Regence Medicare Plans

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General Medicare Information

Regence is proud to offer:

Regence MedAdvantage + Rx Enhanced (PPO), Regence MedAdvantage + Rx Classic (PPO) and Regence MedAdvantage Basic (PPO)
Regence MedAdvantage Basic (PPO) provides medical coverage only. Regence MedAdvantage + Rx Enhanced (PPO) and Regence MedAdvantage + Rx Classic (PPO) provide medical coverage plus Part D prescription drug coverage.
Medicare Script Enhanced (PDP) and Medicare Script Basic (PDP)
Need a separate plan for Medicare Part D prescription drug coverage? Learn more about our plans, Medicare Script Enhanced (PDP) and Medicare Script Basic (PDP).
Regence Bridge Medigap Plans
We offer four standard Medigap (Medicare Supplement) plans.

Regence MedAdvantage + Rx Enhanced, Regence MedAdvantage + Rx Classic and Regence MedAdvantage Basic

Scope of Appointment Form (PDF)
Required authorization form completed by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment.

Key Dates

Enrollment October 15 – December 7
Plans effective January 1

2013 Highlights

Low out-of-pocket expenses.
Large national provider network through the Blue Medicare Advantage PPO Network Sharing Program. Receive in-network benefits and the freedom from filing claims when you use a participating provider.
No referrals needed to see a provider of your choice.*
Freedom to see any provider across the United States.* Choose from thousands of providers in our network to save money.
Benefits beyond Original Medicare, with coverage for routine vision care and preventive dental care included in all plans.
Healthways SilverSneakers® Fitness Program with access to more than 11,000 participating fitness facility locations across the country.
Programs to help you get and stay well. Regence Advantages is a members-only discount program that offers savings on a wide range of health-related goods and services, including hearing aids, eye wear, LASIK surgery and alternative medicine.

* Your out-of-pocket costs may be higher if you see an out-of-network provider.

2013 Regence MedAdvantage + Rx Enhanced (PPO)	2013 Regence MedAdvantage + Rx Classic (PPO)	2013 Regence MedAdvantage Basic (PPO)
Monthly premium: $143 Annual medical deductible: $0 Lower copays for many in-network medical services Annual prescription drug deductible: $0 Tiered pharmacy benefit with $5 copay for Tier 1 generic medications, even throughout the Coverage Gap	Monthly premium: $53 Annual medical deductible: $50 Moderate copays for many in-network medical services Annual prescription drug deductible: $165 Tiered pharmacy benefit with $7.50 copay for Tier 1 generic medications	Monthly premium: $35 Annual medical deductible: $0 Moderate copays for many in-network medical services

Deductibles, copays and coinsurance amounts are based on a 30-day supply of medication (31-day supply for long-term care) and are effective Jan. 1, 2013, through Dec. 31, 2013. You must go to a network pharmacy to receive coverage except under non-routine circumstances. Quantity limitations and restrictions may apply.

Regence MedAdvantage + Rx Enhanced (PPO) & Regence MedAdvantage + Rx Classic (PPO)	Regence MedAdvantage Basic (PPO)	Description
Plan Ratings (PDF)	Plan Ratings (PDF)	The Medicare program rates how well plans perform in different categories.
Overview Booklet • 2013 (PDF)	Overview Booklet • 2013 (PDF)	High-level overview of benefits and premiums.
Summary of Benefits • 2013 (PDF)	Summary of Benefits • 2013 (PDF)	This brochure contains detailed information about this plan, including applicable conditions and limitations, premiums, cost-sharing (e.g., copays, coinsurance and deductibles), and any conditions associated with receipt or use of benefits.
Evidence of Coverage Brochure • 2013 (PDF)	Evidence of Coverage Brochure • 2013 (PDF)	The EOC contains a detailed explanation of coverage; sent to all new members.
Provider Directory • 2013 (PDF)	Provider Directory • 2013 (PDF)	A listing of providers in the state. The directory is current as of the date at the bottom of each provider listing page.
Pharmacy Directory • 2013 (PDF)	N/A	We have contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your customers' areas.
Comprehensive Formulary • 2013 (PDF)	N/A	Search prescription medications to determine copay/coinsurance amounts.
Regence Advantages • 2013 (PDF)	Regence Advantages • 2013 (PDF)	Discount services available to members such as vision care services and hearing-care services. The products and services described are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the Regence grievance process.
Agent Counter card • 2013 (PDF)	Agent Counter card • 2013 (PDF)	These pamphlets provide a high-level overview of our Medicare Advantage plans and provide space for your contact information.
Counter card • 2013 (PDF)	Counter card • 2013 (PDF)	These pamphlets provide a high-level overview of our Medicare Advantage plans.
Application Form • 2013 (Fillable PDF)	Application Form • 2013 (Fillable PDF)	Use this form to apply for coverage. Download, complete and mail to the address on the form.
Surepay Information and Authorization Form (PDF)	Surepay Information and Authorization Form (PDF)	Give this form to the member to set up automatic payment of premium from the member's personal account.
Short Enrollment Form • 2013 (PDF)	Short Enrollment Form • 2013 (PDF)	Change between MedAdvantage Basic, Classic or Enhanced
Extra Assistance Information • 2013 (PDF)	N/A	Flyer that provides information about plan premiums for clients who are eligible for Extra Help from Medicare.
Scope of Appointment Form (PDF)	Scope of Appointment Form (PDF)	Required authorization form completed by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment. Agents and brokers can document the scope of appointment in writing via a scope of appointment form or by recording a phone call in advance of the appointment.
FAQs	FAQs	Answers to frequently asked questions.

Customer Service is available by calling 1 (800) 541-8981. Hours are 8:00 a.m. to 8:00 p.m., Monday through Friday. From October 1 through February 14, Customer Service is available from 8:00 a.m. to 8:00 p.m., seven days a week. TTY users should call 711.

Agent Desk 1 (800) 452-7278 ext. 4960

Regence BlueCross BlueShield of Oregon is a Health plan with a Medicare contract. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. You must continue to pay your Medicare Part B premium. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year.

Agents/brokers are required to take annual training to sell Regence MedAdvantage (PPO) and must be certified to receive commission. For further information, please contact your sales representative.

Medicare Script Enhanced (PDP) and Medicare Script (PDP)

Scope of Appointment Form (PDF)
Required authorization form completed by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment.

Key Dates

Enrollment October 15 – December 7
Plans effective January 1

Training and Certification Required
To be eligible to sell these drug plans, you must take an annual training session. To schedule, please contact your sales representative.

2013 Medicare Script Enhanced (PDP)	2013 Medicare Script Basic (PDP)
Monthly premium: $116.50 Annual deductible: $0 Tiered pharmacy benefit with $5 copay for Tier 1 generic medications, even throughout the Coverage Gap	Monthly premium: $82 Annual deductible: $187 Tiered pharmacy benefit with $7.50-copay for Tier 1 generic medications

Medicare Script Resource	Description
Plan Ratings (PDF)	The Medicare program rates how well plans perform in different categories.
Overview Booklet • 2013 (PDF)	High-level overview of benefits and premiums.
Summary of Benefits • 2013 (PDF)	This brochure contains detailed information about this plan, including applicable conditions and limitations, premiums, cost-sharing (e.g., copays, coinsurance and deductibles), and any conditions associated with receipt or use of benefits.
Evidence of Coverage (EOC) • 2013 (PDF)	The EOC is a detailed explanation of coverage sent to all new members.
Pharmacy Directory • 2013 (PDF)	We have contracts with pharmacies that equal or exceed CMS requirements for pharmacy access in your customer's area.
Comprehensive Formulary • 2013 (PDF)	Search a list of prescription medications to determine your copay/coinsurance amounts.
Advantages • 2013 (PDF)	Discount services for members on vision and hearing care services. The products and services described are neither offered nor guaranteed under our contract with the Medicare program. In addition, they are not subject to the Medicare appeals process. Any disputes regarding these products and services may be subject to the plan grievance process.
Application Form • 2013 (Fillable PDF)	Use this form to apply for coverage. Download, complete and mail to the address on the form.
Surepay Information and Authorization Form (PDF)	Give this form to member to set up automatic payment of premium from the member's personal account.
Short Enrollment Form • 2013 (PDF)	Change between Medicare Script Basic or Enhanced.
Extra Assistance Information • 2013 (PDF)	Flyer that provides information about plan premiums for clients who are eligible for Extra Help from Medicare
Scope of Appointment Form (PDF)	Required authorization form completed by the Medicare beneficiary prior to any face-to-face personal/individual marketing appointment. Agents and brokers can document the scope of appointment in writing via a scope of appointment form or by recording a phone call in advance of the appointment.

Agent Desk 1 (800) 452-7278 ext. 4960

A Medicare-approved Part D sponsor. The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan. You must continue to pay your Medicare Part B premium. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year.