Providence Medicare Advantage Plans – Part C

Providence Medicare Advantage Plans offer members competitive premiums and cost shares, no-cost fitness facility memberships and over 12,000 in-network providers. Below is a comparison of Providence Medicare Advantage plans available in your area.

Download printer-friendly version - 2017 central Oregon and Hood River County plan comparison (PDF)

2017 plan comparison – Medical benefits (Part C)

  Providence Medicare Compass + Rx
(HMO-POS)
Providence Medicare
Latitude + Rx
(HMO-POS) 
Monthly premium (includes prescription drug coverage)  $99 $169
Note: You must continue to pay your Medicare Part B premium.  
  Enroll now Enroll now

  In-network Out-of-network  In-network Out-of-network
Out-of-pocket maximum $5,000 $6,700
combined 
$3,400 $5,550
combined
Deductible $0 $0
 
Benefits You pay You pay
Gym membership Included at no additional cost
Doctor office visit (PCP) $15Δ
 $45Δ
$15Δ
$30Δ
Specialist visit $45Δ
$60 no referralΔ
$60Δ 
$40Δ
$50 no referralΔ
$50Δ
Secure video visit $0Δ
No coverage  $0Δ  No coverage
Preventive care $0Δ
30%Δ  $0Δ
20%Δ
Lab 20% 30%  20% 20%
X-ray 20%
30%  20% 20%
Durable medical equipment 20%
30%
20%
20%
Diabetic supplies $0 30%  $0 20%
Outpatient surgery $295 30%
$200 20%
Inpatient hospital
Days 1-5: $340
Day 6 and beyond: $0
30%
Days 1-5: $250/day
Day 6 and beyond: $0
20%
Skilled nursing facility
Days 1-20: $0
Days 21-100: $160/day
30%
Days 1-20: $0
Days 21-100: $150/day
20%
Home health $0 30%  $0 20%
Mental health counseling $40 30% $40
20%
Chemical dependency counseling $45  30%   $40 20% 
Therapy: PT, OT, ST $40 30%  $40 20%
Medical eye exam $45Δ
$75Δ
$40Δ
$50Δ
WellVision eye exam° $25Δ – one exam per year
$25, covered up to $45Δ – one exam per year $20Δ – one exam per year
$20, covered up to $45Δ – one exam per year
Basic lenses°
Includes glass, plastic, single vision, lined bifocal or trifocal, or lenticular prescription
Covered in full – every two years Single vision: up to $30
Bifocal or progressive: up to $50
Trifocal: up to $65
Covered in full – every two years
Single vision: up to $30
Bifocal or progressive: up to $50
Trifocal: up to $65
Frames Covered up to $100 – every two years Covered up to $70 – every two years
Covered up to $100 – every two years
Covered up to $70 – every two years
Contact lenses – in lieu of glasses Covered up to $100 - every two years Covered up to $85 - every two years
Covered up to $100  - every two years
Covered up to $85 – every two years
Worldwide Coverage
Urgent care* $40+ $40+  $30+ $30+
Emergency room* $75+ $75+
$75+
$75+
Ambulance (air/ground) $300 one way $300 one way  $150 one way $150 one way

* Diagnostic testing copayment may apply.
Δ For office visits, other charges may apply.
+ Copayment waived if admitted within 24 hours for the same condition.
° Through VSP providers.

See pharmacy coverage – Part D ›

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The pharmacy network may change at any time. You will receive notice when necessary.