PacificSource Medicare MyCare Choice 30 (HMO-POS) H3864-030

PacificSource Medicare MyCare Choice 30 (HMO-POS) (HMOPOS) is a Medicare Advantage plan that the current plan record identifies as not including Part D prescription drug coverage. The plan record does not identify Part D prescription drug coverage. Published supplemental benefits include dental ($1,000/yr preventive dental allowance), vision ($200/yr eyewear allowance), hearing ($599–$999 copay per hearing aid), and over-the-counter (OTC) ($50/quarter OTC allowance). Review the plan documents for covered services, limits, and rules. Coverage can change each plan year.

The published 2026 monthly plan premium for PacificSource Medicare MyCare Choice 30 (HMO-POS) (HMOPOS) is $15. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The in-network medical out-of-pocket maximum is $4,950; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $0. These figures are plan data, not a personal yearly-cost estimate.

CMS lists PacificSource Medicare MyCare Choice 30 (HMO-POS) (HMOPOS) as a HMOPOS plan. The record also identifies point-of-service flexibility, but exact out-of-network rules can vary. 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.

PacificSource Medicare MyCare Choice 30 (HMO-POS) (HMOPOS) is listed in the current plan record as a Medicare Advantage plan without Part D prescription drug coverage. Do not assume that a separate standalone Part D plan can be added: many Medicare Advantage plans cannot be paired with a PDP, and joining one can affect Medicare Advantage enrollment. Confirm this plan's rules and how your prescriptions will be covered before enrolling.

The current plan record for PacificSource Medicare MyCare Choice 30 (HMO-POS) (HMOPOS) lists dental ($1,000/yr preventive dental allowance), vision ($200/yr eyewear allowance), hearing ($599–$999 copay per hearing aid), over-the-counter (OTC) ($50/quarter OTC allowance), and meals (Meal benefit). The current data does not list fitness and transportation as offered benefits. Benefit allowances, frequency, eligibility, and participating providers can have additional limits, so review the Summary of Benefits or Evidence of Coverage for the complete rules.

PacificSource Medicare MyCare Choice 30 (HMO-POS) (HMOPOS) is a 2026 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. A qualifying circumstance may create a Special Enrollment Period outside those dates. Confirm the enrollment window and effective date that apply to you before changing coverage.