Medicare Advantage Plans in Oregon

For seniors in Oregon that want the benefits of Medicare without the complication of managing multiple plans at once, Medicare Advantage, also known as Part C, provides a strong alternative. Unlike the separate Part A and B of traditional Medicare that requires the addition of Part D to cover prescriptions, Medicare Advantage often includes all three with other additional benefits added, such as coverage for hearing, vision, and dental. This means all health care is covered under one premium. Medicare Advantage is offered through private insurance companies, eliminating the extra effort needed to navigate a government program. By law, these plans are required to provide the same benefits as original Medicare but are free to add additional perks and benefits to attract enrollees.

Although Medicare Advantage can offer savings, add benefits and simplify health care premiums for some seniors, there are some limitations that could impact the care received. The most notable is the introduction of a care network that specifically names the facilities and providers that are eligible for the full coverage amount. Seeing someone outside this network can result in additional costs to the enrollee. Despite this, Medicare Advantage is a popular choice among eligible residents in Oregon, with just under 500,000 enrollees as of July 2023. This comes out to 53% of those eligible, a 5% increase over the national average and a 4.11% increase when compared to this same time in 2022. This follows a continued trend of increased interest among Oregon seniors who are choosing to explore their options and enroll in the program that provides them with the most benefit for their premiums.

This comprehensive guide can help interested seniors decide whether Medicare Advantage is the right choice over traditional Medicare and provide the information needed to choose the best plan for their needs. Seniors can find out the potential costs they can expect if they make the switch and what benefits may be available.

The Top 10 Medicare Advantage Plans in Oregon

For Oregon seniors considering Medicare Advantage, there are several providers that offer these plans in the area. The top 16 providers, listed by greatest number of enrollees, are listed in the table below. Most providers have more than one plan to choose from, so the cost range reflects the possible differences in price. The satisfaction rating is pulled from government satisfaction surveys that ask plan members about their experiences with the coverage provided. The information provided is accurate as of July 2023. For a more recent account on these and other Part C options in Oregon, seniors can visit Medicare.gov.

How Medicare Advantage Plans Work in Oregon

Due to the high number of Medicare Advantage beneficiaries in Oregon, insurance companies offer a variety of plans. In order to get the best possible care with the lowest costs, it’s important for seniors to know how Part C works in this state. Each plan has different premiums, deductibles, copays and other out-of-pocket expenses. Companies that offer Medicare Advantage plans in Oregon have to renew their contracts with the federal government every year, so coverage options and costs may change. The plans available to seniors vary from county to county. 

What Medicare Advantage Plans Cover in Oregon

The Centers for Medicare & Medicaid Services only certifies a Medicare Advantage insurance plan if it covers the same benefits as Parts A and B, excluding hospice care. This includes inpatient hospital care, preventative medicine and durable medical equipment. These private health insurance policies may also offer coverage for routine annual physicals, dental care and vision. Many types of Medicare Advantage plans in Oregon are available with and without prescription drug coverage.

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in Oregon

Seniors in Oregon must already have Medicare Parts A and B to be eligible for a Medicare Advantage policy. Original Medicare requires the beneficiary to be at least 65 years old, or younger with certain disabilities or end-stage renal disease. They must also live in the service area where the coverage is provided. While this is usually determined by county, some policies just cover certain zip codes because certain insurance companies only provide managed care in specific cities. Seniors who meet all of these qualifications can only enroll during certain times of the year. These enrollment periods are listed in the table below.

• Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
• Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
• Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in Oregon

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

State-Wide Medicare Advantage Resources

Local Medicare Advantage Resources