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PacificSource Medicare Advantage Plan Information
2014 PacificSource Medicare Advantage Plan Information
Helpful Information

**2015 AEP Notice**

2015 Medicare Advantage Plan information for this company has not been released yet. Please let us know which company's information you would like to have. We will be posting the new information as soon as we get it and we can notify you when we do.

PacificSource Customer Support

Existing Customers

From October 1st - February 14th:
8:00 a.m. - 8:00 p.m., seven days a week

From February 15th - September 30:
8:00 a.m. - 8:00 p.m., Monday - Friday

(541) 385-5315 - Bend
(541) 225-3771 - Springfield
(888) 863-3637 - Toll Free
(800) 735-2900 - TTY

2014 PacificSource Medicare Advantage Plans

Essentials RX 6 (HMO MAPD)
Essentials RX 14 (HMO MAPD)
Essentials RX 15 (HMO MAPD)
Essentials RX 19 (HMO MAPD)
Explorer RX 1 (PPO MAPD)
Explorer RX 4 (PPO MAPD)
Explorer RX 7 (PPO MAPD)
Essentials 2 (HMO MA)
Explorer 5 (PPO MA)
Explorer 8 (PPO MA)

PacificSource Plan List
Plan Name Plan Type Plan Details Application Premium
Essentials RX 19 HMO MAPD Benefit Summary Apply online
Download app
$63
Available in: Coos and Curry County
Explorer RX 7 PPO MAPD Benefit Summary Apply online
Download app
$88
Available in: Coos and Curry County
Explorer 8 PPO MA Benefit Summary Apply online
Download app
$45
Available in: Coos and Curry County
Essentials RX 6 HMO MAPD Benefit Summary Apply online
Download app
$126
Available in: Crook, Deschutes, Grant, Hood River, Jefferson, Klamath: 97731, 97733, 97737, 97739, Lake: 97638, 97641, 97735, 97739, Sherman, Wasco, and Wheeler counties
Essentials RX 14 HMO MAPD Benefit Summary Apply online
Download app
$88
Available in: Crook, Deschutes, Grant, Hood River, Jefferson, Klamath: 97731, 97733, 97737, 97739, Lake: 97638, 97641, 97735, 97739, Sherman, Wasco, and Wheeler counties
Essentials 2 HMO MA Benefit Summary Apply online
Download app
$25
Available in: Crook, Deschutes, Grant, Hood River, Jefferson, Klamath: 97731, 97733, 97737, 97739, Lake: 97638, 97641, 97735, 97739, Sherman, Wasco, and Wheeler counties
Explorer RX 1 PPO MAPD Benefit Summary Apply online
Download app
$103
Available in: Crook, Deschutes, Grant, Hood River, Jefferson, Klamath: 97731, 97733, 97737, 97739, Lake: 97638, 97641, 97735, 97739, Sherman, Wasco, and Wheeler counties
Essentials RX 15 HMO MAPD Benefit Summary Apply online
Download app
$0
Available in: Lane County
Explorer RX 4 PPO MAPD Benefit Summary Apply online
Download app
$106
Available in: Lane County
Explorer 5 PPO MA Benefit Summary Apply online
Download app
$59
Available in: Lane County

Important details and dates

  • You must be enrolled in both Medicare Part A and Medicare Part B and live in the plan's service area to be eligible for these plans.
  • You are first eligible during the 7–month Initial Coverage Enrollment Period (ICEP), the 3 months before your 65th birthday, the month of, and 3 months after. CAUTION: You only have one choice so take your time, ask for help and choose wisely.
  • You are also eligible during the Annual Election Period (AEP) which is from Oct.15 to Dec.7. You can change as many times as you want. The last change received by CMS prevails.
  • You have an opportunity to disenroll from your plan and return to Original Medicare and purchase a Part D Prescription Drug Plan during the new Annual Disenrollment Period from Jan 1 to Feb 14.
  • You must continue to pay your Medicare Part B premium in addition to any plan premium shown above.
  • You may be eligible for a Special Enrollment Period (SEP) if you reside in a nursing home, join a Special Needs Plan (SNP), move outside the plan's service area, the plan leaves your area, or other special situations.
  • PacificSource Community Solutions Inc., 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.
  • Limitations, copayments, and restrictions may apply.
  • Benefits, formulary, pharmacy network, premium, and copayments/coinsurance may change on January 1 of each year.

* denotes partial county. Klamath County includes zip codes 97731, 97733, 97737 and 97739. Lake County includes zip codes 97638, 97641, 97735 and 97739.