Best Medicare Advantage Plans in Oregon for 2019
Many people have reasonable concerns about managing out-of-pocket expenses when they rely only upon Original Medicare for health insurance after retirement. Some of the best Medicare Advantage plans in Oregon for 2019 offer solutions that can help a beneficiary control coinsurance, co-pays, deductibles and other out-of-pocket costs they might have with just Medicare Part A and Part B. Learn more about how this kind of Medicare insurance works and if an Oregon Medicare Advantage plan will suit your needs.
Best Time Enroll in Medicare Advantage Plans in Oregon for 2019
Almost every Medicare beneficiary who is enrolled in Medicare Part A and Part B can also enroll in a Medicare Advantage plan in Oregon for 2019. If you suffer from End Stage Renal Disease ESRD, you may have to enroll in a special plan.
Otherwise, you will need to pay attention to certain dates when you can enroll in a Medicare Advantage plan with the help of an insurance agent:
- Initial Coverage Election Period: This is the first time that a Medicare beneficiary will have to enroll. This ICEP is three months before the first day of the month a beneficiary is enrolled in Medicare Part A and Part B and three months after that day. Most people get this period around their 65th birthday, but it can vary.
- Annual Election Period: This is the annual period each fall that most people refer to as Open Enrollment. This is the time each year to compare and choose the best Medicare Advantage plan for your needs.
- Special Election Period: Some events may trigger a Special Election Period for enrollment in Medicare Advantage plans. Examples may include losing group coverage from work or moving out of a plan’s service area. If the health insurance company that you have coverage through does not do a contract renewal with Medicare, then you will also be in this period to find another health care option.
- Annual Medicare Advantage Disenrollment Period: The government also gives you a few weeks at the start of every year to drop your Medicare Advantage plan in Oregon. If you need drug coverage because you had it with your MA plan, you can also enroll in Medicare Advantage Prescription Drug plans at this time.
Most Common Type of Medicare Advantage Plans in Oregon for 2019
These are the most popular kinds of Oregon Medicare Advantage plans:
Health Maintenance Organization HMO plans: An HMO will usually require sticking with in-network providers to get covered. It may also force you to choose a primary care doctor, and this PCP has to give you a referral to visit a specialist. Even though an HMO will have more restrictions, it’s also likely to have low costs and might come with a $0 premium. About 65 percent of everybody with Medicare Part A and B choose an HMO Medicare Advantage plan in Oregon.
Preferred Provider Organization PPO plans:
You may pay somewhat higher premiums, but you will also enjoy the best flexibility with a PPO. Your rates may be higher than with an HMO, but you can get medical services covered outside of the plan network and don’t need a primary care doctor to get specialist referrals. Out-of-network services will cost more than they would if you stayed in the network. About 35 percent choose an Oregon PPO Medicare Advantage plan.
Private Fee-for-Service PFFS plans:
PFFS options are rare in Oregon. They don’t use plan networks, but it’s not as easy to find an insurance company that offers one.
Special Needs Plans SNPs:
In some cases, Special Needs Plans may offer a beneficiary the best option. These plans have been tailored to suit the needs of people who need to manage specific institutional conditions and/or chronic health conditions.
A beneficiary with Oregon Medicaid and Original Medicare may have to sign up for these plans. Typically, they come with a $0 premium and few out-of-pocket expenses.
Private Fee-for-Service Plan:
These plans are a little different from most Medicare Advantage plans and are not quite as popular. The insurance company determines how much it is responsible for and how much you will pay for things like doctor’s visits, hospital care and temporary skilled care in a nursing home or other similar facility.
Regardless of which type of Medicare Advantage plan in Oregon for 2019 you choose, you may want to look for a plan that includes a Medicare prescription drug plan. Medicare Part D prescription drug coverage is a great perk that is offered by many companies. It can save you a lot of money on medication, particularly if you have multiple prescriptions or if your medication is expensive.
Enrollment Statistics: Medicare Advantage Plans in Oregon
These enrollment statistics may help you understand the best choices that other beneficiaries with Medicare Part A and Part B make for their Oregon Medicare Advantage plans:
- Enrollment in Medicare Advantage plans in Oregon: 355,000
- Percentage: About 44 percent
- Popular choices for Oregon Medicare Advantage plans: HMOs and PPOs
Most plan options are available in highly populated areas, such as these five largest counties in Oregon. There are Medicare plans available for those who live in smaller and less populated areas — like Columbia county — though. No matter where you live, you should look for a company that does well on the 5-star rating system so that you’ll have the best coverage you can count on.
- Multnomah County, OR: 807,555
- Washington County, OR: 588,957
- Clackamas County, OR: 412,672
- Lane County, OR: 374,748
- Marion County, OR: 341,286
How Medicare Advantage Plans in Oregon Cover Prescription Medicine in 2019
Medicare Part A and Part B only help with prescription costs in specific instances. This gap in Original Medicare is one reason that they developed Medicare Advantage Prescription Drug plans or Part D plans. Many Medicare Part C plans in Oregon come bundled with prescription benefits along with medical benefits. Getting Part C that comes with a prescription plan may help beneficiaries enjoy all the coverage they need at cheaper rates than by buying separate policies.
As you compare your options for drug benefits, you should understand a few things about the drug plans that may come with Medicare Part C plans in Oregon for 2019 or can be purchased on their own. You will have a formulary that lists all of the medicine included in the plan. In addition, the insurance company will probably have Prescription Drug tiers that show you the different costs of generic vs. brand-name medicine.
Network Restrictions for Typical Oregon Medicare Advantage Plans
As noted above, HMOs and PPOs are the most common kind of Medicare Part C plans in Oregon. Medicare Part A and Part B don’t use a provider network. If you decide to enroll in Medicare Advantage, you should make sure that you can find a doctor and hospital on the network list, and be aware that you might not be able to continue seeing the same doctors if you sign up for one of these health plans.
These are important things to understand about managed care:
- With an HMO, you almost always need to use in-network medical services. The plan will make exceptions for medical emergencies. You may also need to visit your primary care physician to get a referral before you see specialists.
- With a PPO, you can save money if you stick with the network.
If you have only had Medicare Part A and Part B or another kind of insurance, you should make sure that you understand how your plan network works. You will also want to be aware of your monthly premium and look for a premium that you can easily afford.
Additional benefits for Medicare Advantage Plans in Oregon
One of the main reasons to consider Medicare Advantage over Original Medicare is because most plans come with prescription coverage. Besides helping to pay the doctor and hospital, they can also help pay the pharmacist.
Besides coverage for prescriptions, most plans also come bundled with additional money-saving perks that Original Medicare does not have. These might include:
- Discounts or insurance for routine vision and dental
- Hearing programs
- An assortment of wellness programs, like Silver Sneakers or nutritional plans
Companies offering The Best Medicare Advantage Plans in Oregon
We have been comparing Medicare Advantage plan providers for quite some time now in an effort to assist seniors from all over the country. During all of this time and throughout all of our research, some of the providers for Oregonians have really stood out. These are some favorites that we have found you should consider for 2019 and beyond:
This should make it easy to find coverage that you can count on, rates that you can afford and companies that you can trust.
Oregon Medicare Resources
If you are looking for a complete description of benefits that are included in your Medicare coverage, if you need information about the Medicare Part B premium or if you want other information about Medicare, these helpful resources can assist you. They can also give you some extra help with signing up for Medicare if you need it.
- State Medicare Contacts for Oregon
- Oregon Department of Seniors
- CMS: Centers for Medicare and Medicaid Services
Medicare can work as a stand-alone option, but many people find that it’s better to purchase additional coverage. We can help you find a plan that fits your needs. From the best Medicare Advantage plans in Oregon — either that do or don’t include prescription drug coverage — to Medicare Supplement plans, we’ll talk to you about all of your options so that you can make the right choice.