Regence MedAdvantage + Rx Enhanced (PPO)

Regence MedAdvantage + Rx Enhanced (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 Enhanced (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 Enhanced (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 Enhanced (PPO) plan features a $200 annual drug deductible before coverage begins. For Tier 1 preferred generic drugs, you will pay no copay when using a preferred pharmacy or preferred mail order service, compared to a $3.00 to $6.00 copay at standard locations. Tier 2 generic drugs carry a $3.00 to $6.00 copay at preferred pharmacies, though you can get a three-month supply with no copay through preferred mail order. Higher-tier medications are subject to coinsurance rather than set copays. Tier 3 preferred brands require a 20% coinsurance at preferred pharmacies and 23% at standard pharmacies, while Tier 4 non-preferred drugs require 35% to 38% coinsurance. Tier 5 specialty drugs require a 30% coinsurance for a one-month supply at both preferred and standard pharmacies.

Additional Benefits

The Regence MedAdvantage + Rx Enhanced (PPO) plan offers affordable access to essential medical care, featuring no copays or coinsurance for primary care visits and preventive services. Inpatient hospital stays require a $300 daily copay for the first five days and no copay for days 6 through 90, while specialist visits and outpatient hospital services carry a $30 copay, with outpatient services also requiring a 20% coinsurance. Emergency room visits have a $130 copay, which is waived if you are admitted to the hospital within 48 hours. For supplemental care, the plan provides routine vision exams and up to $150 for eyewear with no copay, alongside preventive dental care with no copay and comprehensive dental covered with 50% coinsurance up to a $1,500 annual limit. Routine hearing exams also have no copay, though prescription hearing aids require copays ranging from $499 to $999. Home health services are covered with no copay, while skilled nursing facility stays require daily copays of $10 for days 1 through 20 and $218 for days 21 through 44 before transitioning to no copay.