October 6, 2016
As a Medicare beneficiary in Oregon, a Medicare Supplement (Medigap) plan can help pay for out-of-pocket expenses related to Original Medicare, Part A and Part B. Medigap plans in Oregon are available through private insurance companies, and they can help fill the gap between what Original Medicare covers and expenses you’re responsible for, like copayments, coinsurance, deductibles, and emergency health coverage when you’re out of the country. As an Oregon resident, you may have a number of Medigap plan options, depending on where you live. Here’s an overview of how Medicare Supplement coverage works in your state.
There are 10 standardized Medicare Supplement plans available in 47 US states, including Oregon. Each Medigap plan is identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and plans of the same letter offer the same benefits. In other words, a Plan A offered anywhere in Oregon will have the exact same benefits (although costs may vary by location and insurance company). Massachusetts, Minnesota, and Wisconsin are three states that offer different types of standardized Medigap plans.
If you want to enroll in a Medigap plan in Oregon, you must first be enrolled in Original Medicare, Part A and Part B. A good time to sign up for a Medigap plan in Oregon is during your Medigap Open Enrollment Period, which begins the first day you are both age 65 or older and enrolled in Medicare Part B. This enrollment period lasts for six months, and during this time, you have special Medigap protections known as guaranteed-issue rights. This means you have the right to enroll in any Medigap plan offered by any insurance company in your area, without being denied coverage because of pre-existing conditions (although waiting periods may apply). In addition, if you enroll during this time, insurance companies can’t charge you more because of your health status or require medical underwriting. After your Medigap Open Enrollment Period, it may be much harder for you to enroll in a Medigap plan without guaranteed-issue rights if you have health problems — you may be denied coverage or charged more for your insurance policy.
Remember that Medigap in Oregon (like the rest of the United States) is meant to supplement and not replace Original Medicare, so you have to remain enrolled in Original Medicare for your Part A and Part B coverage and keep paying your Medicare Part B premium. And since Medigap in Oregon does not offer prescription drug coverage, you may want to consider signing up for Medicare Part D to get help paying for your prescription drugs. Stand-alone Medicare Prescription Drug Plans are available for Original Medicare beneficiaries who want help paying for medication costs.
If you’re just starting to research Medigap coverage, you may want to take a quick look at the 10 types of standardized Medicare Supplement plans available in Oregon. Once you’ve narrowed down the plan type that best fits your needs, you can start comparing plan options and insurance companies in your area.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional
365 days after Medicare benefits are exhausted
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility (SNF) care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B ‘excess charges’||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Medicare Part B preventive care coinsurance||X||X||X||X||X||X||X||X||X||X|
|Out-of-pocket limits apply**|
If you’re looking for broad coverage, Medicare Supplement Plan F is the most comprehensive plan, covering almost 100% of Medicare-associated costs in the above chart after Original Medicare has paid its share; please note that you’ll still be responsible for paying the Medicare Part B premium.
Also be aware that Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, but the same plan does not cover up to $20 copayment on some office visits and up to $50 copayment on emergency room visits that don’t result in an inpatient admission. Additionally, Medicare Supplement Plan K and Plan L have out-of-pocket limits that are subject to change each year; keep in mind that Original Medicare doesn’t have an annual cap on your out-of-pocket spending.
As previously mentioned, Medicare Supplement plans in Oregon with the same letter designation don’t vary in coverage or benefits. However, each independent insurance company that offers Medicare Supplement plans has the freedom to set premium costs for plans. Because of this, an identical Medicare Supplement plan for a certain premium amount in Portland, in Multnomah County, may cost more or less in Eugene, in Lane County. Since coverage doesn’t vary across plans of the same letter type, it can be smart to compare all Medicare Supplement plans in Oregon available in your location before making a selection based on your health needs and budget.
Hopefully, you now have a better idea of how Medicare Supplement coverage works in Ohio and what some of your coverage options may be. If you’re ready to start browsing and comparing, you can use eHealth’s plan finder tool to view Medigap plan options in your area; just enter your zip code into the tool on this page. If you’d rather get help choosing a Medigap plan in Oregon that may fit your personal budget and health needs, you can call the phone number on this page to reach a licensed insurance agent.
To get more information about Medicare insurance in Oregon, check out the following resources:
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program.