Are you planning on spending the rest of your golden years in Portland? Then you’re going to need to take a little time and plan out how to make your health care costs more affordable. As you age, it will begin to cost more and more money to keep yourself healthy and loving life. But the dangerous gaps in Medicare coverage which most seniors don’t know about can seriously jeopardize your ability to pay for the medical care you need. Keep reading to find out more about how to protect yourself from unexpected expenses.

Senior Medicare in Portland: Facts and Figures

  • There are 78,373 senior citizens living in Portland right now
  • There are 10 hospitals in the Portland area where seniors can get emergency and/or in-patient care
  • 44% of Oregon seniors have a Medicare Advantage plan
  • 16% of seniors have a Medicare Supplement (Medigap) plan
  • Which leaves 40% of seniors potentially uninsured or underinsured against costly Medicare coverage gaps!

Part of the reason medical expenses are so much higher for seniors is because of chronic medical conditions. If you don’t currently suffer from one right now, consider yourself lucky. But the odds are good that you will eventually have to get one treated if you aren’t seeking medical care for one (or several) already. According to the available data for seniors in the Portland area, high blood pressure and arthritis are two of the most common chronic conditions which require ongoing medical care. But there are also a significant number of people living in the area who have to deal with things like diabetes and heart disease.

Disease Prevalence (in Portland)
Arthritis 20%
High Blood Pressure 24%
Coronary Heart Disease 5%
Diabetes 8%
Kidney Disease 2%

Healthcare Costs in Portland, OR

The unfortunate thing about chronic disease is that it doesn’t go away with time. If you and your doctor work hard and coordinate well with each other, the best you can do is slow it down; but it will catch up to you eventually. The amount of time and money that most people have to spend maintaining a higher quality of life in the face of chronic disease will also increase as time goes on. Below is a snapshot of the types of annual costs people with common chronic diseases can expect to pay for treatment in Portland. But everyone’s medical needs are very specific and will vary by individual; so your costs might not be exactly the same.

Disease Prevalence (in Portland) Annual Cost of Treatment
Arthritis 20% $280
High Blood Pressure 24% $108
Coronary Heart Disease 5% $8,246
Diabetes 8% $2,189
Kidney Disease 2% $7,969

Medicare Advantage Savings in Portland, OR

Did you know that Medicare Advantage is not technically from the government? Medicare Advantage plans in Oregon are private health insurance plans sold and managed by private companies. The government is only involved enough to approve the plan for sale as a Medicare replacement (by law, it must offer the exact same benefits as Medicare Parts A and B or else it cannot qualify) and to pay a share of the monthly premium on your behalf. For some qualifying seniors, the share of the premium which the government pays is so large that their monthly premium is $0.

Of course, most Medicare Advantage plans don’t just replace Medicare Parts A and B. Many of them give you the option to purchase additional coverage which can help protect you from the coverage gaps in Medicare Parts A and B. This will likely make your monthly premium more expensive, but if you’re one of the lucky seniors who’s getting your Medicare Advantage at a low or no monthly premium to begin with, this shouldn’t put you too far out. You will, of course, still be expected to pay for things like coinsurance, co-pays, and other shared expenses between you and your health insurance provider. But it can still end up costing you less than paying for medical expenses completely out-of-pocket if those expenses fall through the gaps of Original Medicare coverage.

Beyond Medicare coverage gaps, most Medicare Advantage plans allow you to add vision or dental coverage to your health plan. Many will also give you some sort of prescription drug coverage option. Just keep in mind that because it is a private health insurance plan, they will choose your medical network and available providers (usually in the form of an HMO or a PPO). You will have to go to those specific dentists, optometrists, and pharmacies if you want your costs covered.

Medicare Supplement (Medigap) Savings in Portland, OR

Medicare Advantage gives people the option to truly customize their plan, depending on the provider and the coverage options available for purchase. But Medicare Advantage doesn’t work for all seniors. This is especially true if you are relatively healthy and if your main focus is exclusively dedicated towards plugging the holes in Original Medicare coverage. If that is your biggest concern, then don’t overlook Medicare Supplement Insurance in Oregon.

Medicare Supplement Insurance (Medigap) policies are appealing to seniors who don’t need to purchase a lot of coverage, who want to save money on their monthly premiums, and who would rather keep their Original Medicare benefits and allow the government to manage their health care needs. These policies have a laser-tight focus on only those gaps in Medicare Parts A and B which seniors would otherwise have to pay for out-of-pocket. This includes things like extended hospital stays, excess blood transfusions beyond 3 pints, and certain cost-share charges with hospice care – among many other uncovered expenses that seniors don’t know about.

The Medigap plan you choose will largely depend on whether you are more concerned with Medicare Part A coverage gaps, Medicare Part B coverage gaps, or both. The less expensive plans are plans A, D, K, and L, and largely concern themselves with Medicare Aart A coverage gaps. These are also the least expensive plans.

Then there are Medigap plans B, C, D, F, G, M, and N which dedicate most of their resources towards both Medicare Part A and Medicare Part B coverage gaps. Medicare Part B coverage gaps will cost you the most money when it comes to Part B excess charges, your Part B deductible, foreign travel, and skilled nursing facilities (among other things). But not everyone will need the maximum amount of coverage. It’s a delicate balancing act. The more coverage you purchase, the higher your monthly premium will be; but the better protected you’ll be from unexpected medical bills. If you don’t plan on traveling out of the country that much, then you might not need to spend extra money on a monthly premium for a plan like C or D. Medigap Plan F is the most comprehensive right now, but it will only remain available for sale to new Medicare recipients until the end of 2020. After that, you’ll have to resort to Medicare Plan G for a similarly comprehensive plan.

Because Medigap plans are narrower in scope than Medicare Advantage, you won’t have the luxury of adding additional coverages like dental or vision to your plan. And if you want prescription drug assistance, then you’ll have to sign up for Medicare Part D. You can still shop around for local dental and/or vision insurance at your leisure. But if you find it, you’ll have to purchase, pay for, and manage those plans separately from your Medicare benefits and your Medigap policy. Luckily, some vision and dental insurance providers offer discounts for seniors – so be on the lookout for those!

PayIng for proper medical care in Portland can be a challenge. But with the right Medicare Supplement Insurance – whether that be Medicare Advantage or a Medicare Supplement Policy – you can get affordable coverage at a price that won’t break your bank. More importantly, you’ll be protected from the potentially costly gaps in Medicare coverage which could cost you tens of thousands of dollars or more at a time in your life when you can least afford it. Even if you overestimate your medical needs, the peace of mind you get can still be worth its weight in gold.

Medigap Plan Minimum Monthly Premium Maximum Monthly Premium Average Estimated Monthly Premium (Part B Premium Included)
Plan A $72 $191 $267
Plan B $96 $217 $292
Plan C $113 $247 $316
Plan D $105 $154 $265
Plan F $102 $211 $292
Plan F (high deductible) $27 $83 $191
Plan G $92 $157 $260
Plan K $40 $92 $202
Plan L $74 $118 $232
Plan M $95 $139 $253
Plan N $74 $158 $252
by Lindsay Malzone, Lindsay Malzone is the Medicare expert for She's been contributing to many well-known publications as an industry expert 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.