Oregon Medford Klamath Falls
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Oregon
Medford Klamath Falls
Centene is pleased to highlight the following plans, which will be a great addition to your
portfolio. These plans have been carefully designed to provide high-quality healthcare
choices for your beneficiaries, greatly impacting your 2021 selling season.
12021 Key Features
PLAN Key Selling Features
HEALTH NET VIOLET 3 (PPO) New for 2021; $30 Part B Giveback; $0 Premium; Health Club Membership;
H5439015000 Routine Exam and Aids
HEALTH NET MEDICARE $0 PCP; Routine Exam and Aids;
COMPLEMENT (HMO) Up to 24 visits a year for chiropractic, acupuncture, and alternative therapies;
H6815037000 $0.00 Copay Prev Services; Health Club Membership
2Here are more details about the Centene
portfolio this year. This includes the plans
mentioned above, as well as a portfolio of
plans your customers will love.
32021 Agents’ First Look
2019 Agents’
Medford KlamathFirst
FallsLook
Oregon
Health Net Violet 3 (PPO) Health Net Violet 3 (PPO)
Plan Benefits H5439015000 H5439015000
In-Network Out-Of-Network
Benton, Clackamas, Clark, Douglas, Benton, Clackamas, Clark, Douglas,
Counties Jackson, Josephine, Lane, Linn, Marion, Jackson, Josephine, Lane, Linn, Marion,
Multnomah, Polk, Washington, Yamhill Multnomah, Polk, Washington, Yamhill
Premium Part B Giveback $30 $30
Total Premium (Part C Part D) $0 $0
In-Network Plan Deductible $200 $200
Maximum Out of Pocket (MOOP) $7,550 $7,550
$450 Copay per day for days 1-4 and a $500 Copay per day for days 1-10 and a
Inpatient Hospital - Acute
$0 Copay per day for days 5-90 $0 Copay per day for days 11-90
PCP Office Visits $20 $30
Specialist Office Visits $50 $60
Over-the-Counter Items N/A N/A
Medically Necessary Transportation N/A N/A
Health Club Membership $0 $0
Dental Benefits Not Covered Not Covered
$250 Max Plan Benefit Every two years $250 Max Plan Benefit Every two years
Vision Benefits
(combined for all Eyewear) (combined for all Eyewear)
Hearing Benefits Routine Exam and Aids Routine Exam and Aids
Flex Card N/A N/A
In-Home Support Services N/A N/A
Rx Deductible $200 $200
Deductible Tiers Tiers 3 to 5 Tiers 3 to 5
Tier 1: Preferred Generic $5 $5
Tier 2: Generic $15 $15
Tier 6: Select Care Drugs $0 $0
Laboratory Services $15 $20
X-Ray Services $18 $20
SSBCI Package N/A N/A
Optional Supplemental Packages N/A N/A
Agent use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for
contract termination. Plan and benefit information contained in this document is pending government approval and subject to change. Final 2021 plan and benefit information may be
discussed with beneficiaries on or after October 1.
12021 Agents’ First Look
2019 Agents’
Medford KlamathFirst
FallsLook
Oregon
Health Net Medicare Complement (HMO)
Plan Benefits H6815037000
In-Network
Benton, Clackamas, Columbia, Coos, Crook, Deschutes,
Counties Douglas, Jackson, Jefferson, Josephine, Lane, Linn, Marion,
Multnomah, Polk, Washington, Yamhill
Premium Part B Giveback $0
Total Premium (Part C Part D) $10.80
In-Network Plan Deductible N/A
Maximum Out of Pocket (MOOP) $5,600
$465 Copay per day for days 1-4 and a
Inpatient Hospital - Acute
$0 Copay per day for days 5-90
PCP Office Visits $0
Specialist Office Visits $40
Over-the-Counter Items $35 every quarter
Medically Necessary Transportation N/A
Health Club Membership $0
Dental Benefits $0 Copay Prev Services
Vision Benefits $250 Max Plan Benefit Every two years (combined for all Eyewear)
Hearing Benefits Routine Exam and Aids
Flex Card N/A
In-Home Support Services N/A
Rx Deductible $445
Deductible Tiers Tiers 2 to 5
Tier 1: Preferred Generic $0
Tier 2: Generic $20
Tier 6: Select Care Drugs N/A
Laboratory Services $0
X-Ray Services $20
SSBCI Package N/A
Optional Supplemental Packages N/A
Agent use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for
contract termination. Plan and benefit information contained in this document is pending government approval and subject to change. Final 2021 plan and benefit information may be
discussed with beneficiaries on or after October 1.
22021 Agents’ First Look
2019 Agents’
Medford KlamathFirst
FallsLook
Oregon
Health Net Violet 1 (PPO) Health Net Violet 1 (PPO)
Plan Benefits H5439011000 H5439011000
In-Network Out-Of-Network
Benton, Clackamas, Clark, Douglas, Benton, Clackamas, Clark, Douglas,
Counties Jackson, Josephine, Lane, Linn, Marion, Jackson, Josephine, Lane, Linn, Marion,
Multnomah, Polk, Washington, Yamhill Multnomah, Polk, Washington, Yamhill
Premium Part B Giveback $0 $0
Total Premium (Part C Part D) $120 $120
In-Network Plan Deductible $145 $145
Maximum Out of Pocket (MOOP) $4,000 $4,000
$225 Copay per day for days 1-7 and a $250 Copay per day for days 1-7 and a
Inpatient Hospital - Acute
$0 Copay per day for days 8-90 $0 Copay per day for days 8-90
PCP Office Visits $12 $20
Specialist Office Visits $25 $40
Over-the-Counter Items N/A N/A
Medically Necessary Transportation N/A N/A
Health Club Membership $0 $0
Dental Benefits $0 Copay 2000 Prev Services Comp $0 Copay 2000 Prev Services Comp
$250 Max Plan Benefit Every two years $250 Max Plan Benefit Every two years
Vision Benefits
(combined for all Eyewear) (combined for all Eyewear)
Hearing Benefits Routine Exam and Aids Routine Exam and Aids
Flex Card N/A N/A
In-Home Support Services N/A N/A
Rx Deductible $95 $95
Deductible Tiers Tiers 3 to 5 Tiers 3 to 5
Tier 1: Preferred Generic $5 $5
Tier 2: Generic $10 $10
Tier 6: Select Care Drugs $0 $0
Laboratory Services $12 $20
X-Ray Services $12 $20
SSBCI Package N/A N/A
Optional Supplemental Packages N/A N/A
Agent use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for
contract termination. Plan and benefit information contained in this document is pending government approval and subject to change. Final 2021 plan and benefit information may be
discussed with beneficiaries on or after October 1.
32021 Agents’ First Look
2019 Agents’
Medford KlamathFirst
FallsLook
Oregon
Health Net Violet 2 (PPO) Health Net Violet 2 (PPO)
Plan Benefits H5439019000 H5439019000
In-Network Out-Of-Network
Counties Douglas, Jackson, Josephine Douglas, Jackson, Josephine
Premium Part B Giveback $0 $0
Total Premium (Part C Part D) $25 $25
In-Network Plan Deductible $225 $225
Maximum Out of Pocket (MOOP) $5,900 $5,900
$385 Copay per day for days 1-5 and a $500 Copay per day for days 1-10 and a
Inpatient Hospital - Acute
$0 Copay per day for days 6-90 $0 Copay per day for days 11-90
PCP Office Visits $0 $0
Specialist Office Visits $30 $30
Over-the-Counter Items N/A N/A
Medically Necessary Transportation N/A N/A
Health Club Membership $0 $0
Dental Benefits $0 Copay 1000 Prev Services Comp $0 Copay 1000 Prev Services Comp
$250 Max Plan Benefit Every two years $250 Max Plan Benefit Every two years
Vision Benefits
(combined for all Eyewear) (combined for all Eyewear)
Hearing Benefits Routine Exam and Aids Routine Exam and Aids
Flex Card N/A N/A
In-Home Support Services N/A N/A
Rx Deductible $150 $150
Deductible Tiers Tiers 3 to 5 Tiers 3 to 5
Tier 1: Preferred Generic $5 $5
Tier 2: Generic $15 $15
Tier 6: Select Care Drugs $0 $0
Laboratory Services $15 $20
X-Ray Services $18 $20
SSBCI Package N/A N/A
Optional Supplemental Packages N/A N/A
Agent use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for
contract termination. Plan and benefit information contained in this document is pending government approval and subject to change. Final 2021 plan and benefit information may be
discussed with beneficiaries on or after October 1.
42021 Agents’ First Look
2019 Agents’
Medford KlamathFirst
FallsLook
Oregon
Health Net Ruby (HMO)
Plan Benefits H6815005000
In-Network
Counties Jackson, Josephine
Premium Part B Giveback $0
Total Premium (Part C Part D) $29
In-Network Plan Deductible N/A
Maximum Out of Pocket (MOOP) $5,900
$350 Copay per day for days 1-5 and a
Inpatient Hospital - Acute
$0 Copay per day for days 6-90
PCP Office Visits $10
Specialist Office Visits $35
Over-the-Counter Items N/A
Medically Necessary Transportation N/A
Health Club Membership $0
Dental Benefits $0 Copay Prev Services
Vision Benefits $250 Max Plan Benefit Every two years (combined for all Eyewear)
Hearing Benefits Routine Exam and Aids
Flex Card N/A
In-Home Support Services N/A
Rx Deductible $125
Deductible Tiers Tiers 3 to 5
Tier 1: Preferred Generic $3
Tier 2: Generic $8
Tier 6: Select Care Drugs $0
Laboratory Services $10
X-Ray Services $20
SSBCI Package N/A
Optional Supplemental Packages N/A
Agent use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for
contract termination. Plan and benefit information contained in this document is pending government approval and subject to change. Final 2021 plan and benefit information may be
discussed with beneficiaries on or after October 1.
52021 Agents’ First Look
2019 Agents’
Medford KlamathFirst
FallsLook
Oregon
Health Net Aqua (PPO) Health Net Aqua (PPO)
Plan Benefits H5439010000 H5439010000
In-Network Out-Of-Network
Benton, Clackamas, Clark, Douglas, Benton, Clackamas, Clark, Douglas,
Counties Jackson, Josephine, Lane, Linn, Marion, Jackson, Josephine, Lane, Linn, Marion,
Multnomah, Polk, Washington, Yamhill Multnomah, Polk, Washington, Yamhill
Premium Part B Giveback $0 $0
Total Premium (Part C Part D) $0 $0
In-Network Plan Deductible $125 $125
Maximum Out of Pocket (MOOP) $2,500 $2,500
$175 Copay per day for days 1-8 and a $200 Copay per day for days 1-8 and a
Inpatient Hospital - Acute
$0 Copay per day for days 9-90 $0 Copay per day for days 9-90
PCP Office Visits $12 $20
Specialist Office Visits $25 $40
Over-the-Counter Items N/A N/A
Medically Necessary Transportation N/A N/A
Health Club Membership $0 $0
Dental Benefits $0 Copay 2000 Prev Services Comp $0 Copay 2000 Prev Services Comp
$250 Max Plan Benefit Every two years $250 Max Plan Benefit Every two years
Vision Benefits
(combined for all Eyewear) (combined for all Eyewear)
Hearing Benefits Routine Exam and Aids Routine Exam and Aids
Flex Card N/A N/A
In-Home Support Services N/A N/A
Rx Deductible N/A N/A
Deductible Tiers N/A N/A
Tier 1: Preferred Generic N/A N/A
Tier 2: Generic N/A N/A
Tier 6: Select Care Drugs N/A N/A
Laboratory Services $0 $20
X-Ray Services $12 $20
SSBCI Package N/A N/A
Optional Supplemental Packages N/A N/A
Agent use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for
contract termination. Plan and benefit information contained in this document is pending government approval and subject to change. Final 2021 plan and benefit information may be
discussed with beneficiaries on or after October 1.
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