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Medicare Advantage · C-SNP · Local PPO · 2027

ATRIO Support Rx (PPO C-SNP)

ATRIO Health Plans H7006-0222.5 CMS rating for 2027
Is it offered where you live?

No referral needed to see a specialist

At a glance: $0 monthly premium, a Part B giveback of up to $20 a month, and $0 primary care visits.

Eligibility required for this C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. See who can enroll

Monthly premium
$0
Part B premium separate
Yearly limit
$5,300
Most you’d pay for in-network care
Part B giveback
Up to$20/mo
Up to $240 a year
Doctor visits
$0
Primary care · specialists $45

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Your doctors
Not checked yetSee if they’re in this plan’s network
Your prescriptions
Not checked yetSee your drug tier and monthly cost
Extra benefits
8 includedPart B giveback · Hearing · OTC allowance · Dental · Vision · Fitness · Transportation · Meals

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Eligibility required for this C-SNP

The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.

Talk with a licensed advisor

A licensed agent can review this plan and other plans in your area that fit your needs.

TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST

Who can enroll

Eligibility for this Special Needs Plan

Eligibility required for this C-SNP

The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.

Costs and copays

Deductibles, yearly limit, visits, hospital stays and drug tiers
DeductiblesMedical · $0 for drugs
$0
Yearly limitIn-network care, not counting drugs
$5,300
Yearly limit, in and out of networkCombined, not counting drugs
$5,300
Primary doctorPer visit
$0
SpecialistPer visit · no referral needed
$45
Hospital stayNo limit on covered hospital days
Days 1-5: $470/day, Days 6-90: $0/day
Inpatient mental healthHospital stay
Days 1-5: $470/day, Days 6-90: $0/day
Outpatient surgeryPer procedure
$375
Emergency roomPer visit
$130
Urgent carePer visit
$50
Tier 1 · Preferred Generic30-day supply at a retail pharmacy
$0
Tier 2 · Generic30-day supply at a retail pharmacy
$8
Tier 3 · Preferred Brand30-day supply at a retail pharmacy
$47
Tier 4 · Non-Pref Brand30-day supply at a retail pharmacy
$100
Tier 5 · Specialty30-day supply at a retail pharmacy
33%
Tier 6 · Drugs30-day supply at a retail pharmacy
$0

Our take

Where this plan shines, and what to know

Where this plan shines

  • This plan has a $0 monthly premium.
  • This plan’s out-of-pocket maximum is below the national median.
  • See your primary doctor for $0.
  • No separate drug deductible.
  • No separate medical deductible.

Things to know before you enroll

  • Limited coverage while traveling outside the plan’s service area.

Similar plans

Other Medicare Advantage plans offered in Oregon

Common questions

6 answers about this plan

What does ATRIO Support Rx (PPO C-SNP) (Local PPO) cover?

ATRIO Support Rx (PPO C-SNP) (Local PPO) is a Chronic Condition Special Needs Plan, a Medicare Advantage plan for people whose qualifying condition the plan verifies, including cardiovascular disorders and diabetes. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental ($300 preventive & comprehensive dental allowance per 6 months), vision ($200/yr eyewear allowance), hearing ($699–$999 copay per hearing aid), and over-the-counter (OTC) ($40/quarter OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

Learn about Medicare Advantage

How much does ATRIO Support Rx (PPO C-SNP) (Local PPO) cost in 2027?

The published 2027 monthly plan premium for ATRIO Support Rx (PPO C-SNP) (Local PPO) is $0. Any Medicare premiums you owe are separate from the listed plan premium. The listed medical deductible is $0. The listed Part D deductible is $0. The in-network medical out-of-pocket maximum is $5,300; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $45. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with ATRIO Support Rx (PPO C-SNP) (Local PPO)?

CMS lists ATRIO Support Rx (PPO C-SNP) (Local PPO) as a Local PPO plan. The plan record says specialist referrals are not required. A network label alone does not confirm that a specific doctor participates. Use the doctor lookup tool, then confirm with the doctor's office and the plan before receiving care. Provider networks and member costs can change. Emergency care and travel coverage can follow different network rules.

Check your doctors

What chronic conditions qualify for ATRIO Support Rx (PPO C-SNP) (Local PPO)?

ATRIO Support Rx (PPO C-SNP) (Local PPO) is listed in the current plan record as a C-SNP. The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.

Learn about Special Needs Plans

How does ATRIO Support Rx (PPO C-SNP) (Local PPO) coordinate care for my chronic condition?

ATRIO Support Rx (PPO C-SNP) (Local PPO) is identified in the current plan record as a Chronic Condition Special Needs Plan for qualifying conditions that include Cardio DIS CHF and Diabetes. The record also lists dental ($300 preventive & comprehensive dental allowance per 6 months), vision ($200/yr eyewear allowance), and hearing ($699–$999 copay per hearing aid). The data on this page does not describe a personal care plan or promise a specific care coordinator. Review the Evidence of Coverage and ask the plan how its model of care, provider communication, and medication support apply to your verified condition.

When can I enroll in ATRIO Support Rx (PPO C-SNP) (Local PPO)?

ATRIO Support Rx (PPO C-SNP) (Local PPO) is a 2027 Medicare Advantage plan. The Annual Enrollment Period runs from October 15 through December 7, with changes taking effect January 1. The Medicare Advantage Open Enrollment Period runs from January 1 through March 31 for people already enrolled in Medicare Advantage. Because this is a C-SNP, the plan must also verify its eligibility requirements. A qualifying circumstance may create a Special Enrollment Period, but eligibility alone does not guarantee a year-round right to enroll. Confirm the enrollment window and effective date that apply to you before changing coverage.

Review Medicare enrollment periods

Plan documents

Summary of Benefits and Evidence of Coverage

Talk to a licensed agent

Eligibility required for this C-SNP

The plan must verify that you have one of its qualifying chronic or disabling conditions, such as Cardio DIS CHF and Diabetes. If the plan uses a pre-enrollment assessment, provider verification is due by the end of your first month of enrollment. If verification is still missing, the plan must notify you and may disenroll you at the end of your second month. Your coverage continues if verification arrives before then. Review the official plan documents for the exact criteria.

Talk with a licensed advisor

A licensed agent can review this plan and other plans in your area that fit your needs.

TTY: 711 · Monday to Friday, 8:00 AM to 6:00 PM CST

ATRIO Support Rx H7006-022 (PPO C-SNP) — 2027 Costs & Benefits