Atrio Health Plans Special Needs Plan Review

The Atrio Health Plans Special Needs Plan is available in Douglas and Klamath Counties in Oregon. In order to be eligible to enroll in this plan you must have both Medicare and Medicaid; and you must reside in one of these counties.  The Atrio special-needs plan is a Medicare Advantage plan (HMO – SNP).  The Medicare Advantage plan can offer several benefits over having just regular Medicare and Medicaid.  These benefits could include a larger provider network as well as extra benefits not offered by Medicare and Medicaid.  Let’s take a look at what benefits the Atrio Special Needs plan offers.

Atrio Health Plans Special Needs Plan

  • Must have both Medicare and Medicaid
  • Premium – $0/monthly
  • Maximum Out of Pocket – $6,700
  • Referral required for specialists
  • All services offered at $0 copay depending on level of Medicaid assistance
  • Drugs will be $0 – $6.50 based on level of LIS
  • Preventative dental not covered
  • Routine hearing exam and hearing aids not covered
  • Eye exam and glasses not covered
Based on the benefits listed here it does not make sense to sign up for this plan based on benefits alone.  The other option you should look at is the provider network.  With Medicaid you must go to providers that accept Medicare and Medicaid.  On the Atrio Special Needs Plan you must go to providers that are in their network.  You must also have a referral to see specialists.  You would only want to join this plan if it offer an extensive network of doctors that Medicaid does not offer.

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