Regence offers Medicare Advantage (Part C) plans in Idaho, Oregon, Utah, and Washington. Each plan may offer prescription drug coverage and additional benefits.
Regence is a health insurance company that’s part of the Blue Cross Blue Shield Association. It provides Medicare Advantage (Part C) health plans to enrollees in the northwestern United States.
Regence offers both Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. It also offers prescription drug or Part D coverage options.
Keep reading to learn more about the plan options and costs Regence offers by geographic region.
Regence offers two main types of Medicare Advantage plans: HMOs and PPOs. Each has different rules about the healthcare providers you can see and how much you’ll pay when you see them.
The following are some of the key aspects of each type of plan.
Regence HMO plans
An HMO plan involves selecting a primary care physician within the Regence network. If you need to see a specialist, like an orthopedic specialist or a gastroenterologist, you’ll have to see your primary care physician and ask for a referral.
However, you don’t need a referral to see an in-network gynecologist for preventive care visits or annual screenings.
Typically, HMO plans are less expensive than PPOs. This is because the provider network is limited to specific providers with a cost-savings agreement through the plan.
Regence PPO plans
A PPO plan doesn’t require getting a referral to a medical specialist.
You can see doctors in the network to get the greatest cost savings, but you can also see an out-of-network doctor if you’d like. But if you see a doctor out of network, you’ll likely have higher copay costs.
Because PPOs offer greater flexibility in terms of which doctors you can see and do not require referrals, the premium may be higher than with an HMO plan.
Medicare requires all enrollees to have some form of drug coverage. Individual prescription drug plans are called Part D plans.
Medicare Advantage plans may include prescription drug coverage along with other coverage. Regence offers many of these plans with a $0 premium. This means you will not have to pay an additional premium on top of the Part A and Part B premiums.
Whether you purchase a separate Part D plan from Regence or choose a Medicare Advantage plan with prescription drug coverage, each plan has a formulary. A formulary is a list of medications that the plan covers.
A Regence Part D plan usually separates the medications on its formulary into tiers. For Regence, these tiers include:
- Tier 1: preferred generic
- Tier 2: generic
- Tier 3: preferred brand
- Tier 4: nonpreferred drug
- Tier 5: specialty
Generic medications will be the least expensive, while specialty tiers will cost the most. When deciding on a plan, consider the medications you currently take and whether the plan you’re considering covers them.
Using Medicare’s plan finder tool, you can input medications you use and search for plans that cover them.
Like Medicare Advantage plans, Part D plans have star ratings, which can help you compare them.
Regence offers Medicare Advantage plans in the following states:
However, the plans are specific to certain areas. This means you may live in one of the ZIP codes where a plan is offered, but the same one might not be available in another location that Regence serves.
To find out which plans are offered in your area, you can use Medicare’s plan finder tool.
Medicare Advantage (Part C) is a plan type where a private insurance company fulfills your Part A and Part B Medicare benefits.
Some people choose Medicare Advantage plans because they can offer additional benefits compared to parts A and B. For Regence, these added benefits may include:
- dental services, such as preventive dental care and problem-focused exams
- hearing services, such as routine hearing exams and hearing aids
- vision services, such as routine eye exams and eyeglasses or contact lenses
- Silver&Fit Exercise & Healthy Aging Program, which is membership to a fitness center and the YMCA, as well as a home fitness kit
Not all Regence plans offer these benefits. Read the benefits summary carefully to determine which ones you may need.
The table below compares costs for different plans in Regence’s coverage area. These costs can help you get an idea of how much you might expect to pay if you were to participate in a Regence Medicare Advantage plan in 2025.
| Seattle, WA: Regence MedAdvantage + Rx Primary (PPO) | Portland, OR: Regence Valiance (PPO) | Boise, ID: Regence Blue MedAdvantage HMO (HMO) | Homedale, ID: Regence MedAdvantage + Rx Primary (PPO) | Provo, UT: Regence MedAdvantage + Rx Enhanced (PPO) | |
|---|---|---|---|---|---|
| Star rating | 3 | 3.5 | 4 | 3.5 | 4 |
| Monthly premium | $61 | $0 | $0 | $11 | $130 |
| Health deductible | $0 | $0 | $0 | $0 | $0 |
| Drug deductible | $300 | drugs not covered | $0 | $225 | $0 |
| Out-of-pocket max | $6,700 in network | $5,000 in network | $6,700 in network | $5,600 in network, $10,100 in and out of network | $5,000 in network, $9,550 in and out of network |
| Primary doctor visit copay | $0 | $0 | $0 | $0 | $0 |
| Specialist visit copay | $30 | $35 | $35 | $45 | $30 |
Medicare will pay your insurance company of choice a certain amount to provide your benefits through a Medicare Advantage plan.
Medicare Advantage plans have periods during the year when you can enroll. These include:
- Initial enrollment period: 3 months before the month of your birthday up until 3 months after your birth month
- Medicare open enrollment period: October 15 through December 7
- Medicare Advantage open enrollment period: January 1 to March 31
Regence Medicare Advantage plans are an option if you want extra benefits.
As a member of the Blue Cross Blue Shield network, you may have access to greater perks that a larger company can offer, such as fitness coverage.
To find out if Regence offers a plan in your area, you can use Medicare’s online plan finder tool or contact Regence directly to learn more about plans in your area.