CareOregon Advantage Benefit Changes to Medicare Advantage Program

Dual eligibles to get OTC support in 2014

 

Much of a person’s health is affected by what goes on outside the doctor’s office or hospital. 
 
With that in mind, and understanding the challenge our members face every month to make ends meet, CareOregon Advantage is providing a significant new benefit in 2014 for members who have both Medicare and Medicaid.
 
The benefit for CareOregon Advantage Plus HMO-POS SNP members—those members qualified for and receiving benefits from both Medicare and Medicaid—is a $40 debit card that renews monthly that they may use to purchase covered non-prescription pharmacy items.
 
The cards will be honored at any Rite Aid or Walgreens pharmacy. More pharmacies may be added over the year.
 
Allowable purchases include a long list of items likely to be needed for health, but that are not covered by a prescription formulary. (The full list is available on the CareOregon Advantage website, http://www.careoregonadvantage.org/faqs/otc-card.)
 
For members who are dually eligible, $40 a month can make a great deal of difference, said Stefanie Cao, Medicare Market Manager.
 
The $40 does not carry over from month to month.
 
This new CareOregon Advantage OTC Card is one of the benefit changes for CareOregon Advantage plans coming in 2014.
 
Both CareOregon Advantage plans—Plus for dually eligible and Star—have a new tier in the drug formulary. This tier is for preferred generic drugs and has a $0 copayment. For CareOregon Advantage Star members, that cuts a $2.55 copayment for this class of drugs in 2014.
 
“A lot of our members have 10, 12 or more prescriptions,” Stefanie says. “Even with a copayment of only $2.55, that adds up. So we decided to help them out.”
 
Both plans will continue to cover Routine vision Exams and eyeglasses.
 
Another benefit change coming in 2014 is a lower premium for CareOregon Advantage Star: 
 
$34.80, down from $37.50 in 2013.
 
CareOregon Advantage covers all parts of Original Medicare, Parts A, B, Prescription Drugs and more. We serve members in nine Oregon counties: Clackamas, Clatsop, Columbia, Jackson, Josephine, Marion, Multnomah, Polk and Washington.
 
CareOregon Advantage Plus HMO-POS SNP is an HMO plan with a Medicare Contract and the Oregon Medicaid Program. Enrollment in CareOregon Advantage Plus depends on contract renewal. This plan is available for anyone in the service area who has both Medical Assistance from the State and Medicare.
 
CareOregon Advantage Star HMO-POS is an HMO plan with a Medicare Contract. Enrollment in CareOregon Advantage Star HMO-POS depends on contract renewal.
 
Members must continue to pay their Medicare Part B premium. The Part B premium is covered for members who have Oregon Health Plan and Medicare.
 
Premiums, co-pays may vary based on the level of Extra Help the member receives. Please contact the plan for further details. The benefit summary provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, Copays and restrictions may apply. Benefits, premiums, or co-pays may change on January 1st year.
 
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