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PacificSource Medicare Essentials Choice 2 (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for PacificSource Medicare Essentials Choice 2 (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on PacificSource Medicare Essentials Choice 2 (HMO-POS) in 2026, please refer to our full plan details page.
PacificSource Medicare Essentials Choice 2 (HMO-POS) is a HMO-POS plan offered by PacificSource available for enrollment in 2025 to people living in Select Oregon Counties. This plan received an overall rating of 3.5 out of 5 stars in 2026.
It's important to know that PacificSource Medicare Essentials Choice 2 (HMO-POS) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about PacificSource Medicare Essentials Choice 2 (HMO-POS).
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.
For PacificSource Medicare Essentials Choice 2 (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $8950.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $8950.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for PacificSource Medicare Essentials Choice 2 (HMO-POS)
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Drug Coverage
Prescription drugs are not covered by PacificSource Medicare Essentials Choice 2 (HMO-POS).
Additional Benefits
The PacificSource Medicare Essentials Choice 2 (HMO-POS) plan offers robust medical coverage with affordable out-of-pocket costs, featuring no copay to a $10 copay for primary care visits and no copay for preventive exams. Specialist visits and physical therapy require a low $10 copay, while emergency care has a $120 copay that is waived upon hospital admission. For inpatient hospital stays, members pay a $425 daily copay for the first seven days, and skilled nursing care is available with no copay for the first 20 days. Members also receive excellent supplemental benefits, including a $200 annual eyewear allowance and routine vision exams with no copay. Dental services are covered up to a $2,500 annual limit, featuring no copay for preventive care and 50% coinsurance for comprehensive services. Additionally, the plan includes a $75 quarterly allowance for over-the-counter items with no copay, and routine hearing exams for a $30 copay.
Inpatient Hospital See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers inpatient hospital services with no coinsurance, requiring a $425 daily copay for days 1 to 7 of acute stays and a $230 daily copay for days 1 to 5 of psychiatric stays, with no copay for remaining days. This benefit is partially covered because non-Medicare-covered stays, upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers outpatient hospital services with no coinsurance and copays ranging from $0 to $425, and observation services with a $425 copay per stay and no coinsurance. Ambulatory surgical center and outpatient blood services are fully covered with no copays and no coinsurance. Some outpatient substance abuse services are covered with no copay or coinsurance, but individual and group sessions are not covered.
Partial Hospitalization See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers partial hospitalization services with a $40 copay and no coinsurance. Prior authorization is required to receive this covered benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are partially covered by the PacificSource Medicare Essentials Choice 2 (HMO-POS) plan, which covers ground and air ambulance services with a $300 copay and no coinsurance, subject to prior authorization. Transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers emergency services with a $120 copay and no coinsurance, which is waived if you are admitted to the hospital within 72 hours. Urgently needed services are covered with a $50 copay and no coinsurance, while worldwide emergency services are offered with no coinsurance and copays of $120 for emergency care, $50 for urgent care, and $300 for emergency transportation.
Primary Care See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) offers primary care, telehealth, and opioid treatment services with no coinsurance and copays ranging from no copay to $10. Specialist visits, physical therapy, and mental health services require a $10 copay and no coinsurance, while chiropractic care is partially covered—excluding non-routine services—and podiatry is not covered.
Preventive Services See details
Preventive services under the PacificSource Medicare Essentials Choice 2 (HMO-POS) are partially covered, offering annual physicals and routine screenings with no copay and no coinsurance, alternative therapies for a $10 copay and no coinsurance, and kidney disease education with no copay and 20% coinsurance. Sub-services not covered under this plan include health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, re-admission prevention, wigs, weight management, therapeutic massage, adult day health, nutritional/dietary benefits, home-based palliative care, in-home support, caregiver support, tobacco cessation counseling, enhanced disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by PacificSource Medicare Essentials Choice 2 (HMO-POS), which offers routine hearing exams for a $30 copay and no coinsurance, and up to two prescription hearing aids per year with a copay between $599 and $999 and no coinsurance. There is no deductible for these services, but OTC hearing aids as well as inner-ear, outer-ear, and over-the-ear prescription hearing aids are not covered.
Vision Services See details
Vision Services are covered by PacificSource Medicare Essentials Choice 2 (HMO-POS) with no copay, no coinsurance, and no deductible for exams and eyewear. The plan includes one routine eye exam per year and a $200 annual allowance for glasses or contact lenses, though eyewear upgrades are not covered.
Dental Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) offers partially covered dental services up to a $2,500 annual limit, excluding maxillofacial prosthetics and orthodontics. Medicare-covered dental requires a $40 copay and no coinsurance, preventive services are available with no copay and no coinsurance, and comprehensive services require no copay and 50% coinsurance.
Home Infusion bundled Services See details
Home infusion bundled services are covered by PacificSource Medicare Essentials Choice 2 (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs carry a 0% to 20% coinsurance, while Medicare Part B insulin has a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers dialysis services with no copay and a 20% coinsurance.
Medical Equipment See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers durable medical equipment and medical supplies with no copay and 20% coinsurance, and prosthetic devices with no copay and no coinsurance to 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers diagnostic and radiological services with prior authorization, requiring a $15 copay and 20% coinsurance for diagnostic procedures, and a copay with no coinsurance for lab services. Diagnostic radiological services and outpatient X-rays feature no copay, while therapeutic radiology and X-ray services carry a 20% coinsurance.
Home Health Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are offered by PacificSource Medicare Essentials Choice 2 (HMO-POS) with no coinsurance, but some services are covered while cardiac rehabilitation ($35 copay), intensive cardiac rehabilitation ($35 copay), pulmonary rehabilitation ($15 copay), and supervised exercise therapy for peripheral artery disease ($25 copay) are not covered.
Skilled Nursing Facility (SNF) See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) covers skilled nursing facility services with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. There is no copay for days 1 through 20, followed by a $203 daily copay for days 21 through 100, with no coverage for additional days beyond the Medicare-covered limit.
Other Services See details
PacificSource Medicare Essentials Choice 2 (HMO-POS) provides partially covered other services, featuring acupuncture for a $10 copay and no coinsurance up to 24 treatments per year, alongside an annual wellness visit with no copay and no coinsurance. Over-the-counter items are also covered with no copay or coinsurance up to $75 every three months, while meal benefits are not covered.
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