Medicare Advantage · Local PPO
ATRIO Health Plans
Plan year 2026

ATRIO Choice Rx (PPO) H6743-001

2.5 · 2026 Star Rating · source: CMS · Ratings are updated annually
Monthly premium
$26
+ your Part B premium
Max out-of-pocket
$6,750
in-network annual cap
Primary care
$0
per visit copay
Specialist
$40
per visit

Your costs at a glanceIn-network, for the 2026 plan year

Rx deductible
$300
Inpatient hospital
Days 1-7: $350/day, Days 8-90: $0/day
no limit on covered hospital days
Inpatient mental health
Days 1-5: $450/day, Days 6-90: $0/day
Outpatient surgery
$500
Emergency room
$130
Urgent care
$50

What's included, and what it's actually worth6 benefits included. Tap any card for the detail

Hearing

$999/yr hearing aid allowance
Hearing aid allowance$999/yr hearing aid allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Dental

$200preventive dental allowance per 6 months
Details$200 preventive dental allowance per 6 months
This is a supplemental benefit with plan-specific limits. See plan documents for details.

Vision

$150/yr eyewear allowance
Eyewear allowance$150/yr eyewear allowance
This is a supplemental benefit with plan-specific limits. See plan documents for details.

OTC allowance

$25/quarter OTC allowance
Prepaid card$25/quarter OTC allowance
See more details about this plan
Doctor Visits: PCP$0 copay
In-network$0 copay per visit
Doctor Visits: Specialist$40 copay
In-network$40 copay per visit
Inpatient Hospital$350/day, days 1–7
In-networkDays 1-7: $350/day, Days 8-90: $0/day
Benefit limitNone — additional covered days are unlimited
Outpatient Surgery$500 copay
In-network$500 copay per procedure
Mental HealthDays 1-5: $450/day, Days 6-90: $0/day
Inpatient psychiatricDays 1-5: $450/day, Days 6-90: $0/day
Transportation24 one-way trips/year
Trips per year24 one-way trips/year
MealsMeal benefit

Your coverageCheck your coverageFrom the doctors and prescriptions you added

Your plan's drug tiers30-day retail · after any applicable deductible

Tier 1
$0
Preferred Generic
Tier 2
$10
Generic
Tier 3
$47
Preferred Brand· after deductible
Tier 4
$100
Non-Pref Brand· after deductible
Tier 5
28%
Specialty· after deductible
Tier 6
$0
Tier 6· after deductible

Our take

Where this plan shines

See your primary doctor for $0.

Things to know before you enroll

This plan’s out-of-pocket maximum is above the national median.
Limited coverage while traveling outside the plan’s service area.
Questions? Talk to a licensed agent at1-866-764-3312 (TTY: 711)

Plan documents

Plan questions

Common questions about ATRIO Choice Rx (PPO) (Local PPO)

What does ATRIO Choice Rx (PPO) (Local PPO) cover?

ATRIO Choice Rx (PPO) (Local PPO) is a Medicare Advantage plan that the current plan record identifies as including Part D prescription drug coverage. The plan record also identifies Part D prescription drug coverage. Its published drug benefit lists 6 formulary tiers. Published supplemental benefits include dental ($200 preventive dental allowance per 6 months), vision ($150/yr eyewear allowance), hearing ($999/yr hearing aid allowance), and over-the-counter (OTC) ($25/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 Choice Rx (PPO) (Local PPO) cost in 2026?

The published 2026 monthly plan premium for ATRIO Choice Rx (PPO) (Local PPO) is $26. The standard Part B premium is $202.90/month in 2026 for most people; assistance may pay it for some members. The listed Part D deductible is $300. The in-network medical out-of-pocket maximum is $6,750; it does not include Part D drug spending. Published visit costs include primary care $0 and specialist visits $40. These figures are plan data, not a personal yearly-cost estimate.

Understand Medicare drug-cost limits

Can I use my current doctors with ATRIO Choice Rx (PPO) (Local PPO)?

CMS lists ATRIO Choice Rx (PPO) (Local PPO) as a Local PPO plan. 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

Does ATRIO Choice Rx (PPO) (Local PPO) cover my prescriptions?

ATRIO Choice Rx (PPO) (Local PPO) has 6 published formulary tiers in the current plan record. Published preferred-pharmacy 30-day retail costs include Tier 1 at $0, Tier 2 at $10, Tier 3 at $47, Tier 4 at $100, and Tier 5 at 28%. The listed Part D deductible is $300. A tier listing does not confirm that a specific prescription is covered. Check each medication against the plan's current formulary, restrictions, pharmacy network, and costs before enrolling.

Check your prescriptions

What dental, vision, and hearing benefits does ATRIO Choice Rx (PPO) (Local PPO) include?

The current plan record for ATRIO Choice Rx (PPO) (Local PPO) lists dental ($200 preventive dental allowance per 6 months), vision ($150/yr eyewear allowance), and hearing ($999/yr hearing aid allowance). It also lists over-the-counter (OTC) ($25/quarter OTC allowance). 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.

When can I enroll in ATRIO Choice Rx (PPO) (Local PPO)?

ATRIO Choice Rx (PPO) (Local PPO) 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.

Review Medicare enrollment periods

More plan options

Browse the full 2026 Medicare Advantage with drug coverage directory. This plan is offered in Oregon. Plan availability can vary by county.

Helpful next steps

ATRIO Choice Rx H6743-001 (PPO) — 2026 Costs & Benefits