Find 2020 Medicare Plans in Oregon - OR Medicare Insurance Overview

Medicare Insurance in Oregon

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Oregon Medicare Insurance

Oregon Medical Insurance Stats

Medicare in Oregon

Medicare offers healthcare coverage to Oregon residents age 65 or older, or to those Oregon residents that suffer from certain medical disabilities. In 2016, 753,000 people are enrolled in Medicare in Oregon, accounting for 18.6% of the population in Oregon. In 2009 approximately $8,247 was spent per Medicare enrollee in Oregon, about 20.43% lower than the national average of $10,365. Between 2015 to 2030 the senior population in Oregon is expected to increase by an estimated 49.29% according to calculations based off of the 2000 Census. Therefore the number of eligible Medicare beneficiaries in Oregon is also projected to increase.

Local Medicare Resources

Medicare beneficiaries, their families, and their caregivers who reside in Oregon can receive free, one-on-one, and unbiased health insurance counseling from the Senior Health Insurance Benefits Assistance program (SHIBA). Additionally, the state has a Senior Medicare Patrol (SMP) program which is dedicated to educating and empowering individuals on how to identify, avoid, and report instances of healthcare fraud, errors, and/or abuse.

Types of Medicare Coverage

Individuals that qualify for Medicare can sign up for Medicare Part A & Part B (medical services) through the Federal government. Part A is generally paid for by paycheck deductions from their working years (or their spouse's) but most Medicare beneficiaries pay for Part B through monthly premiums unless they qualify for financial assistance. If you are eligible for Original Medicare (Parts A & B) or if you are already enrolled in it, you also have the option to enroll in a Medicare Advantage plan (Part C) instead of Original Medicare or add a stand alone prescription drug plan (Part D) to your current Original Medicare coverage. Medicare Advantage and Medicare Part D insurance plans are sold by private insurance companies that have a contract with Medicare. Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. Many Medicare beneficiaries will elect to enroll in a Medicare Advantage plan that includes prescription drug coverage (MAPD) or purchase a stand alone prescription drug plan to go with their Original Medicare coverage. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Additional benefits of Medicare Advantage plans such as dental, vision, or hearing coverage can help reduce out-of-pocket expenses for seniors with certain medical needs.

Oregon 2017 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2017 Medicare Advantage plan in Oregon is $78.02, 24.87% greater than the national average of $62.48. 13.37% of 2017 Medicare Part C insurance plans in Oregon have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2017 Medicare Advantage plan with a drug component is $400, but in Oregon the average annual drug deductible for Medicare Part C insurance plans with drug components is $139.84. 24.83% of 2017 Medicare Part C insurance plans with a drug component in Oregon have a $0 annual drug deductible.
  • The average total monthly premium for a 2017 Medicare Advantage plan without a drug component in Oregon is $35.11. 13.56% of 2017 Medicare Part C insurance plans without a drug component in Oregon have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2017 Medicare Part C insurance plans in Oregon is $4337.53. 49.01% of 2017 Medicare Advantage plans in Oregon had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in Oregon was 4 stars in 2017.
  • Among Oregon's 2017 Medicare Advantage plans with CMS star ratings:
    • 4.46% earned a score of 5 stars
    • 51.73% earned a score of 4 or 4.5 stars
    • 40.59% earned a score of 3 or 3.5 stars
    • 3.22% of plans are “Not enough data available” or “Too new to be measured”.

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

There are 25 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in Oregon. Of these, the companies that offer the largest variety of plans to choose from are Providence Medicare Advantage Plans, PacificSource Health Plans, and Humana. In Oregon,ATRIO Health Plans has the largest selection of Medicare Advantage plans while Anthem BCBS offers the most Medicare Part D plans. The following are all medicare insurance providers in Oregon:

Providence Medicare Advantage Plans

11 Plans

Humana

10 Plans

Anthem MediBlue Rx (PDP)

6 Plans

Health Net Life Insurance Company

5 Plans

Aetna

4 Plans

Regence BlueShield of Idaho

3 Plans

Mutual of Omaha Rx

2 Plans

MII Life Insurance, Incorporated

2 Plans

Clear Spring Health

2 Plans

Blue Shield of California

2 Plans

Health Net Health Plan of Oregon, Inc.

1 Plans

EnvisionInsurance

1 Plans

Humana Honor (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
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ATRIO Bronze (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Regence MedAdvantage Basic (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
PacificSource Medicare Essentials 2 (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Health Net Aqua (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
Regence BlueAdvantage HMO No Rx (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Humana Gold Plus H1036-153 (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Regence BlueAdvantage HMO (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Aetna Medicare Elite Plan (HMO)
TYPE:HMOCOST:from $0CMS Rating:Not Rated
Select
Regence MedAdvantage + Rx Primary (PPO)
TYPE:PPOCOST:from $0CMS Rating:Not Rated
Select
PacificSource Medicare Essentials Rx 6 (HMO)
TYPE:HMOCOST:from $217CMS Rating:Not Rated
Select
HumanaChoice H5216-048 (PPO)
TYPE:PPOCOST:from $200CMS Rating:Not Rated
Select
ATRIO Gold Rx (PPO)
TYPE:PPOCOST:from $199CMS Rating:Not Rated
Select
Providence Medicare Latitude + RX (HMO-POS)
TYPE:HMO-POSCOST:from $196CMS Rating:Not Rated
Select
Moda Health PPORX Enhanced (PPO)
TYPE:PPOCOST:from $195CMS Rating:Not Rated
Select
PacificSource Medicare Essentials Rx 6 (HMO)
TYPE:HMOCOST:from $217CMS Rating:Not Rated
Select
HumanaChoice H5216-048 (PPO)
TYPE:PPOCOST:from $200CMS Rating:Not Rated
Select
ATRIO Gold Rx (PPO)
TYPE:PPOCOST:from $199CMS Rating:Not Rated
Select
Providence Medicare Latitude + RX (HMO-POS)
TYPE:HMO-POSCOST:from $196CMS Rating:Not Rated
Select
Moda Health PPORX Enhanced (PPO)
TYPE:PPOCOST:from $195CMS Rating:Not Rated
Select
PacificSource Medicare Essentials Rx 6 (HMO)
TYPE:HMOCOST:from $217CMS Rating:Not Rated
Select
HumanaChoice H5216-048 (PPO)
TYPE:PPOCOST:from $200CMS Rating:Not Rated
Select
ATRIO Gold Rx (PPO)
TYPE:PPOCOST:from $199CMS Rating:Not Rated
Select
Providence Medicare Latitude + RX (HMO-POS)
TYPE:HMO-POSCOST:from $196CMS Rating:Not Rated
Select
Moda Health PPORX Enhanced (PPO)
TYPE:PPOCOST:from $195CMS Rating:Not Rated
Select
PacificSource Medicare Essentials Rx 6 (HMO)
TYPE:HMOCOST:from $217CMS Rating:Not Rated
Select
HumanaChoice H5216-048 (PPO)
TYPE:PPOCOST:from $200CMS Rating:Not Rated
Select
ATRIO Gold Rx (PPO)
TYPE:PPOCOST:from $199CMS Rating:Not Rated
Select
Providence Medicare Latitude + RX (HMO-POS)
TYPE:HMO-POSCOST:from $196CMS Rating:Not Rated
Select
Moda Health PPORX Enhanced (PPO)
TYPE:PPOCOST:from $195CMS Rating:Not Rated
Select

The following are the most popular medicare doctors in Oregon based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
RadiologyMEDFORD, OR
RadiologySPRINGFIELD, OR
DermatologySALEM, OR
General PracticeBEND, OR
SurgerySALEM, OR
DermatologyBEND, OR
OphthalmologyASHLAND, OR
DermatologyPORTLAND, OR
DermatologySALEM, OR
DermatologyBEND, OR

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