Medicare Supplement Plans in Oregon

Summary: Medicare Supplement plans in Oregon provide help in filling in the out of pocket cost gaps left by Original Medicare. There are various Medigap plans in Oregon to suit different healthcare needs and budgets. Take the time to compare the available Medicare Supplement plans and find the one that’s right for you. Estimated Read Time: 13 mins

Table of Contents:

1. Best Medicare Supplement Plans in Oregon
2. Eligibility for Medigap Plans in Oregon
3. Medicare Supplement Plan Costs in Oregon
4. Companies Offering Medigap Plans in Oregon
5. Medigap Plans in Oregon for the Disabled Under 65
6. Medicare Supplement Plan Rating Methods in Oregon
7. Medigap Guaranteed Issue Protections in Oregon
8. When to Enroll in Medigap Plans in Oregon
9. Does Oregon Allow Medicare Excess Charges?
10. Oregon Birthday Rule for Medicare Supplement Plans
11. Additional Medicare Coverage Options in Oregon

Like most states, the Medicare Supplement plans in Oregon are standardized. No matter which carrier you choose, each plan will have the same benefits across the board. The only differences between carriers are premium price, the company’s rating, and additional perks.

Ten Medicare Supplement (Medigap) plans and two high-deductible versions are available, identified by letters A through N. Each of the 12 plans is available to seniors on Medicare in Oregon. However, not every beneficiary will be eligible for each plan.

Keep in mind not every carrier offers every Medigap plan in Oregon. So, it is essential to compare policies to ensure you are receiving the best plan at the lowest cost.

Best Medicare Supplement Plans in Oregon

Choosing the best Medicare Supplement plan in Oregon depends on several factors. These factors include your medical needs, budget, and age when enrolling. The plan for you may not work for your neighbor or spouse and vice versa.

Original Medicare does not cover everything. The two parts, Medicare Part A (inpatient/hospital insurance) and Medicare Part B (medical insurance), only cover 80% after you meet the deductible. Medicare Supplement plans in Oregon bridge the gap Original Medicare leaves, providing more extensive coverage.

Some seniors require more coverage, while others want to save on premiums. There is no one-size-fits-all Medicare Supplement, and your options may vary per carrier. A licensed agent can review your needs and assist in finding the best plan for you.

Medicare Supplement Plan F in Oregon

Medicare Supplement Plan F in Oregon is only available to beneficiaries eligible for Medicare coverage before January 1, 2020. This plan provides seniors with the most comprehensive coverage for gaps in Original Medicare.

Residents enrolling in Medigap Plan F in Oregon enjoy many benefits, including coverage for the entire cost of Original Medicare’s deductibles, copayments, and coinsurances.

Seniors with Original Medicare only will pay 20% out-of-pocket for the services both parts of Medicare cover. Medigap Plan F includes these costs as part of your coverage.

Medigap Plan F in Oregon includes:

• Part A deductible, coinsurance costs, hospital costs, and hospice care coinsurance
• Part B deductible, copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Medicare Supplement Plan G in Oregon

Medicare Supplement Plan G is the plan closest to Plan F. Seniors enjoy the same coverage, except for coverage towards their Medicare Part B deductible. Despite this omission, because your premium savings with Medigap Plan G over Plan F each year may exceed the total deductible, you may receive better savings. in Oregon is the plan closest to Plan F. Seniors enjoy the same coverage, except for coverage towards their Medicare Part B deductible. Despite this omission, because your premium savings with Medigap Plan G over Plan F each year may exceed the total deductible, you may receive better savings.

Your Medigap Plan G policy helps you when receiving care for a chronic condition through both preventive care and emergency healthcare services. A great example is how Medicare Supplement Plan G in Oregon will cover as much as 80% of foreign travel emergency care costs.

Medigap Plan G in Oregon includes:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays, coinsurance, and any excess charges
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Medicare Supplement Plan G in Oregon is an excellent option for seniors who require extra medical care and want to enjoy more comprehensive coverage than enrolling in Original Medicare alone can provide.

Medicare Supplement Plan N in Oregon

Although seniors will find less coverage, Medicare Supplement Plan N in Oregon offers the lowest premiums of the top three Medigap plans. However, you’ll have to cover copays at the doctor’s office or for a hospital visit out of your pocket or through other means.

Medigap Plan N in Oregon includes:

• Part A deductible, coinsurance, hospital costs, and hospice care coinsurance
• Part B copays/coinsurance
• Blood (first 3 pints)
• Skilled nursing facility care coinsurance
• Foreign travel emergency – 80%

Although Plan N has more out of pocket costs than Plan G, or Plan F, it typically offers the lowest monthly premiums. Medigap Plan N in Oregon can be a good option for those who don’t need to see a doctor as often.

Eligibility for Medigap Plans in Oregon

To be eligible for Medicare Supplement plans, Oregon residents must meet the eligibility requirements for Original Medicare. These requirements typically include:

• Being at least 65 years old.
• Being a United States citizen for at least five years.

There are exceptions to these requirements that may allow individuals to qualify for a Medicare Supplement insurance plan at a younger age. These exceptions include:

• Getting diagnosed with end-stage renal disease (ESRD). However, any Medicare coverage won’t start until after a waiting period, which is typically four months of undergoing dialysis.
• Getting diagnosed with Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease.
• Receiving Social Security Disability Insurance (SSDI) for at least 24 months.

It’s important to note that if you are currently enrolled in a Medicare Advantage plan (Medicare Part C) and wish to enroll in a Medigap plan in Oregon, you will need to choose one or the other. It is not possible to have both types of coverage simultaneously.

Before applying for a Medigap policy, you must first disenroll from your Medicare Advantage plan, and this can only be done during valid election periods. These periods include the Annual Enrollment Period, the Medicare Advantage Open Enrollment Period, or a Special Enrollment Period.

What is the Cost of Oregon Medicare Supplement Plans?

The cost of your Medigap premiums in Oregon will vary depending on the pricing method your insurance provider uses. Medicare Supplement carriers often use the attained-age rating method in Oregon, meaning rates increase the older you are.

What you pay in monthly premiums for an Oregon Medicare Supplement plan varies due to several factors. However, men can expect to spend more typically, as can smokers, and those of more advanced age. You’ll also pay more if you have more benefits within your coverage.

Below, we provide sample Medicare Supplement premium rates for seniors in Oregon who are non-smokers, male and female, ages 65 and 75, in the same Oregon ZIP Code. Learn more and compare Medicare Supplement plans in Oregon with our cost comparison chart below.

* If on Medicare before 01/01/2020

* Sample rates sourced from Medicare.gov

Remember, the prices shown in the chart are just average examples of premium costs. Your actual costs may be higher or lower than those listed above due to the aforementioned factors or other personal factors.

Enrolling in a Medicare Supplement plan in Oregon as soon as you are eligible can help seniors save money. The cost of Medigap premiums rises with age and will likely be higher for those enrolling when they turn 75 rather than those taking advantage of their Medigap Open Enrollment Period.

Seniors should prepare for their monthly premium and any out-of-pocket costs their Medigap plan requires.

Medicare Supplement Insurance Companies in Oregon

If you’re looking for the right Medicare Supplement insurance company in Oregon, then you’re in luck. Many popular brands are available throughout the state to deliver Medigap coverage to those eligible.

Below is a list of some of the more prominent Medicare Supplement insurance companies in Oregon for seniors:

• Aetna
• Blue Cross Blue Shield (BCBS) of Oregon
• Cigna
• Humana
• UnitedHealthcare

All carriers and programs are regulated in the state by the Oregon Division of Financial Regulation.

While the cost of monthly premiums is an important consideration when selecting a Medicare Supplement insurance company, there are other factors to consider as well. Independent credit agencies like A.M. Best and S&P look at the financial stability of insurance providers, providing insights into their ability to cover your healthcare expenses effectively.

Additionally, consumer agencies like the Better Business Bureau (BBB) evaluate customer service based on complaints, giving you valuable information about the overall consumer experience. Taking all these factors into account will allow you to make an informed decision when choosing a Medigap carrier for your supplemental coverage in Oregon.

Medicare Supplement Plans for Disabled Under 65 in Oregon

In Oregon, those under 65 with Medicare due to disability can enroll in a Medicare Supplement plan. Oregon state law requires carriers to offer a minimum of one Medigap plan option to Medicare beneficiaries under 65. If you are disabled, you have a six-month window after enrolling in Medicare Part B to elect Medigap coverage.

Often, beneficiaries under 65 find that premium costs are higher for those on disability, and a Medicare Advantage plan may better fit their budget. Because of this, when you turn 65, you will receive a second Open Enrollment Period to elect a Medicare Supplement plan at standard pricing. This ensures everyone on Medicare has an equal opportunity to enroll in a Medicare Supplement plan in Oregon.

Medicare Supplement Rating Methods in Oregon

There are three rating methods for Medicare Supplement insurance plans in Oregon. They are:

• Attained-Age Rated
• Issue-Age Rated
• Community Rated

In Oregon, most Medigap insurers use the attained-age rating method. This means that the premiums for Medicare supplements are based on your current age. Initially, when you enroll in a Medigap policy, the premiums are typically lower and gradually increase as you age. This increase in premiums is usually a result of the higher healthcare costs associated with aging and the greater use of medical services.

Under the issue-age rating method, the premium is based on your age at the time of enrollment. Generally, if you enroll as soon as you are eligible at 65, you will have lower premiums that do not increase solely due to age. However, the premium may still increase over time due to factors such as inflation.

The community-rated method ensures that all individuals enrolled in the same Medigap plan in a specific geographic location pay the same premium, regardless of their age. Similar to the issue-age rating method, the premium may increase due to external factors like inflation, but it is not based on age alone

Medigap Guaranteed Issue Rights in Oregon

Under federal law, Medicare Supplement plans are required to provide guaranteed issue rights, commonly referred to as GI rights or Medigap protections. These protections ensure that individuals in Oregon can enroll in a Medigap plan without facing coverage denial or higher premiums based on pre-existing conditions. The purpose of these protections is to ensure access to Medigap coverage when it is needed.

One significant guaranteed issue right is the Medicare Advantage trial period. If you initially joined a Medicare Advantage (Part C) plan when you first became eligible for Medicare and decide to disenroll within the first year, you have a one-time guaranteed issue right to enroll in a Medigap plan. This allows you to obtain Medigap coverage without undergoing medical underwriting.

Another important protection is available for those who experience a loss of coverage. If you lose employer-based retirement coverage or if your current Medigap plan is terminated or discontinued, you have a guaranteed issue right to enroll in another Medigap plan.

This guaranteed issue right also applies if you move out of state and your Medigap carrier is no longer available. To qualify for this protection, you must apply for a new Medigap plan within 63 days of the termination of your existing plan.

Additionally, there are guaranteed issue rights associated with Medicare Advantage plans. If your Medicare Advantage plan is terminated, you move out of its service area, or you lose coverage due to circumstances beyond your control, you have a guaranteed issue right to enroll in a Medigap plan. To be eligible for this protection, you must apply for a Medigap plan within 63 days of the termination of your Medicare Advantage plan.

When to Enroll in a Medigap Plan in Oregon

Enrolling in Medicare Supplement plans in Oregon is simple. Once you have Medicare Part A and Part B, you are eligible for a Medigap plan. When it comes to Medicare Supplement plans in Oregon, there is no specific timeframe in which you must apply. However, if you enroll outside your Open Enrollment Period, you may be subject to underwriting health questions.

When you first enroll in Medicare Part B, you get a six-month Medigap Open Enrollment Period. During this time, you can enroll while bypassing medical underwriting. This window is the best time to sign up for Medigap coverage because carriers cannot deny you a policy due to pre-existing conditions.

If you delay Medicare Supplement enrollment because of creditable coverage secondary to Medicare Part B, you will be eligible for a Special Enrollment Period. This enrollment period will grant you guaranteed issue rights to obtain in a Medicare Supplement plan with no underwriting health questions.

Are There Medicare Excess Charges in Oregon?

Medicare Part B Excess charges are a rare additional cost on top of the Medicare-approved amount for a service. These charges only apply when your healthcare provider accepts Medicare but does not accept Medicare assignment.

Not all states allow these excess charges, but most do, and Oregon is one of them. If your provider does not accept Medicare assignment, they may bill you for an additional charge of up to 15% for services provided. However, most healthcare providers do accept Medicare assignment so excess charges are uncommon.

Oregon Birthday Rule for Medicare Supplement Plans

When you enroll in a Medicare Supplement plan in Oregon, you receive a unique enrollment timeframe each year beginning on your birthday. The Oregon Medigap birthday rule allows seniors 31 days to change their Medicare Supplement coverage.

During this time, you do not need to answer underwriting health questions. Additionally, pre-existing conditions do not play a role in your admittance to a Medigap plan.

Medigap policyholders can enroll in a new plan offering equal or lesser benefits when using the birthday rule. For example, if you have a Medicare Supplement Plan G policy with Cigna and wish to change to a Medigap Plan G or Medicare Supplement Plan N with Humana, you can do so during this time. However, you cannot switch to a plan with more benefits.

The Oregon birthday rule begins on your birthday each year. The birthday rule provides an open enrollment opportunity for the following 30 days.

When your birthday rolls around, you must have an active Medicare Supplement policy to utilize the rule. Those with Medicare Advantage coverage will need to go through underwriting when applying for Medigap if they do not qualify for guaranteed issue rights.

Additional Medicare Coverage Options in Oregon

If you feel like you need other options for Medicare coverage, there are several available in Oregon for beneficiaries to choose from.

Whether you want to enroll in a Medigap plan or just have your Original Medicare coverage, a Medicare Part D plan can be helpful. Medicare Part D provides prescription drug coverage that can cover the costs of your medications. You can enroll in Part D through an eligible private carrier, but there are some things to note before enrolling.

First, Medicare Part D plans operate based on a formulary. This is a list of prescription drugs covered by each plan. You should make sure that the Part D plan you want to enroll in offers coverage for the medications you need.

A second thing to consider is the late enrollment penalty. If you don’t enroll in a Part D plan as soon as you’re eligible, the penalty can cost you much higher premiums if you choose to enroll later on.

If a Medicare Supplement plan isn’t for you, private insurance companies in Oregon also offer Medicare Advantage plans. Also called Medicare Part C, these plans combine the benefits of Medicare Part A and Part B and may offer prescription drug coverage too. However, these plans typically come with high deductibles, regular copayments, doctor networks, and the need for a referral to see a specialist.

There are also ancillary hearing, dental, and vision plans. These stand-alone plans can provide you with additional coverage not included in Original Medicare or any Medigap plan without losing all of the benefits of Medicare Supplement insurance along with Medicare Part A and Part B.