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ATRIO Select Rx (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for ATRIO Select Rx (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on ATRIO Select Rx (PPO) in 2025, please refer to our full plan details page.
ATRIO Select Rx (PPO) is a PPO plan offered by ATRIO Health Plans available for enrollment in 2025 to people living in Reno Suburbs. This plan received an overall rating of 3 out of 5 stars in 2025.
It's important to know that ATRIO Select Rx (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 ATRIO Select Rx (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.
For ATRIO Select Rx (PPO), 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. Additionally, this plan comes with a Part B Premium reduction of $20.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $6200.00 (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 $6200.00 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:
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Drug Coverage
The ATRIO Select Rx (PPO) plan has a $0 deductible for prescription drugs. In the initial coverage phase, you will pay different copays depending on the drug tier and pharmacy you use. For example, you will pay no copay for preferred generic drugs at a standard pharmacy and $35 for standard generic drugs. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The ATRIO Select Rx (PPO) plan offers a wide array of benefits with varying costs. Inpatient hospital stays have no copay, while outpatient services range from no copay to $350 depending on the service. Emergency services have a $140 copay. The plan includes coverage for primary care, preventive services, hearing, vision, and dental services. Many services have no copay, such as routine hearing exams and physical therapy. Other benefits include ambulance services with a $300 copay, and coverage for home health, skilled nursing facilities, and other services, with specific copays and coinsurance depending on the service.
Inpatient Hospital See details
Inpatient Hospital benefits include coverage for Inpatient Hospital-Acute with no copay for a Medicare-covered stay and additional days, and Inpatient Hospital Psychiatric with a $300 copay for days 1-5 and no copay for days 6-90. Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services, including outpatient hospital services and observation services, are covered with a copay between $0 and $350, and $0 and $300 respectively. Ambulatory Surgical Center (ASC) Services have a $225 copay, while Outpatient Substance Abuse Services have a $10 copay for both individual and group sessions. Outpatient blood services are also covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the ATRIO Select Rx (PPO) plan. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the ATRIO Select Rx (PPO) plan. The plan has a $300 copay for both ground and air ambulance services, and offers transportation services to plan-approved health-related locations, with 24 one-way trips per year using rideshares, bus/subway, medical transport, or other means.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage have a copay of $140, $30, and $140, respectively, with no coinsurance. Worldwide Urgent Coverage also has a copay of $140, with no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
ATRIO Select Rx (PPO) covers primary care physician services, chiropractic services with a $10 copay for routine care, occupational therapy services with no copay, physician specialist services with a $25 copay, and physical therapy and speech-language pathology services with no copay. The plan also covers mental health specialty services, psychiatric services, opioid treatment program services, and additional telehealth benefits.
Preventive Services See details
The ATRIO Select Rx (PPO) plan covers preventive services, including annual physical exams, with no copay. Additional preventive services like Personal Emergency Response System (PERS) are covered with a maximum plan benefit of $18.50 monthly, Alternative Therapies with a $300 maximum every six months, and Fitness Benefit with a $200 maximum every six months. Health Education, In-Home Safety Assessment, Medical Nutrition Therapy (MNT), and other services are not covered.
Hearing Services See details
Hearing services with ATRIO Select Rx (PPO) include routine hearing exams (1 per year), and fitting/evaluation for hearing aids with no copay or coinsurance. Prescription hearing aids are covered up to $1500 per year, and all types of prescription hearing aids are covered, except for inner ear, outer ear, and over the ear hearing aids, which are not covered. OTC hearing aids are not covered.
Vision Services See details
The ATRIO Select Rx (PPO) plan covers vision services, including routine eye exams with one visit covered every year, and eyewear, with a maximum benefit of $100 for contact lenses per year, and $200 for eyeglasses (lenses and frames) per year, though eyeglass lenses and frames are not covered.
Dental Services See details
The ATRIO Select Rx (PPO) plan covers a variety of dental services, including oral exams, dental x-rays, and other diagnostic and preventative services, all of which require prior authorization. Other services, such as orthodontics, are covered under the diagnostic and preventative dental services. There is a maximum benefit of $400 every three months.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the ATRIO Select Rx (PPO) plan, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay and a coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, there is a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the ATRIO Select Rx (PPO) plan with a coinsurance between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits are covered by ATRIO Select Rx (PPO), including Durable Medical Equipment (DME) with a 20% coinsurance, and Prosthetic Devices with a 20% coinsurance. Medical Supplies have a 20% coinsurance, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
The ATRIO Select Rx (PPO) plan covers diagnostic and radiological services, but not diagnostic procedures/tests, lab services, or outpatient X-ray services. Diagnostic Radiological Services have a copay of at most $60, and Therapeutic Radiological Services have a copay of at most $20.
Home Health Services See details
Home Health Services are covered by the ATRIO Select Rx (PPO) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the ATRIO Select Rx (PPO) plan, but the specific services like Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services are not covered. There is a copay for some services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, the copay is $20, and for days 21-100, the copay is $170.
Other Services See details
The ATRIO Select Rx (PPO) plan covers acupuncture, over-the-counter items, and meal benefits. Acupuncture is covered up to $300 every six months, while over-the-counter items are covered up to $75 every three months. Meal benefits are covered, with prior authorization required. Other services, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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