moderate copays for many in-network medical services Annual pharmacy deductible: $200 Tiered pharmacy benefit with $7.50 copay for Tier 1 generic medications	Monthly premium: $79 Annual medical deductible: $50 Moderate copays for many in-network medical services

Deductibles, copays and coinsurance amounts are based on a 30-day supply of medication (31-day supply for long-term care) and are effective Jan. 1, 2012, through Dec. 31, 2012. You must go to a network pharmacy to receive coverage except under non-routine circumstances. Quantity limitations and restrictions may apply.

Regence MedAdvantage + Rx Enhanced Regence MedAdvantage + Rx Classic	Regence MedAdvantage Basic	Description
Plan Ratings (PDF)	Plan Ratings (PDF)	The Medicare program rates how well plans perform in different categories.
Highlights Flyer • 2012 (PDF)	Highlights Flyer • 2012 (PDF)	High level overview of benefits and premiums.
Comparison chart PPO/HMO/ Medicare Supplement (PDF)	Comparison chart PPO/HMO/ Medicare Supplement (PDF)	Compares benefits of Regence MedAdvantage PPO to HMO and Medicare Supplement products.
Summary of Benefits • 2012 (PDF)	Summary of Benefits • 2012 (PDF)	This brochure contains detailed information about this plan, including applicable conditions and limitations, premiums, cost-sharing (e.g., copays, coinsurance and deductibles), and any conditions associated with receipt or use of benefits.
Evidence of Coverage Brochure • 2012 (PDF)	Evidence of Coverage Brochure • 2012 (PDF)	This is the Evidence of Coverage (EOC) which contains a detailed explanation of coverage; sent to all new members.
Provider Directory • 2012 (includes dental) (PDF)	Provider Directory • 2012 (includes dental) (PDF)	A listing of providers in the state. The directory is current as of the date at the bottom of each provider listing page.
Pharmacy Directory • 2012 (PDF)	N/A	We have contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your customer's area.
Comprehensive Formulary • 2012 (PDF)	N/A	Search prescription medications to determine copay/coinsurance amounts.
Regence Advantages (PDF)	Regence Advantages (PDF)	Discount Services available to members such as vision care services, hearing care services. The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Regence grievance process.
Counter card • 2012 (PDF)	Counter card • 2012 (PDF)	Order these brochures to send to your clients.
Application Form • 2012 (Fillable PDF)	Application Form • 2012 (Fillable PDF)	Use this form to apply for coverage. Download, complete and mail to the address on the form.
Surepay Information and Authorization Form • 2012 (PDF)	Surepay Information and Authorization Form • 2012 (PDF)	Give this form to the member to set up automatic payment of premium from the member's personal account.
Short Enrollment Form (PDF)	Short Enrollment Form (PDF)	Change between MedAdvantage Basic, Classic or Enhanced
Extra Assistance Information • 2012 (PDF)	N/A	Income levels that qualify for extra help. Annual income less than $15,600 (single) Annual income less than $21,000 (married) Limited resources/assets
Scope of Appointment Form (PDF)	Scope of Appointment Form (PDF)	Required authorization form completed by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment. Agents and brokers can document the scope of appointment in writing via a scope of appointment form or by recording a phone call in advance of the appointment.
FAQs	FAQs	Answers to frequently asked questions.

Customer Service 1 (800) 541-8981, Hours are 8:00 a.m. to 8:00 p.m. Monday through Friday. From October 15 through February 14, Customer Service is available from 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 711.

Agent Desk 1 (800) 452-7278 ext. 4960

Regence MedAdvantage is a health plan with a Medicare contract. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, premiums, and/or copayments/coinsurance may change on January 1, 2013. Formularies and pharmacy and provider networks may change during 2012 and/or on Jan 1, 2013. You must continue to pay your Part B premium.

Agents/brokers are required to take annual training to sell Regence MedAdvantage (PPO) and must be certified to receive commission. For further information, please contact your sales representative.

Medicare Script™ Enhanced (PDP) and Medicare Script (PDP)

Key Dates

Enrollment October 15 – December 7
Plans effective January 1

Training and Certification Required
To be eligible to sell these drug plans, you must take an annual training session. To schedule, please contact your sales representative.

2012 Medicare Script Enhanced (PDP)	2012 Medicare Script Basic (PDP)
Monthly premium: $106.50 Annual deductible: $0 Tiered pharmacy benefit with $5 copay for Tier 1 generic medications, even throughout the coverage gap	Monthly premium: $74.50 Annual deductible: $195 Tiered pharmacy benefit with $7.50-copay for Tier 1 generic medications

Medicare Script Resource	Description
Plan Ratings (PDF)	The Medicare program rates how well plans perform in different categories.
Highlights Flyer • 2012 (PDF)	High level overview of benefits and premiums.
Summary of Benefits • 2012 (PDF)	This brochure contains detailed information about this plan, including applicable conditions and limitations, premiums, cost-sharing (e.g., copays, coinsurance and deductibles), and any conditions associated with receipt or use of benefits.
Evidence of Coverage (EOC) • 2012 (PDF)	This is the EOC, a detailed explanation of coverage sent to all new members.
Pharmacy Directory • 2012 (PDF)	We have contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your customer's area.
Comprehensive Formulary • 2012 (PDF)	Search a list of prescription medications to determine your copay/coinsurance amounts.
Advantages (PDF)	Discount services for members on vision and hearing care services. The products and services described above are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the plan grievance process.
Application Form • 2012 (Fillable PDF)	Use this form to apply for coverage. Download, complete and mail to the address on the form.
Surepay Information and Authorization Form • 2012 (PDF)	Give this form to member to set up automatic payment of premium from the member's personal account.
Short Enrollment Form (PDF)	Change between Medicare Script Basic or Enhanced
Extra Assistance Information • 2012 (PDF)	Income levels that qualify for extra help. • Annual income less than $15,600 (single) • Annual income less than $21,000 (married) • Limited resources/assets
Scope of Appointment Form (PDF)	Required authorization form completed by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment. Agents and brokers can document the scope of appointment in writing via a scope of appointment form or by recording a phone call in advance of the appointment.

Customer Service 1 (800) 541-8981 Hours are 8:00 a.m. to 8:00 p.m. Monday through Friday. From October 15 through February 14, Customer Service is available from 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 711.

Agent Desk 1 (800) 452-7278 ext. 4960

Medicare Script is a stand-alone prescription drug plan with a Medicare contract. The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, premiums, and/or copayments/coinsurance may change on January 1, 2013. Formularies and pharmacy networks may change during 2012 and/or on Jan 1, 2013. You must continue to pay your Part B premium.