Medicare Supplement Plans in Oregon

What are Medicare Supplements?

Medicare Supplements pay some or all of the health care costs that Original Medicare doesn’t cover, like copayments, coinsurance, and deductibles. Medicare supplement plans in Oregon vary and premium is based on how much coverage you may need. Medicare Supplement Plans work alongside with Medicare Part A and Part B.

Does Medicare Supplements cover prescription drugs?

No. You may want to enroll in a prescription drug plan to cover your prescriptions. Your drug plan is a separate insurance policy from your Medicare Supplement and Original Medicare.

Medicare Supplements Eligibility Requirements

Medigap coverage, also known as Medicare Supplement, is designed to help cover out-of-pocket costs of Parts A and B. It may be added to your Original Medicare and is an additional charge to your monthly premiums.

What is a Medicare Gap Guarantee?

The federal government prevents companies from charging a higher premium, limited coverage or making you wait because of your pre-existing condition. However, this protection is only applied if you opted in Medigap under rare circumstances.

How can Medicare Supplements help you?

If you have Medicare (Part A and Part B), it does not cover all medical and hospital bills. Usually, there is a gap between what is covered by Medicare (Part A and Part B) and what you are expected to pay out of pocket (cost sharing). The good thing is that Medicare Supplements can help you in paying these out of pocket expenses.

Where can you find the best Medicare Supplements in Oregon?

Medicare Supplements are standardized in most states. Medicare Supplement Plans in Oregon consist of plans labeled with the letters A through N. No matter where you buy these lettered Medigap plans, it still offers the same benefits as per letter category. What varies is their premium costs depending on the insurance company and type of plan you choose to enroll in. Medicare.gov also offers all the Medigap plans sold in Oregon.  Shiba issues an annual guide of all the Medicare supplement plans in Oregon. It’s good to work with a volunteer from SHIBA or from a local insurance agent such as Health Plans in Oregon.

So how can you get Medicare Supplements with better premium costs?

All Medicare Supplement in Oregon and in all other states offer the same benefits for each lettered plan but insurance companies might charge you for higher out-of-pocket costs.

This means that you have to shop around carefully and compare Medicare Supplements. It is highly recommended that you choose a trusted insurance company that will give you the supplements that fit your medical and financial needs.

When is the best time to enroll in a Medicare Supplement?

Medicare Supplements open enrollment is during the 6 months when you qualify for Medicare Part A and or Part B.

Medigap Open Enrollment Period: The best time to buy a Medicare Supplement or Medigap policy is during your 6-month Medigap open enrollment period. It is because you can enroll in any Medigap policy sold in your state, even if you have some existing medical condition or problems. This period automatically starts on the month you turn 65 and enrolled in Medicare Part B. And when it’s over, you can’t get it again. Medigap insurance companies in Oregon are generally allowed to use medical underwriting to decide whether to accept your application or not. It’s the best time because you have certain protections called guaranteed rights:

• You can’t be denied coverage.
• You don’t have to undergo a medical history.
• Insurers can’t charge you higher rates based on your medical status

Guaranteed Issue : Certain circumstances trigger guaranteed issue situations.In these cases, you can purchase a Medigap plan even without underwriting. These GI Protections last for 63 days.

Loss of Medicaid: If you lost your Medicaid or QMB, you are given 63 days to apply for a Medigap policy. You may want to consider it to afford treatments like chemotherapy, dialysis, and infused medications.

Your Birthday:  In Oregon, if you are a Medigap policyholder, you have 30 days beginning on your birthday to shop for other policies. This is the best time for compare plans that will best suit you.

People under 65 and receiving Medicare through disability have additional opportunities for guaranteed issue open enrollment:

• When They turn 65 for 6 months
• During the first 6 months after they receive notice of retroactive enrollment – which begins on the first day of the month after receiving their notice.

What factors should I consider when buying a Medigap policy?

Finding the best Medicare Supplement plan in Oregon hinges on two things:

• Benefits and coverage
• Medigap rates (monthly premiums)

The amount of protection you need rests on your health status and financial risk tolerance:

• Number of times you visit the doctor
• Pre-existing conditions you might have
• Whether you need — or are likely to need — skilled care at home or in a facility
• Comfort level paying higher out-of-pocket costs in return for a lower monthly premium
• Willingness to pay a higher premium for reassurance that you’re covered for all out-of-pocket costs

Where do Insurance Companies in Oregon base their Medicare supplements premiums?

Medigap are standardized plans with prices that vary amongst insurance companies. Their rate was calculated based on your:

• Gender
• Age
• Location
• Pricing method

Take Note: Most Oregon insurers use the attained-age calculation, which means your monthly premiums will climb the older you get.

Will I have to wait before using my Medigap policy?

No. Your Medicare Supplement plan will take effect the month that you qualify for Medicare A and B takes effect or can start the following month that you apply for it.

Medicare supplement plans coverage outside the United States

In certain situations, Medicare will not cover health services outside the US. However, Medigap plans C, D, F, F High Deductible, G, M, and N will cover emergency care outside the U.S. in certain circumstances. They pay 80% of the billed charges after you met the yearly deductible of $250.  These Medigap policies begin to cover during the first 60 days of the trip and have a lifetime limit of $50,000.

Types of Medicare Supplement plans in Oregon

It is the best option for you to research on Medigap plans and be familiar with the benefits in order to compare plan options.

If you consider a plan with broader coverage, you may want to consider getting Medicare Supplement  Plan F, which covers nearly 100% of the Medicare-associated costs after Medicare has paid its share. Take note that you still have to pay your Medicare Part B premium.

Best Medicare Supplement Plans in Oregon for 2019: Enrollment Statistics

Oregon’s population totals more than 4 million. The five largest counties by population are:

• Multnomah
• Washington
• Clackamas
• Lane
• Marion

Medicare numbers for Oregon’s seniors:

• Roughly 17 percent of Oregon residents are 65 or older.
• Nearly 20 percent of residents have Medicare.
• About 14 percent of those on Medicare are younger than 65.
• In 2018, 55 percent of Medicare beneficiaries had Medicare Part A and Medicare Part B.
• Forty-three percent had a prescription drug plan in 2018.
• In 2016, about 33 percent of Medicare beneficiaries had Medigap policies

How Many Medicare Supplement Plans are Available in Oregon for 2019?

Oregon joins 46 other states in offering 10 standardized Medigap policies. Here’s how Medicare Supplement plans in Oregon work:

• A letter designates each Medigap policy (A, C, N).
• Each plan offers standard benefits regardless of which insurance company sells you the health plan. Medicare Plan N from Cigna is the same as Plan N from Aetna.
• Medigap policies in Oregon are automatically renewed each year as long as you pay your monthly premiums and stay enrolled in Medicare Part A and Part B.
• Oregon guarantees Medicare beneficiaries under age 65 access to Medicare Supplement insurance plans.

Oregon Medicare beneficiaries buy Medicare Supplement from a private Medicare insurance company. These companies aren’t required to sell all of the available Medigap plans in Oregon. If they choose to sell Medigap policies, however, they are required to:

• Sell Plan A
• Sell Medicare Plan C or Medicare Plan F as well

Premiums of Medicare Supplemental Plans in Oregon for 2019?

A 65-year-old woman who lives in Portland and is shopping for Medigap Plan N coverage, here are some Medicare Supplement rates in Oregon for a non-tobacco user:

• Aetna – $116.28
• Cigna – $103.52
• Mutual of Omaha – $99.91

And for Medicare Supplement Plan F and Plan G, the rates are:

• Regence Plan F- $182/month
• Regence Plan G- $155/month

*Household discounts are available with some insurance carriers such as Regence and Mutual of Omaha.

How does Medicare Supplement Plans and Medicare Advantage Plans differ?

Medicare beneficiaries have the option to enroll in either a Medicare Supplement or Medicare Advantage. These plans are very different and beneficiaries CANNOT have both plans at the same time. Medicare Supplement works alongside with Medicare, while Medicare Advantage acts like an alternative to Original Medicare with additional benefits like dental, vision and hearing.

What is Medicare Supplement Innovative Plan?

With the Medicare Gap Plans being standardized, insurance companies shall clearly follow the rules set by the federal government. Therefore, with Medigap Innovative Plan,  the insurance company may offer an additional benefit at no extra cost to the Medicare Consumer. With approval, these plans cannot be used to change or revise any standardized policy, including cost-sharing provisions.

Medicare Supplement Innovative Plan benefits can include, but not limited to:

• Nurse hotline
• Annual Physical Exam
• Preventive dental care
• Preventive vision care
• Routine hearing exam
• Drug discount card

If a company offers a Medicare Supplement Innovative Plan, they should determine which benefits are included.

More than a decade of service:

Health Plans in Oregon has Over A Decade Of Being An Independent Medicare Licensed Insurance Agent. Our assistance is at no cost to you. Feel free to call us at 503-998-6169 for any questions or to request face to face appointment. Call 503-998-6169or email diane@healthplansinoregon.com to get help.