Regence MedAdvantage + Rx Enhanced (PPO)

Regence MedAdvantage + Rx Enhanced (PPO) is a PPO plan offered by Regence Blueshield available for the 2026 plan year to people living in Select Counties in Washington. 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. For Tier 1 preferred generics, you pay no copay when using a preferred pharmacy or preferred mail-order service, while standard pharmacies charge a $3 copay for a one-month supply. Tier 2 generic drugs cost a low $4 copay for a one-month supply at preferred pharmacies, and you can get a three-month supply with no copay through preferred mail order. For higher-tier medications, costs transition to coinsurance percentages. Tier 3 preferred brand-name drugs require a 20% coinsurance at preferred pharmacies and 23% at standard pharmacies. Tier 4 non-preferred drugs carry a 35% to 38% coinsurance, while Tier 5 specialty drugs require a flat 30% coinsurance for a one-month supply regardless of your pharmacy choice.

Additional Benefits

The Regence MedAdvantage + Rx Enhanced (PPO) plan offers robust coverage for everyday health needs, featuring no copay or coinsurance for primary care visits and routine preventive services. For emergency and urgent care, members pay a flat copay of $130 and $50 respectively with no coinsurance, while inpatient hospital stays require a $390 daily copay for the first six days and no copay thereafter. Specialist visits and outpatient hospital services are also covered with affordable copays ranging from $20 to $40. This plan also includes key supplemental benefits, providing routine vision exams and eyewear with no copay or coinsurance, alongside preventive dental care at no cost up to a $1,500 annual limit. Routine hearing exams have no copay, though prescription hearing aids require a copay between $499 and $999. Durable medical equipment and dialysis services are covered with a standard 20% coinsurance and no copay.

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.