Hundreds of thousands of Oregon residents switched from Original Medicare to an Oregon Medicare Advantage plan; there are 292,697 Medicare Advantage beneficiaries in Portland, OR.

However, it’s crucial to understand what Oregon Medicare Advantage plans cover and their differences to find the perfect plan for you and your loved ones.

That’s why we put together a brief guide to teach you about Medicare Advantage plans and how they can make your medical expenses more affordable.

How Medicare Advantage Plans Work in Oregon

Medicare Advantage plans provide numerous medical benefits like vision, dental, and hearing, which Original Medicare does not cover. Private carriers offer various Medicare Advantage plans across Oregon, giving residents several programs depending on their zip code.

It’s essential to know that enrolling in a Medicare Advantage plan means receiving your benefits from a private insurance carrier rather than the federal government.

Oregon Medicare Advantage plan coverage differs depending on the plan you purchase. One might cover vision and dental, while another focuses on prescription drug costs. Currently, the state offers between two to 44 Medicare Advantage plans, depending on the county.

If you decide to enroll in an Oregon Medicare Advantage plan, research each plan to ensure you find one that matches your specific medical needs and budget.

Medicare Advantage Plans Offers in Oregon

Since the US government doesn’t standardize Oregon Medicare Advantage plans, the coverage usually fluctuates from ZIP code to ZIP code. Some cover vision and dental, while another pays for hearing and prescription drug costs.

We focused on one specific Oregon county to provide the information below. It’s important to note that the plan coverage may differ depending on your region. We categorized each plan by those with zero-dollar premiums and zero-dollar deductibles.

Medicare Advantage Plans with a Zero-Dollar Premium in Oregon

Most Oregon Medicare Advantage plans with zero-dollar premiums have higher MOOP (maximum out-of-pocket) costs. Before committing to a specific zero-dollar Medicare Advantage plan, consider this.

FamilyCare offers HMO (Health Maintenance Organization) plan types with zero-dollar premiums and a $6,700 MOOP.

Humana is another private carrier that provides an HMO with a $0 monthly premium and a $5,700 MOOP.

Health Net also has an HMO with a zero-dollar premium and a $3,950 MOOP.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
FamilyCare $0 $6,700 HMO N/A
Humana $0 $5,700 HMO N/A
Providence $0 $5,500 HMO N/A
Health Net $0 $3,950 HMO N/A
Regence $0 $3,400 HMO N/A

Medicare Advantage Plans with Zero Dollar Drug Deductibles

Kaiser Permanente is a popular private insurance provider that offers an HMO plan with a $44 monthly premium and a $4,900 MOOP.

ATRIO provides a PPO (Preferred Provider Organization) plan with a zero-dollar premium and a $3,500 maximum out-of-pocket cost.

Providence offers an HMO-POS (Health Maintenance Organization with Points of Service) plan with a $0 monthly premium and a $3,400 MOOP.

PLAN PREMIUM MOOP PLAN TYPE STAR RATINGS
Kaiser Permanente $44.00 $4,900 HMO N/A
Humana $0 $4,500 PPO N/A
Regence $0 $6,700 HMO N/A
ATRIO $0 $3,500 PPO N/A
Providence $0 $3,400 HMO-POS N/A

Ancillary/DVH

Unlike Medigap and Original Medicare, Medicare Advantage plans often cover additional medical coverage. Some Oregon Medicare Advantage plans provide ancillary coverage for vision, dental, hearing, and prescription drugs.

Always research each plan until you find one that covers your specific medical needs, as each plan will have different benefits in different areas.

Cities in Oregon with Medigap Coverage’s Estimated Premiums

When trying to select the right Medigap plan for yourself in Oregon, you can reference these handy charts with the estimated premiums for the below cities:

FAQs

Which Medicare Advantage plan is best in Oregon?

Determining which Medicare Advantage plan is the best depends on what you want to get out of your insurance plan. Since different plans cover different medical expenses, the provided coverage and prices tend to fluctuate.

For example, Kaiser Permanente offers zero-dollar drug deductible HMO plans with $44 premiums and a $4,900 MOOP, while Providence offers HMO-POS plans with zero-dollar premiums and a $3,400 MOOP. It would be best to research each policy and carrier until you find one that fits your specific financial and insurance needs.

What is the highest-rated Medicare Advantage plan in Oregon?

The Regence BlueCross of Oregon and Kaiser Permanente plans are currently the highest-rated Medicare Advantage plans in Oregon.

Regence Blue Cross of Oregon has the best low out-of-pocket plans, while Kaiser Permanente offers superior HMO plans without drug coverage. Always analyze each plan to ensure they provide the coverage you need before purchasing a specific policy.

Why is Medicare Advantage being pushed so hard in Oregon?

Funding is the primary reason you see so many Medicare Advantage plan advertisements in Oregon. The CMS (Centers for Medicare & Medicaid Services) pays private insurance carriers for each person who enrolls in a Medicare Advantage plan. The carriers then use the funds to pay for the beneficiaries’ medical expenses.

The carriers also bid on the beneficiary’s estimated medical expenses. If the bid meets Medicare’s requirements, it accepts the offer and provides the necessary funding. It’s a somewhat controversial issue with numerous supporters and critics alike.

Is Medicare Advantage more expensive than Medicare in Oregon?

The cost of a Medicare Advantage plan compared to Original Medicare depends on your purchase plan. Part C plan prices often fluctuate from carrier to carrier and region to region. Some cover more medical expenses than Original Medicare but demand higher prices.

You must examine the Medicare Advantage plan you want and compare its price to Original Medicare to learn which one better suits your budget and healthcare needs.

Does Medicare have a Maximum Out-of-Pocket in Oregon?

Currently, Original Medicare doesn’t have an out-of-pocket maximum in Oregon. However, some Medicare Supplement plans do have a maximum out-of-pocket limit.

How to Get Help Enrolling in an Oregon Medicare Advantage Plan

Contact us today if you need help enrolling in an Oregon Medicare Advantage plan. Our team works with all of Oregon’s leading private insurance providers, which allows us to find the perfect Medicare Advantage plan for you and your loved ones.

Our licensed insurance agents have experience helping countless Oregon residents find their Medicare plans, and they can do the same for you.

Give us a call, or complete our convenient online rate form to receive the best rates in Oregon today!

Written By:
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Lindsay Malzone, Lindsay Malzone is the Medicare editor for Medigap.com. She's been contributing to many well-known publications since 2017. Her passion is educating Medicare beneficiaries on all their supplemental Medicare options so they can make an informed decision on their healthcare coverage.
Reviewed By:
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Rodolfo Marrero, Rodolfo Marrero is one of the co-founders at Medigap.com. He has been helping consumers find the right coverage since the site was founded in 2013. Rodolfo is a licensed insurance agent that works hand-in-hand with the team to ensure the accuracy of the content.