Oregon Medicare Plans
Oregon is a beautiful state home to Crater Lake National Park, Mount Hood National Forest, and Columbia River Gorge National Scenic Area. Its landscapes are the most unique in the country and offer tourists and those who call Oregon their home with breathtaking places to visit regularly.
If you are one of the many people who have decided to make Oregon your forever home, it is important to understand everything that goes along with retirement, including Medicare coverage. Oregon even has one specific Medigap rule that is state-specific! Whether you are new coming into Medicare or already enrolled, you will want to make sure you fully understand all of the rules, timelines, and options you have for your health insurance needs!
What are Medicare Options in Oregon ?
Oregon , like many states, offers the standard Medicare Supplement plans, also known as Medigap plans. If you are a resident, you can choose from the following plans: A, B, C, D, F, G, H, K, L, M, N, high-deductible Plan F, and high-deductible Plan G. You’re able to enroll during the year, but if you want your coverage to be guaranteed, you want to enroll during your open enrollment period in Oregon .
What are the Most Popular Medicare Supplement Plans in Oregon ?
When is the Open Enrollment Period in Oregon ?
As a Medicare beneficiary, you can enroll in any Medicare Supplement within your first six months of your Part B effective date. This is considered your open enrollment period. During this time, insurance carriers are required to approve your MediGap application, and are prohibited from declining the coverage you need because you have a pre-existing condition. You can still apply outside of this window, but you will be required to go through medical underwriting, and could be denied coverage based on your health history.
Can I Change Medicare Supplement Plans in Oregon ?
Oregon Birthday Rule
Oregon is one of few states that gives Medicare Supplement plan enrollees the ability to change their MediGap plans once per year with no medical underwriting. This is known as the Oregon Birthday Rule.
The Oregon Birthday Rule begins 30 days before your birthday and ends 30 days after your birthday. This gives you a total of sixty days around your birthday to change your MediGap plan. Like all good things, however, there are a few rules to remember. The first rule is that you must already be enrolled in a Medicare Supplement plan to take advantage of the Birthday Rule. This means that people with no additional coverage or Medicare Advantage plans do not qualify. The second rule is that you must change your plan to one of equal or lesser coverage. Essentially you can change from one Plan G to another Plan G, or down to a Plan N, but you cannot use this rule to change from a Plan N to a Plan G.
Changing MediGap Plans without Oregon Birthday Rule
Outside of using the Oregon Birthday Rule, changing Medicare Supplement plans in Oregon follows the same guidelines as most other states. Once you are more than 6 months past your Medicare Part B effective date, you must go through medical underwriting in order to be approved to enroll into or change your Medicare Supplement plan. This means that insurance carriers are given the ability to assess your health history, prescriptions, height and weight, as well as other health-related factors to determine if you will be approved or denied coverage. During medical underwriting, insurance carriers have the ability to deny a Medicare Supplement plan application based on pre-existing conditions, so it is important to enroll in a MediGap plan during your open-enrollment period to guarantee your acceptance.
Medigap Plan F in Oregon
Medicare Supplement Plan F has been a very popular plan with Medicare beneficiaries over time. The reason for the popularity of Plan F, is that it covers the gaps left by Medicare Part A and B with no out-of-pocket. However, if you became Medicare eligible after January 1st 2020, you are not eligible to enroll in MediGap Plan F. Luckily, there are other great Medicare Supplement plan options available.
Medigap Plan G in Oregon
Medicare Supplement Plan G is a very comprehensive Medicare Supplement plan with very little out-of-pocket expense. Once you have met your Part B annual deductible, MediGap Plan G becomes a full coverage plan, covering all of the gaps left by Original Medicare, with no additional out-of-pocket expenses. Plan G is typically a very cost-efficient plan with an affordable monthly premium to ensure gold-standard coverage.
Medigap Plan N in Oregon
Medicare Supplement Plan N is also a great, comprehensive MediGap plan available in Oregon . This plan has slightly more out-of-pocket cost than MediGap Plan G, but also comes with a lower monthly premium. As with Plan G, you are still responsible for the Medicare part B annual deductible. Once you have met this deductible, your Original Medicare coverage kicks in, but you still have some cost-share. With MediGap Plan N, you will pay copayments up to $20 for office visits, and up to $50 for ER visits that do not result in an inpatient admission. Plan N also has the possibility of an excess charges if you use a doctor or healthcare provider that does not accept Medicare Assignment. Excess charges can be up to 15% of the Medicare-approved payment. If the monthly premium difference between Plan G and Plan N is large enough, Plan N is often times a very attractive option for your Medicare Supplement plan.
What is the Cost of a Medicare Supplement Plan in Oregon ?
Monthly premiums for Medicare Supplement plans are based on three main factors- age, gender, and location. There are other things that may impact your premium such as tobacco use. The premium amounts will vary based on these factors, so it is important to receive a quote based on your specific demographic information.
Medicare Plans in Oregon for Those Under 65
When it comes to Medicare under 65 in Oregon , there is an open enrollment period for MediGap plans. This is a 6 month period beginning on your Medicare Part B effective date, giving you guaranteed acceptance into the offered Medicare Supplement plans, meaning you cannot be denied due to your health status. If you do not enroll during this 6 month window, you will be required to go through and pass any medical underwriting that is necessary for acceptance. If you’re under 65 and disabled but still qualify for Medicare, you may not pass this underwriting. If you fit within this category, there are Medicare Advantage Policies that you can look into.
Once you reach 65, more Medicare supplement plans will open up for enrollment in Oregon without any health questions. This period guarantees acceptance.
Medicare Advantage in Oregon
Oregon also offers options for Medicare Advantage plans. In these plans you must live in your plan’s service area and enroll during an appropriate election period. Medicare Advantage plans do not required medical underwriting if enrolling during an election period, but are also significantly different plans than Medicare Supplement plans.
Medicare and Medicaid in Oregon
It is possible to qualify for both Medicare and Medicaid in the state of Oregon . These two programs, however, are separate and have different qualifications you must meet in order to receive benefits. To qualify for Medicaid, you must meet state income requirements. To qualify for Medicare, you must be either over the age of 65, or under 65 but receiving Social Security Disability Insurance for a minimum of 24 months before applying for Medicare.
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