PERS ODS Advantage PPORX benefits
The PERS ODS Advantage PPORX plan features a number of valuable medical and prescription drug benefits designed to help you manage your health.
Medical benefits
- Annual out-of-pocket maximum of $1,000
- No medical deductible
- Copayments and coinsurance amounts are the same for both in- and out-of network services; PERS ODS Advantage PPORX pays up to the limiting charge for Medicare-covered services
- $0 copayment for your annual physical
- Routine vision exam benefit
- See any Medicare provider in- or out-of-network
- Travel and visitor coverage for up to 12 months
- Worldwide coverage for emergency medical services
Prescription drug benefits
- An open formulary that includes almost all eligible Part D drugs
- Generic: A generic drug has the same active ingredient formula as the brand-name drug. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective. You generally pay less for a generic drug than a brand-name drug.
- Brand: A prescription drug that is manufactured and sold by the pharmaceutical company that originally researched and developed the drug.
- 40 percent coinsurance up to $150 for a 30-day supply
- 40 percent coinsurance up to $450 for a 90-day supply of brand drugs
- Catastrophic coverage limit (True out-of-pocket (TrOOP) maximum) of $4,550
- After your annual out-of-pocket drug costs reach $4,550, you pay $0 coinsurance and PERS ODS Advantage PPORX pays in full for Part D-covered drugs
- Access to in-network pharmacies in Oregon, Washington and across the U.S.
- Access to a mail-order pharmacy
- A 90-day supply through retail or mail-order
Our members receive all of the benefits that the Original Medicare plan offers. We also offer more benefits, which may change from year to year.
The PERS ODS Advantage PPORX Annual Notice of Changes and Evidence of Coverage includes details about plan benefits, limitations, restrictions, the appeal and grievance process and other important information. For more information about PERS ODS Advantage PPORX benefits, contact member services.
updated 10/2009
H3813-802
H3813_4006EGPPORX10A (11/2009)
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