Whether you’re shopping for Medicare plans in Oregon for the first time or are considering changing your current Medicare coverage, it’s important to first understand all your options.
Read on to learn about the different Medicare plans available in Oregon, enrollment timelines, and more.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in Oregon for the 2021 plan year:
- A total of 885,102 residents of Oregon are enrolled in Medicare.
- The average Medicare Advantage monthly premium slightly decreased in Oregon compared to last year — from $48.18 in 2020 to $44.04 in 2021.
- There are 128 Medicare Advantage plans available in Oregon for 2021, compared to 121 plans in 2020.
- All Oregon residents with Medicare have access to buy a Medicare Advantage plan, including plans with $0 premiums.
- There are 12 different Medigap plans offered in Oregon for 2021.
Medicare is a national health insurance program managed by the federal government. It’s available to people age 65 and over, as well as those of any age who have certain disabilities or health conditions.
Parts A and B make up the original Medicare that you can get from the government.
Part A is hospital insurance. It helps pay the costs of:
- inpatient healthcare services you get in a hospital
- a limited stay in a skilled nursing facility
- hospice care
- some limited home health services
Medicare Advantage in Oregon
Medicare Advantage (Part C) plans offer an “all-in-one” replacement to original Medicare plus supplemental coverage. These plans can include a more comprehensive set of benefits, including coverage for prescription drugs, vision and dental, long-term care, hearing, and more.
The following companies offer Medicare Advantage plans in Oregon:
- Aetna Medicare
- Atrio Health Plans
- Health Net
- Kaiser Permanente
- Lasso Healthcare
- Moda Health Plan, Inc.
- PacificSource Medicare
- Regence BlueCross BlueShield of Oregon
Plan offerings vary by county, so your options will depend on what’s available in the county and even ZIP code where you live.
Medicare supplement plans in Oregon
Medicare supplement plans, sometimes called Medigap, add coverage to your original Medicare. They may help lower the amount you pay out of pocket when you seek care. They might also add dental, vision, long-term care, or other coverage.
Many companies offer Medigap plans in Oregon. In 2021, some of the companies offering Medigap plans throughout the state include:
Medicare eligibility depends on your age or health status. You’re eligible to enroll if you’re:
- age 65 or older
- younger than age 65 and have a qualifying disability
- any age and have end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS)
When can I enroll in Medicare Oregon plans?
If your Medicare eligibility is age-based, you can begin the enrollment process 3 months before the month of your 65th birthday. This is your initial enrollment period. It then lasts for 3 months after month in which you turn 65 years old.
If you or your spouse choose to continue working and continue to qualify for employer-sponsored coverage, you may want to put off enrolling in Part B or any supplemental coverage. In such cases, you’ll qualify for a special enrollment period later on.
You can make changes to an existing original Medicare plan or enroll for the first time in Medicare during the open enrollment period from October 15 to December 7.
There’s also a Medicare Advantage open enrollment period each year. At this time, you can switch coverage from original Medicare to a Medicare Advantage plan. The open enrollment period for Medicare Advantage plans is from January 1 through March 31.
Tips for enrolling in Medicare in Oregon
When shopping for Medicare plans in Oregon, you’ll want to keep in mind that private insurance companies have more flexibility, so they can structure their plans in different ways.
Which type of plan makes sense for you? That depends on your individual circumstances and preferences. You may want to consider the following questions when weighing your options:
- How much is this plan going to cost me? How much are the premiums? Are there out-of-pocket costs when I see a doctor or fill a prescription?
- Will I have access to doctors and hospitals that are convenient for me? Does the network include providers I already have relationships with? Will I be covered if I need care while I’m traveling?
- What types of programs are included? Would these programs be helpful to me?
These resources can be useful if you’d like to learn more about Medicare plans in Oregon:
- More than 800,000 Oregon residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in Oregon.
- There are also several Medigap plan options if you live in Oregon and are looking for additional coverage.