PacificSource Dual Care (HMO D-SNP)

PacificSource Dual Care (HMO D-SNP) is a HMO D-SNP plan offered by Pacificsource Community Health Plans available for the 2026 plan year 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 Dual Care (HMO D-SNP) 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 PacificSource Dual Care (HMO D-SNP).

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 PacificSource Dual Care (HMO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic drugs filled at standard pharmacies or through standard mail order for up to a three-month supply. For Tier 2 generic and Tier 3 preferred brand drugs, you will pay a 25% coinsurance rate for standard pharmacy fills and mail orders. Tier 4 non-preferred drugs require a 26% coinsurance payment for one-, two-, or three-month supplies. Tier 5 specialty drugs carry a 25% coinsurance rate, which is limited to a one-month supply for standard retail and mail-order options. This structured cost-sharing allows you to easily estimate your out-of-pocket expenses based on your specific prescription needs.

Additional Benefits

The PacificSource Dual Care (HMO D-SNP) plan offers comprehensive coverage where many medical services, including outpatient care, emergency visits, primary and specialist care, and medical equipment, require no copay and a 20% coinsurance. High-tier benefits like inpatient hospital stays, home health services, and select diagnostic hearing exams are fully covered with no copay and no coinsurance. However, many of these covered services do require prior authorization before you can receive care. For supplemental care, the plan provides vision exams with a 20% coinsurance and eyewear with no copay or coinsurance up to a $190 annual limit, alongside a quarterly $130 allowance for over-the-counter items. While Medicare-covered dental services are available with a 20% coinsurance, routine non-Medicare dental care, hearing aids, and transportation services are not covered. Prescription insulin is also subject to a $35 copay under this plan.

Plan Providers

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring^SM, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.