PacificSource Medicare Essentials Rx 6 (HMO) in Jefferson County, Oregon — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
PacificSource Medicare Essentials Rx 6 (HMO) (H3864-006) is a $223-premium Medicare Advantage HMO from PacificSource available in Jefferson County, Oregon in 2026, with a 3.5-star overall rating, a $5,500 in-network out-of-pocket maximum, and a $99 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | PacificSource |
|---|---|
| Plan name | PacificSource Medicare Essentials Rx 6 (HMO) |
| Contract ID | H3864 |
| Plan ID | 006 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA-PD |
| Plan type | HMO |
| SNP | No |
| Monthly consolidated premium | $223.00 |
| Part C premium | $117.10 |
| Part D basic premium | $105.90 |
| Part D total premium | $105.90 |
| Annual Part D deductible | $99.00 |
| Maximum out-of-pocket (in-network) | $5500.00 |
| Overall star rating | 3.5 |
How this plan is structured
- $223 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- HMO plan type. In an HMO-style Medicare Advantage plan, in-network care and primary-care referral rules generally apply. See how Medicare Advantage HMO and PPO plans differ.
- $5,500 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Jefferson County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Jefferson County
The CMS CY2026 Landscape file lists 6 Medicare Advantage plans in Jefferson County, Oregon, of which 0 carry a 5.0-star overall rating and 1 have a $0 consolidated monthly premium. Consolidated premiums range from $10.50 to $223.00 per month, and in-network out-of-pocket maximums range from $5500.00 to $9250.00.
For the full county plan directory, see all Medicare plans in Jefferson County, Oregon.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H3864-006.
- Call the plan (PacificSource) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H3864-006 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H3864-006, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 3864 are the contract number issued to the organization, and the three-digit 006 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is PacificSource Medicare Essentials Rx 6 (HMO) an HMO or PPO?
PacificSource Medicare Essentials Rx 6 (HMO) is an HMO — a Health Maintenance Organization-style Medicare Advantage plan, meaning in-network care and referral rules generally apply.
Does PacificSource Medicare Essentials Rx 6 (HMO) include prescription drug coverage?
Yes — PacificSource Medicare Essentials Rx 6 (HMO) is a Medicare Advantage plan with prescription drug coverage (MA-PD) and a $99.00 annual Part D drug deductible for 2026.
What is the maximum out-of-pocket cost for PacificSource Medicare Essentials Rx 6 (HMO)?
The 2026 in-network maximum out-of-pocket limit for PacificSource Medicare Essentials Rx 6 (HMO) is $5500.00, per the CMS CY2026 Landscape file.
What counties offer PacificSource Medicare Essentials Rx 6 (HMO) (H3864-006)?
PacificSource Medicare Essentials Rx 6 (HMO) (H3864-006) is offered in seven Oregon counties: Crook County, Deschutes County, Hood River County, Jefferson County, Klamath County, Sherman County, and Wasco County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.