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2015 Regence Medicare Plans - Oregon

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2015 Regence BlueAdvantage HMO Plan

Key Dates

  • Enrollment October 15–December 7
  • Plans effective January 1, 2015

Regence BlueAdvantage HMO offers:

  • $0 premium
  • $0 medical deductible
  • $0 prescription drug deductible 
  • Low or no primary care visit copay 
  • Coverage beyond Original Medicare that may include an annual physical exam and a routine eye exam
  • Worldwide coverage for urgent or emergency care 
  • SilverSneakers® Fitness Program 
  • 24 hour nurseline.  Get medical advice from a registered nurse any time, day or night 
     
Scope of Appointment form Plan Ratings (Star Ratings)
Agent Counter Card Postal Prescription Services
Appointment of Representative Prescription Claim form
Authorization to Disclose Protected Health Information Prescription Coverage Determination
Catamaran Rx home delivery Prior Authorization
Comprehensive Formulary Provider directory
Decision guide Request for Prescription Redetermination
Enrollment form Request Formulary Exception
Evidence of Coverage Short Enrollment form
Grievance (Complaint) form Short Enrollment form - Spanish
Low Income Subsidy premium chart SilverSneakers member flyer
Medical Appeals form SilverSneakers sales flyer
Medication Therapy Management Summary of benefits
Multi-Language insert Walgreens Mail Member Registration
Part D Transition policy Walgreens Mail Service brochure
Pharmacy directory Walgreens Mail Service Prescriber Fax
   

 

2015 Regence MedAdvantage (PPO) Plans

Key Dates

  • Enrollment October 15–December 7
  • Plans effective January 1, 2015

Regence MedAdvantage (PPO) plans offer:

  • $0 medical deductible
  • Prescription drug coverage with deductibles as low as $0  
  • Freedom to see any provider in the United States without a referral 
  • Large national PPO network across the United States when you see participating providers in the Blue Medicare Advantage PPO Network Sharing Program
  • Hearing aid benefit with the Enhanced plan
  • Preventive dental coverage, with optional comprehensive dental coverage available for an additional premium 
  • Routine vision exam and hardware coverage 
  • Coverage beyond Original Medicare that may include an annual physical exam 
  • Worldwide coverage for urgent or emergency care 
  • SilverSneakers® Fitness Program 
  • 24 hour nurseline.  Get medical advice from a registered nurse any time, day or night 
Scope of Appointment form
Agent Counter Card - MedAdvantage (PPO)
Appointment of Representative
Authorization to Disclose Protected Health Information
Authorization to Disclose Protected Health Information - Spanish
Automatic Bank Deduction Authorization
Catamaran Rx home delivery
Comprehensive Formulary - MedAdvantage (PPO) + Rx
Comprehensive Formulary - MedAdvantage (PPO) + Rx - Spanish
Decision guide - MedAdvantage (PPO)
Enrollment form - Dental plan
Enrollment form - Dental plan - Spanish
Enrollment form - MedAdvantage (PPO)
Enrollment form - MedAdvantage (PPO) - Spanish
Evidence of Coverage - MedAdvantage (PPO) + Rx Classic
Evidence of Coverage - MedAdvantage (PPO) + Rx Classic - Spanish
Evidence of Coverage - MedAdvantage (PPO) + Rx Enhanced
Evidence of Coverage - MedAdvantage (PPO) + Rx Enhanced - Spanish
Evidence of Coverage - MedAdvantage (PPO) Basic
Evidence of Coverage - MedAdvantage (PPO) Basic - Spanish
Grievance & Appeals flyer
Grievance (Complaint) form
Low Income Subsidy premium chart - MedAdvantage (PPO) + Rx Metro
Low Income Subsidy premium chart - MedAdvantage (PPO) + Rx Metro - Spanish
Low Income Subsidy premium chart - MedAdvantage (PPO) + Rx Non-Metro
Low Income Subsidy premium chart - MedAdvantage (PPO) + Rx Non-Metro - Spanish
Low Income Subsidy premium chart - MedAdvantage (PPO) + Rx Rural
Low Income Subsidy premium chart - MedAdvantage (PPO) + Rx Rural - Spanish
Medical Appeals form
Medication Therapy Management
Multi-Language insert
Part D Transition policy
Pharmacy directory - MedAdvantage (PPO) + Rx
Pharmacy directory - MedAdvantage (PPO) + Rx - Spanish
Plan Ratings (Star Ratings) - MedAdvantage (PPO)
Plan Ratings (Star Ratings) - MedAdvantage (PPO) - Spanish
Postal Prescription Services
Prescription Claim form
Prescription Coverage Determination
Preventive benefits brochure - Passport 2 Health
Prior Authorization
Provider directory - MedAdvantage (PPO)
Provider directory - MedAdvantage (PPO) - Spanish
Regence Advantages flyer
Request for Prescription Redetermination
Request Formulary Exception
Seminar Schedule
Short Enrollment form - BlueAdvantage (HMO) & MedAdvantage (PPO)
Short Enrollment form - BlueAdvantage (HMO) & MedAdvantage (PPO) - Spanish
SilverSneakers member flyer - MedAdvantage (PPO)
SilverSneakers sales flyer - MedAdvantage (PPO)
Summary of benefits - MedAdvantage (PPO) + Rx
Summary of benefits - MedAdvantage (PPO) + Rx - Spanish
Walgreens Mail Member Registration
Walgreens Mail Service brochure
Walgreens Mail Service Prescriber Fax

Metro: Clackamas, Columbia, Lane, Multnomah, Washington counties
Non-Metro: Benton, Clark (WA), Coos, Curry, Douglas, Jackson, Josephine, Linn, Marion, Polk, Yamhill counties
Rural: Clatsop, Hood River, Lincoln, Tillamook, Wasco counties

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. Members must continue to pay their 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 and must be certified to receive commission. For further information, please contact your sales representative.

2015 Medicare Script Plans

Key Dates

  • Enrollment October 15 – December 7
  • Plans effective January 1, 2015

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.
 

Scope of Appointment form Part D Transition policy
Advantages flyer Pharmacy directory
Appointment of Representative Plan Ratings (Star Ratings)
Automatic Bank Deduction Postal Prescription Services
Catamaran Rx home delivery Prescription Claim form
Comprehensive Formulary Prescription Coverage Determination
Decision guide Prior Authorization
Enrollment form Request for Prescription Redetermination
Evidence of Coverage Basic Request Formulary Exception
Evidence of Coverage Enhanced Short Enrollment form
Grievance & Appeals flyer Summary of benefits
Grievance (Complaint) form Walgreens Mail Member Registration
Low Income Subsidy premium chart Walgreens Mail Service brochure
Medication Therapy Management Walgreens Mail Service Prescriber Fax
Multi-Language insert  

 
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

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. Members must continue to pay their 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.