Oregon Medicare insurance offers coverage primarily to qualified citizens over 65, but workers with specific disabilities may also be eligible. Even though this is a federally funded program, the state of Oregon also offers certain assistance packages to residents who are receiving Medicare benefits.
Oregon Medicare Insurance Trends
The Centers for Medicare & Medicaid Services (CMS) reported the following information on 2022 Medicare trends in Oregon:
- A total of 899,748 residents of Oregon are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased from $43.58 in 2021 to $39.77 in 2022.
- There are currently 132 Medicare Advantage plans available in Oregon.
- All Medicare recipients in Oregon can purchase a Medicare Advantage plan, including those with $0 premiums.
- There are 12 different Medigap plans offered in Oregon for 2022.
- The lowest monthly premium for a Medicare prescription drug plan is $7.70.
Medicare Offered in Oregon
Medicare is a government health care program that offers financial assistance to those 65 or older and people of any age with specific disabilities. Across the United States, 14% of all Medicare beneficiaries were under 65 as of 2019; it was 12% in Oregon.
Original Medicare allows you to receive the core coverage benefits afforded by the program. This is made up of Medicare Part A for hospital insurance covering services such as inpatient care and Medicare Part B for medical insurance, including coverage for treatments, medical supplies, and preventive services.
The Part A aspect of Original Medicare does not normally require payment of premiums. Part B usually does require premiums, but for the lowest income bracket (less than $88,000 per year), this premium is only $134 a month. That’s a far cry from Oregon’s average monthly premium cost of $465 a month.
Both Part A and Part B of Original Medicare require you to pay for out-of-pocket Medicare expenses. These include deductibles, coinsurance, and copayments.
Instead of obtaining Original Medicare and supplemental plans separately, beneficiaries can instead purchase a comprehensive Medicare Advantage Plan that combines all the benefits of Part A, Part B, and supplemental plans such as Part D.
In contrast to traditional Medicare, the two main advantages of a Medicare Advantage plan are prescription drug coverage and dental and vision care. You have fewer out-of-pocket costs with this option than you would if you were, on average, using Original Medicare plans.
As these plans may offer different extra benefits and coverage aside from the core Original Medicare coverage, they will have additional costs. It will also depend on which of the Medicare-approved carriers the beneficiaries buy these plans from, also known as Medicare Part C.
The following companies offer Medicare Advantage plans in Oregon, with ratings:
- Kaiser Permanente Senior Advantage – 5/5 stars
- Providence Medicare Prime – 5/5 stars
- Regence Valiance (HMO) – 4.5/5 stars
- AARP – 4.5/5 stars
- Humana – 4.5/5 stars
- PacificSource Medicare – 4/5 stars
- WellCare – 4/5 stars
- Cigna – 3.5/5 stars
- Lasso Healthcare – 2/5 stars
- Moda Health – 3.5/5 stars
- United Healthcare – 4/5 stars
Medicare Supplement Plans
Some beneficiaries feel that the basic Original Medicare coverage has significant gaps. To compensate for this, they can opt to get Medigap supplemental plans from private health insurance carriers with Medicare approval. However, these plans will come with a premium requirement separate from the premium required by Medicare Part B.
In 2022, some of the companies offering Medigap plans who offer Medicare Supplement plans in Oregon include:
- AARP – UnitedHealthcare
- Colonial Penn
- Garden State
- Moda Health Plan, Inc.
- Regence Blue Cross Blue Shield of Oregon
- State Farm
Oregon Medicare Enrollment
Oregon residents are eligible for Medicare if they are U.S. citizens and above 65 years old or are under 65 but are permanently disabled, have end-stage renal disease, or Amyotrophic Lateral Sclerosis. Use Medicare’s online eligibility tool if you are unsure if you qualify.
- You are 65 or older, and you or your spouse worked and paid Medicare taxes for at least 40 quarters.
- You are under age 65 and collect benefits from Social Security or the Railroad Retirement Board for at least 24 consecutive months.
- You have ESRD or ALS.
Enrollment Period Dates
Initial Enrollment Period
This is a seven-month window that allows you to sign up for a plan
- Begins 3 months before the month you turn 65
- Ends 3 months after the month you turn 65
Medicare Open Enrollment Period
This is when you can sign up for a plan, switch a plan or leave a plan
- Begins Starts October 15th
- Ends December 7th
Special Enrollment Period
Special enrollment periods allow you to enroll outside the regular enrollment periods under specific circumstances.
General Enrollment Period
This is when you can sign up for Medicare Part A and/or Part B if you didn’t sign up when first eligible or if you’re not qualified for a Special Enrollment Period.
- Starts January 1st
- Ends March 31st
Medicare Advantage Open Enrollment Period
This is when you can switch or leave a Medicare Advantage Plan
- Starts January 1st
- Ends March 31st
Oregon Enrollment Tips & Advice
Oregon does have a poverty rate of 11.4%, and residents of the state with lower income may receive assistance from Medicare Savings Programs (MSP) to help cover the Medicare expenses. The MSPs in Oregon do not have a resource limit like in other states.
- Senior Health Insurance Benefits Assistance
- Social Security Administration
How Do I Enroll in a Medicare Plan?
If you have any questions about Oregon Medicare, speak to one of our licensed agents today. Our agents will discuss your Medicare options and help find a plan that works for you.