Oregon Original Medicare Health Plans


Want to get yourself enrolled in a Medicare Health Plan in Oregon?

O'Neal Insurance Group is here with all the information you need to make a wise decision!

oregon map

An Overview of Original Medicare Health Insurance in Oregon

According to the Centers for Medicare and Medicaid Services, below is a list of some useful statistics related to Medicare enrollment in Oregon as of September 2019.

  • More than 471,000 beneficiaries in Oregon have been enrolled in the Original Medicare Health Plan (Part A and/or B)
  • When it comes to Medicare Advantage Plans or other health plans, the number of Oregon beneficiaries is over 396,000
  • The total number of beneficiaries enrolled in Medicare plans in the state is more than 868,000
  • Over 654,000 beneficiaries have opted for Medicare Part D
  • More than 375,000 beneficiaries are enrolled in Medicare Advantage Plans that also offer prescription drug benefits
  • Over 278,000 beneficiaries have opted for a stand-alone Medicare Prescription Drug Plan

Different Medicare Health Plans in Oregon

Whether you’ve recently met Medicare eligibility requirements or are already an Oregon beneficiary, you may wonder what different options you have to choose from to maximize your health insurance.

Below is a list of the Medicare Health Plan options in Oregon:

  • Original Medicare Plan (Part A)

    Part A refers to the hospital insurance part of the Medicare scheme. This federal plan offers basic coverage for hospitals, doctors, and other healthcare facilities that accept Medicare. This means that you’ll get hospital meals, medications, and nurse care covered. In return, you’re required to pay a certain fee. This plan may also cover in-house treatment costs in some serious cases.

  • Original Medicare Plan (Part B)

    Part B offers medical insurance i.e. coverage for healthcare costs that are incurred when you’re not in the hospital. This generally includes the costs of visiting the doctor, ambulance services, special medical supplies, and lab tests.

    To receive both hospital and medical insurance, beneficiaries typically take Part A and B together. These plans don’t cover the costs of dental and eye check-ups, prescriptions, and custodial care.
  • Medicare Advantage Plan (Part C)

    Medicare Advantage Plans are alternative plans offered by private insurance companies in collaboration with Medicare. These plans offer extra perks, such as routine dental and eye check-ups and prescription care along with the standard benefits from Original Medicare Health Plans.

  • Medigap (Medicare Supplement)

    This supplemental plan covers extra healthcare costs that aren’t covered by the basic plans. You can apply for this plan to get your copayments, coinsurance, and deductibles covered.

  • Medicare Prescription Drug Plan (Part D)

    Part D covers the costs of prescriptions given by a healthcare provider for prolonged treatment. After checking the list of drugs for your specific service area, you can simply apply for a stand-alone Part D plan that complements your Original Medicare plan. You can also use Part D as an extension of the Medicare Advantage Plan.

Eligibility Criteria for Medicare Health Plans In ORegon

All U.S. citizens are eligible to apply for Medicare Health Plans in Oregon. Individuals with a permanent legal U.S. residency for five continuous years also qualify. Additionally, below are the eligibility requirements:

  • Residents aged 65 and above with social security automatically qualify for the Original Medicare Plan
  • Residents who have been paying Medicare taxes for the last ten years get Part A for free
  • A premium fee is required for part B
  • Residents with a prolonged disability who have been receiving social security disability for two years also qualify, even if they aren’t 65 yet
  • Residents suffering from Chronic Kidney Disease (stage 5) also qualify regardless of their age

After enrolling for Original Medicare plans, you can apply for Part C and D. To avail full benefits, the health plan and its services need to be on your zip code.

Medicare Advantage Plans

Maximize your medical coverage with the right advantage plan.

To enjoy the standard benefits along with extra perks under Medicare Advantage Plans, you’ll have to pay copayments, deductibles, and coinsurance. These plans come with a lower premium though.

The two common Medicare Advantage Plans are:

elderly patient

1. Health Maintenance Organization (HMO)

HMO is a network of healthcare providers that offer reduced rates for beneficiaries. This means that you’ll have to pay the bills yourself if you consult with any healthcare provider outside the network. Note that you’ll need a reference from your primary care provider to be referred to a specialist.

2. Preferred Provider Organization (PPO)

PPO offers increased flexibility by allowing you to choose a healthcare provider of your choice. You may, however, get a reference from your primary doctor to enjoy even lower rates. Note that choosing a doctor outside of the network will result in additional costs.

Signing Up For A Medicare Health Plan In Oregon

In case you don’t have social security, you’ll have to call them or enrol through the website. Even if your employer is offering healthcare benefits you can qualify for Medicare Part A.

The following are the three enrollment periods during which you can apply for a health plan:

  • Initial Enrollment

    Starting three months before you turn 65, this period lasts for 7 months.
  • Special Enrollment

    In case you missed the initial enrollment period because of spousal or group insurance, you qualify for a special period. It starts when your coverage ends and lasts for 8 months.
  • General Enrollment

    Every year, from January to March, you can apply for a Medicare Health Plan to start receiving coverage from 1st July.

As an eligible candidate, if you don’t sign up for Part B during initial enrollment, you’ll face a 10% penalty for each year you wait. This penalty will last for the entire Medicare coverage period.

Need Help With Your Medicare Health Plan In Oregon?

At O’Neal Insurance Group, our experts are more than willing to share the necessary knowledge and resources regarding Original Medicare Health Plans in Oregon with you. We’ll determine your specific medical needs and requirements to help you choose the best health plan option that secures your future.

The best thing? Our initial consultation session is absolutely FREE.

Are you ready to enroll in a Medicare Health Plan?

Book a free consultation to make the best decision.

Or call 1-888-966-8579 to schedule an appointment.

Insurance Carriers

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