Medicare in Oregon

Oregon may have gotten its start as part of the wild west, but you don’t have to worry about pioneering new frontiers when it comes to healthcare in your later years or times of need.

Residents who are aged 65 and up or qualify for disability benefits have several Medicare plans to choose from based on their health and financial situation. GoHealth agents licensed in Oregon can help you choose a plan that meets your needs.

If you are a U.S. resident aged 65 or older, or qualify for Social Security benefits due to a disability, you can enroll in Medicare. Circumstances that allow you to be eligible for Medicare before age 65 include:

• Securing a disability designation from the Social Security Administration or the Railroad Retirement Board for at least 24 months before enrollment.

• You have end stage renal disease (ESRD) and require kidney dialysis or have received a kidney transplant.

Medicare is a federal healthcare program, so eligibility rules are the same in every state. Plans offered in Oregon include Medicare Part A  to cover hospital and inpatient medical care, and Part B  to cover preventive care and outpatient services.

Some parts of Medicare might not cost you, but it depends on how long you worked and paid into the Medicare system through your taxes. Medicare Part A is usually called the “premium-free” portion, but you will still pay a share for services as you receive them. Other parts of Medicare have premiums that apply, but what you pay will be based in large part on your income level.

Is Oregon Health Plan covered by Medicare?

Oregon Health Plan is the state’s Medicaid plan for low-income individuals or people with special healthcare needs. Medicaid is another public health insurance program that is state-specific. People in low-income groups or with special healthcare needs may qualify for coverage under both Medicare and Medicaid. People who fall into this category are called dual eligible.

U.S. citizens in every state have access to Medicare because it is a federal public health insurance program. There are requirements to be eligible, including age or disability level, but if you meet this criteria, you can use Medicare in any state—including Oregon. Medicare Advantage plans, which are private insurance plans that combine basic Medicare services with additional programs, vary by state.

Medicare in Oregon offers coverage for medically necessary inpatient and outpatient health care services. Like every state, everyone is entitled to receive Original Medicare, or Medicare parts A and B, when they turn 65, or if they meet other health-specific criteria. Additional programs, like prescription drug plans, are also part of the Medicare portfolio, but availability and pricing of these plans may vary by state, or even zip code.

A Medicare Advantage plan is a private insurance product sometimes referred to as Medicare Part C. This can be misleading, because Medicare doesn’t directly offer these plans. Private insurance companies offer Medicare Advantage plans. Part C combines Medicare Part A and Part B services along with other add-ons like prescription drug coverage, dental care, and hearing aid services. Part C allows you to sign up for all your services under one plan, instead of signing up for each plan on your own. There are many options for Medicare Advantage plans, and it depends on where you live. A GoHealth licensed insurance agent can help you find the right plan for you in your area.

There is no “best” Medicare plan. There are many options available, whether you choose Original Medicare or a Medicare Advantage plan. A GoHealth licensed insurance agent can discuss your needs and help you find the right coverage for your situation. Be sure to consider your health in future years, and not just what your immediate healthcare needs might be.

There are a variety of Medicare plans available in Oregon. These include:

• Medicare Part A, which covers inpatient care and hospitalization.

• Medicare Part B, which covers outpatient care and medical equipment.

• Medicare Part C, or Medicare Advantage plans, that combine Parts A and B with additional coverage like Part D, hearing, vision, and dental.

• Medicare Part D, which is Medicare’s prescription drug program. This plan may be included in a Medicare Advantage plan, or added to Original Medicare.
• Medigap, or Medicare Supplement insurance, which you can add on to Original Medicare only and can be used to help cover your out-of-pocket costs.

This depends on what your needs are. There are many Medicare Advantage plans available based on your income, needs, and where you live. Talk to a GoHealth agent to review what plans are available in your zip code that best fits your needs.

There are more than 300 Medicare Advantage plans offered in Oregon by 15 different insurance companies. While you won’t be eligible for every plan, there should be at least several options available in the area you live. A GoHealth agent can help you find and compare your options.

What is the downside to Medicare Advantage plans?

Medicare Advantage plans let you pay one price for all your Medicare services in one plan, but there are some drawbacks to that convenience. Medicare Advantage plans may dictate where you receive coverage in terms of specific hospitals or provider networks. You can choose plans that charge higher premiums with lower deductibles and vice versa. You can change your Medicare Advantage plan if your needs change, but there are only specific periods each year when you can sign up, drop, or change your Medicare Advantage plan.