Regence MedAdvantage + Rx Classic (PPO)

Regence MedAdvantage + Rx Classic (PPO) is a PPO plan offered by Cambia Health Solutions, Inc. available for enrollment in 2025 to people living in Select Counties in Oregon, including Clark Co, WA. This plan received an overall rating of 3 out of 5 stars in 2026.

It's important to know that Regence MedAdvantage + Rx Classic (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Regence MedAdvantage + Rx Classic (PPO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Regence MedAdvantage + Rx Classic (PPO) plan features a $500 annual drug deductible. For Tier 1 preferred generic drugs, you will pay no copay at preferred pharmacies and through preferred mail order, while standard pharmacies charge a $3 copay for a one-month supply. Tier 2 generic drugs cost a $5 copay for a one-month supply at preferred pharmacies, with the option for a three-month supply for no copay when using preferred mail order. For brand-name and specialty medications, coverage costs are determined by coinsurance. Tier 3 preferred brand drugs require a 19% coinsurance at preferred pharmacies and 22% at standard pharmacies, while Tier 4 non-preferred drugs incur 35% or 38% coinsurance. Specialty drugs in Tier 5 require a 25% coinsurance for a one-month supply at both preferred and standard pharmacies.

Additional Benefits

The Regence MedAdvantage + Rx Classic (PPO) plan offers comprehensive coverage for core medical services, featuring no copay and no coinsurance for primary care visits, preventive care, and home health services. For inpatient hospital stays, members pay a daily copay of $395 for the first four days and no copay for days five through ninety. Specialist visits require a $40 copay with no coinsurance, while outpatient hospital services incur a $40 copay and a twenty percent coinsurance. Emergency care is covered with a $130 copay that is waived upon hospital admission, and urgently needed services carry a $50 copay. Routine vision, hearing, and preventive dental services are covered with no copays, though comprehensive dental care requires a fifty percent coinsurance up to a $1,250 annual limit. Additionally, diagnostic lab tests and over-the-counter items are covered with no copay, ensuring affordable access to everyday wellness needs.