CareOregon Advantage Plus (HMO D-SNP) H5859-001 • 2027 • Columbia County, OR
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $9850.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Enhanced, $700.00 deductible
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Columbia County, OR
- Local Enrollment
- 410 beneficiaries in Columbia County
Introduction
CareOregon Advantage Plus is a Medicare Advantage Dual-Eligible Special Needs Plan (D-SNP) offered by CareOregon Advantage. The plan uses a Health Maintenance Organization (HMO) provider network and includes Medicare Part D prescription drug coverage. For the 2027 plan year, it has a $0.00 monthly premium, $0.00 medical deductible, and $9850.00 in-network maximum out-of-pocket. CMS Plan ID H5859-001 identifies this plan. The 2027 Part D prescription drug deductible is $700.00.
You must live in Columbia County, Oregon to enroll in this plan. CMS reports 410 beneficiaries enrolled in this plan in Columbia County. For assistance with this plan, new members can call (888)712-3258 (TTY (800)735-2900).
Eligibility
CareOregon Advantage Plus is a Medicare D-SNP plan for dual-eligible beneficiaries (Medicare and Medicaid).
- Special Needs Plan Type
- Dual-Eligible Special Needs Plan (D-SNP)
- Medicare Requirement
- Medicare Part A and Part B
- Special Needs Requirement
- Must qualify for Medicaid
- Service Area Requirement
- Must live in the plan's service area
- Prescription Drug Coverage
- Medicare Part D prescription drug coverage is included.
Compare Similar Plans in Columbia County
Although no other HMO D-SNP plans meet the comparison criteria in Columbia County, you may have other Medicare Advantage options. Browse all Medicare Advantage SNP plans available in Columbia County, or explore our Oregon Medicare Special Needs directory for statewide information on plan availability, premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
CareOregon Advantage Plus has cost-sharing, meaning there are out-of-pocket costs when receiving covered healthcare services. The tables below detail the most common in-network out-of-pocket expenses for plan H5859-001.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H5859-001-0 Cost Compare.
Office Visits
- Primary care
- In-network: $0 copay
- Specialist
- In-network: $0 copay
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- Not covered
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- In-network: $0 copay
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $0 copay
- Lab services
- In-network: $0 copay
- Outpatient x-rays
- In-network: $0 copay
- Diagnostic tests and procedures
- In-network: $0 copay
Emergency and Urgent Care Services
- Emergency room care
- $0 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $0 copay
- Inpatient hospital care
- Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150 - Skilled Nursing Facility
- Tier 1
$0 per day for days 1-20
$0 per day for days 21-100 - Ground ambulance
- In-network: $0 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
- Outpatient group therapy
- In-network: $0 copay
- Inpatient psychiatric hospital care
- Tier 1
$0 per day for days 1-60
$0 per day for days 61-90
$0 per day for days 91-150
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $0 copay
- Occupational therapy
- In-network: $0 copay
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $0 copay
- Durable medical equipment
- In-network: $0 copay
- Prosthetics
- In-network: $0 copay
Medicare Part B Drugs
- Chemotherapy
- In-network: $0 copay
- Other Part B drugs (Medicare-covered)
- In-network: $0 copay
Dental Services
- Oral exam
- Not covered
- Dental x-rays
- Not covered
- Cleaning
- Not covered
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- In-network: $0 copay
Hearing Services
- Hearing exam
- Not covered
- Fitting/evaluation
- Not covered
- Prescription hearing aids
- Not covered
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by CareOregon Advantage Plus as a Part B benefit.
Prescription Drug Coverage
CareOregon Advantage Plus includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.
Prescription Drug Plan Premium
The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.
| Part D Premium Component | Amount |
|---|---|
| Basic Part D Premium: | ($11.00) |
| Supplemental Part D Premium: | $11.00 |
| Total Part D Premium: | $0.00 |
| Low-Income Premium Subsidy: | $6.27 |
| Low-Income Premium Subsidy Paid by CMS: | $0.00 |
| Low-Income Subsidy Premium: | $0.00 |
For more details, visit the Social Security Extra Help program .
Prescription Drug Plan Deductible
This plan has a $700.00 annual Part D deductible. You'll pay this deductible at the pharmacy before CareOregon Advantage starts contributing towards your prescription costs.
Prescription Drug Plan Out-of-Pocket Costs
Beyond premiums and deductibles, CareOregon Advantage Plus may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic | $0.00 copay | 25% coinsurance |
| Generic | 25% coinsurance | 25% coinsurance |
| Preferred Brand | 25% coinsurance | 25% coinsurance |
| Non-Preferred Drug | 26% coinsurance | 26% coinsurance |
| Specialty Tier | 25% coinsurance | 25% coinsurance |
| Select Care Drugs | $0.00 copay | $0.00 copay |
| *Deductible does not apply. | ||
CMS 5-Star Performance Ratings (Contract ID: H5859)
CMS star ratings reflect how well a Medicare plan performs across key quality measures, such as managing chronic conditions, member satisfaction, and customer service. Ratings range from 1 to 5 stars and are updated each year by Medicare.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | Not enough data available |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for CareOregon Advantage
- Website
- CareOregon Advantage Plan Page
- Providers
- CareOregon Advantage Providers Page
- Formulary
- CareOregon Advantage Formulary Page
- Pharmacy
- CareOregon Advantage Pharmacy Page
- New Member Health Plan Help
- (888)712-3258
- New Member Health Plan TTY
- (800)735-2900
- New Member Part D Help
- (888)712-3258
- New Member Part D TTY Users
- (800)735-2900
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| CareOregon Advantage (official source) | http://www.careoregonadvantage.org | October 4, 2026 |
| CMS.gov | Dual Eligible Special Needs Plans (D-SNPs) | April 28, 2026 |
| CMS.gov | Medicare Advantage Plan Fact Sheet | April 28, 2026 |
| Medicare.gov | Joining a plan | April 28, 2026 |
MedicarePlans.com operates as an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Provenance documentation for this data is maintained under the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.