Regence Bluecross Blueshield Of Oregon
Avg Star Rating
3.0 ★
Compare & Enroll — Part C & Part D
Compare & Enroll in Medicare Plans in 97416, OR
With 14 Medicare Advantage options from 4 insurers, 97416, OR has limited plan options compared to most areas, suggesting a moderately competitive market. About 57% of local plans offer $0 monthly premiums, giving beneficiaries solid options for keeping costs low. With 1 hospital within 25.0 miles, verifying your preferred hospital is in-network is especially important here. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.
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Data freshness: CMS data as of February 2026 •
ACS data as of 2023 •
Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead •
View our methodology
Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
14
Part D Plans
10
Top MA Star
3.0
Top Drug Star
3.5
Medicare Eligibility in 97416, OR
Approximately 220 residents (22.5% of the population) in 97416, OR are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.
The median household income in 97416, OR is $57,207 (23.9% below the National Average), which may affect eligibility for Extra Help with Part D drug costs.
Part C: Medicare Advantage Plans
Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. 97416, OR's 14 Medicare Advantage plans are predominantly PPO-based (11 PPO vs. 3 HMO), offering more flexibility for out-of-network providers. 8 plans offer $0 monthly premiums. Star ratings average 2.8 out of 5, indicating room for improvement across local plans.
Top Medicare Advantage Plans in 97416, OR
We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in 97416, OR range from $0 to $162/month. Among rated plans, No rated plans available.
Highest CMS Star Ratings
Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.
| Plan Name | Insurer | Star Rating | Premium | Type | |
|---|---|---|---|---|---|
| Regence Medadvantage + Rx Primary (PPO) | Regence Bluecross Blueshield Of Oregon | 3.0 ★ | $34.00/mo | PPO | Enroll |
| Wellcare Simple Open (PPO) | Wellcare | 3.0 ★ | $0.00/mo | PPO | Enroll |
| Wellcare Giveback Open (PPO) | Wellcare | 3.0 ★ | $0.00/mo | PPO | Enroll |
| Wellcare Low Premium Open (PPO) | Wellcare | 3.0 ★ | $49.30/mo | PPO | Enroll |
| Regence Valiance (PPO) | Regence Bluecross Blueshield Of Oregon | 3.0 ★ | $0.00/mo | PPO | Enroll |
Lowest Monthly Premium
Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.
| Plan Name | Insurer | Monthly Premium | MOOP | Star Rating |
|---|---|---|---|---|
| Atrio Choice Rx (PPO) | Atrio Health Plans | $0.00/mo | $5,000 | 2.5 ★ |
| Atrio Special Needs Plan (HMO D-SNP) | Atrio Health Plans | $0.00/mo | $9,250 | 2.0 ★ |
| Wellcare Simple Open (PPO) | Wellcare | $0.00/mo | $6,750 | 3.0 ★ |
| Wellcare Giveback Open (PPO) | Wellcare | $0.00/mo | $9,250 | 3.0 ★ |
| Atrio Freedom (PPO) | Atrio Health Plans | $0.00/mo | $4,500 | 2.5 ★ |
Lowest Maximum Out-of-Pocket (MOOP)
MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.
| Plan Name | Insurer | MOOP (In-Network) | Premium | Star Rating |
|---|---|---|---|---|
| Atrio Prime Rx (PPO) | Atrio Health Plans | $4,200 | $90.00/mo | 2.5 ★ |
| Atrio Freedom (PPO) | Atrio Health Plans | $4,500 | $0.00/mo | 2.5 ★ |
| Atrio Choice Rx (PPO) | Atrio Health Plans | $5,000 | $0.00/mo | 2.5 ★ |
| Regence Valiance (PPO) | Regence Bluecross Blueshield Of Oregon | $5,300 | $0.00/mo | 3.0 ★ |
| Regence Medadvantage + Rx Enhanced (PPO) | Regence Bluecross Blueshield Of Oregon | $5,400 | $162.10/mo | 3.0 ★ |
Plan Type Mix in 97416, OR
HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.
| Plan Type | Count | Percentage | Description |
|---|---|---|---|
| PPO | 11 | 78.6% | No referrals; in and out-of-network |
| HMO D-SNP | 2 | 14.3% | Medicare Advantage plan |
| HMO-POS | 1 | 7.1% | HMO with some out-of-network options |
Choosing the Right Medicare Advantage Plan
The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:
- Provider network: Verify your doctors and hospitals near 97416, OR are in-network before enrolling
- Total cost: A $0 premium may have higher copays—calculate your annual cost
- Star Ratings: 4+ stars indicate above-average quality and member satisfaction
Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →
Medicare Advantage Insurers in 97416, OR
4 insurance companies offer Medicare Advantage plans in 97416, OR. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.
Wellcare
Avg Star Rating
2.9 ★
Plan
Premium
MOOP
Stars
Type
Allcare Advantage
Avg Star Rating
2.5 ★
Plan
Premium
MOOP
Stars
Type
Atrio Health Plans
Avg Star Rating
2.4 ★
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Part D: Prescription Drug Plans (PDP)
Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 10 standalone Part D plans in 97416, OR, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 3 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.
Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.
Top Part D Drug Plans in 97416, OR
We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in 97416, OR range from $0 to $110/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.
Highest CMS Star Ratings (Part D)
Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.
| Plan Name | Insurer | Star Rating | Premium | Deductible | |
|---|---|---|---|---|---|
| Wellcare Value Script (PDP) | Wellcare | 3.5 ★ | $0.00/mo | $615 | Enroll |
| Wellcare Classic (PDP) | Wellcare | 3.5 ★ | $0.00/mo | $615 | Enroll |
| Humana Basic Rx Plan (PDP) | Humana | 3.0 ★ | $0.00/mo | $615 | Enroll |
| Humana Value Rx Plan (PDP) | Humana | 3.0 ★ | $22.10/mo | $601 | Enroll |
| Silverscript Choice (PDP) | Aetna Medicare | 3.0 ★ | $85.90/mo | $615 | Enroll |
Lowest Monthly Premium
Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.
| Plan Name | Insurer | Monthly Premium | Drug Deductible | Star Rating |
|---|---|---|---|---|
| Wellcare Value Script (PDP) | Wellcare | $0.00/mo | $615 | 3.5 ★ |
| Healthspring Assurance Rx (PDP) | Healthspring | $0.00/mo | $615 | 2.5 ★ |
| Wellcare Classic (PDP) | Wellcare | $0.00/mo | $615 | 3.5 ★ |
| Humana Basic Rx Plan (PDP) | Humana | $0.00/mo | $615 | 3.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $22.10/mo | $601 | 3.0 ★ |
Lowest Annual Drug Deductible
The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.
| Plan Name | Insurer | Drug Deductible | Monthly Premium | Star Rating |
|---|---|---|---|---|
| Humana Premier Rx Plan (PDP) | Humana | $0 | $108.60/mo | 3.0 ★ |
| Aarp Medicare Rx Preferred From Uhc (PDP) | Unitedhealthcare | $130 | $110.00/mo | 2.0 ★ |
| Humana Value Rx Plan (PDP) | Humana | $601 | $22.10/mo | 3.0 ★ |
| Humana Basic Rx Plan (PDP) | Humana | $615 | $0.00/mo | 3.0 ★ |
| Wellcare Value Script (PDP) | Wellcare | $615 | $0.00/mo | 3.5 ★ |
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →
Choosing the Right Part D Drug Plan
The right Part D plan depends on your specific medications. Key factors to evaluate:
- Formulary: Verify your drugs are covered before enrolling
- Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
- Total annual cost: Premium + deductible + copays for your drugs
Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →
Part D Drug Plan Insurers in 97416, OR
5 insurance companies offer standalone Part D drug plans in 97416, OR. Below, we group plans by insurer.
Wellcare
Avg Star Rating
3.5 ★
Humana
Avg Star Rating
3.0 ★
Aetna Medicare
Avg Star Rating
3.0 ★
Plan
Premium
Deductible
Stars
Type
Healthspring
Avg Star Rating
2.5 ★
Unitedhealthcare
Avg Star Rating
2.0 ★
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Ready to Enroll in 97416, OR?
Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.
📋 Print our Medicare Enrollment Checklist — gather your info before you compare.
📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor
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Pharmacy Access in 97416, OR
Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around 97416, OR.
Total Pharmacies
18
within 25.0 miles
Chain Pharmacies
6
CVS, Walgreens, etc.
Independent Pharmacies
12
locally owned
| Pharmacy | Address & Phone | Distance | Type |
|---|---|---|---|
| VALLEY DRUGS, INC. | 250 NW MAIN ST WINSTON, OR 974966574 541-123-7060 | 14.6 mi | Independent |
| RIDDLE PHARMACY LLC | 142 MAIN STREET RIDDLE, OR 97469 541-187-2406 | 17.1 mi | Independent |
| DAHISSE INC | 821 S MAIN ST MYRTLE CREEK, OR 974579334 541-139-8321 | 19.5 mi | Independent |
| HOME TOWN DRUGS OF ROSEBURG INC | 1813 W HARVARD AVE ROSEBURG, OR 974712709 541-122-1112 | 19.6 mi | Independent |
| PHILIP KASER FAMILY, LLC | 1175 W. HARVARD AVENUE ROSEBURG, OR 97471 541-167-1961 | 20.0 mi | Independent |
| FRED MEYER STORES INC | 929 NW GARDEN VALLEY BLVD ROSEBURG, OR 974716508 541-195-3058 | 20.3 mi | Chain |
| WALGREEN CO | 1236 NW GARDEN VALLEY BLVD ROSEBURG, OR 974711925 541-167-8438 | 20.3 mi | Chain |
| THRIFTY PAYLESS INC | 444 STEPHENS STREET SOUTHEAST ROSEBURG, OR 974703136 541-167-4896 | 20.6 mi | Independent |
| WALMART INC. | 2125 NW STEWART PKWY ROSEBURG, OR 974711693 541-195-8544 | 20.6 mi | Chain |
| MERCY SERVICES CORPORATION | 2475 NW STEWART PKWY ROSEBURG, OR 974701596 541-167-2300 | 20.7 mi | Independent |
Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.
Local Healthcare Access in 97416, OR
Before choosing a plan, consider the healthcare infrastructure in 97416, OR. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.
Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.
Hospitals Nearby
1
within 25.0 miles
Top-Rated Hospitals near 97416, OR
If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near 97416, OR — click a hospital name to see its full profile and verify it's in your plan's network.
| Hospital | CMS Rating | Distance | Beds |
|---|---|---|---|
| Asante Three Rivers Medical Center | 5 ★ | 46.1 mi | 150 |
| Mercy Medical Center | 4 ★ | 21.0 mi | 174 |
| Asante Rogue Regional Medical Center | 4 ★ | 66.0 mi | 378 |
| Providence Medford Medical Center | 3 ★ | 63.8 mi | 168 |
| Bay Area Hospital | 2 ★ | 36.6 mi | 172 |
| Curry General Hospital | 2 ★ | 57.8 mi | 24 |
| Coquille Valley Hospital | Not Rated | 27.0 mi | 30 |
| Southern Coos Hospital & Health Center | Not Rated | 36.8 mi | 24 |
| Lower Umpqua Hospital District | Not Rated | 50.7 mi | 24 |
| Peacehealth Cottage Grove Community Medical Center | Not Rated | 61.7 mi | 11 |
View all 1 hospitals near 97416, OR to check quality before you enroll →
Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of 97416, OR.
Telehealth in 97416, OR: Is Your Internet Ready?
Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in 97416, OR. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.
Check Internet Providers at Your Address
Telehealth works best with reliable internet. Use this tool (provided free by ISP Reports) to see what's available at your address.
Opens ISP Reports in a new tab. This is not a paid relationship. Special thank you to ISP Reports for allowing free use of their address tool.
Internet Coverage in 97416, OR
Fiber Available
95.4%
of households
Cable/DSL Available
98.3%
of households
Top Provider
Douglas Fast Net
95.4% coverage
No Broadband
1.7%
of households
Internet coverage data from ISP Reports. View full internet report for 97416, OR.
Medicare-Relevant Demographics in 97416, OR
Understanding 97416, OR's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.
Total Population
980
Population 65+
220
22.5% of total
Median Age
43
4.6 years older than the national average
Median Income
$57,207
23.9% below the National Average
On Medicare
179
18.3% of residents
On Medicaid
194
19.8% of residents
Uninsured
40
4.1% of residents
Social Security Recipients
518
52.9% of population
Demographic data from U.S. Census Bureau American Community Survey (2023). View full 97416, OR demographics (BestNeighborhood.org).
Local Medicare FAQ: 97416, OR
Common decision points based on 97416, OR's specific plan market and local healthcare landscape.
How does 97416, OR's Medicare Advantage market compare?
97416, OR has 14 Medicare Advantage plans from 4 insurers. This is below the national average of approximately 57 plans. In areas with fewer competing plans, it's especially important to compare the available options carefully. The local mix includes 3 HMO and 11 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).
Should I choose an HMO or PPO Medicare Advantage plan in 97416, OR?
With limited hospital access nearby, a PPO plan (11 available) could be worth the extra cost for out-of-network coverage, especially if you need to travel for specialized care. In 97416, OR, PPO plans are more common, giving you more flexibility options to compare. Always verify your doctors are in-network before enrolling in any plan.
What's the real cost of $0 premium plans in 97416, OR?
8 plans (57% of available options) in 97416, OR charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In 97416, OR, maximum out-of-pocket limits range from $4,200 to an average of $6,696. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.
How does the 2026 $2,000 drug cap affect 97416, OR beneficiaries?
The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 10 standalone Part D plans in 97416, OR.
What this means locally:
- Cost predictability — No matter which of the 10 Part D plans you choose, your drug costs are capped at $2,000/year
- $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
- Low-income options — 3 plans meet the regional benchmark for Extra Help/LIS eligibility
While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.
See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions
About the Data & Editorial Team
Wes Ward
Founder & Data Lead
Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.
With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.
Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.
Transparency & Disclosures
InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.
TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.
Sources
- CMS Medicare Plan Finder Data (Part C & D): cms.gov
- CMS Provider Directory: Hospital and pharmacy data from data.cms.gov
- American Community Survey: Demographic data from census.gov
- FCC Broadband Map: Internet availability data from broadbandmap.fcc.gov
- ISP Reports: Internet provider coverage for 97416, OR from ispreports.org
- Telehealth.HHS.gov: Official telehealth guidance from U.S. Dept. of Health & Human Services
- BestNeighborhood.org: Community demographic profiles for 97416, OR from bestneighborhood.org
All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.