We do not offer every plan available in your area. Currently, we represent 9 organizations which offer 25 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
MEDICARE COVERAGE OPTIONS
*You must be enrolled in Original Medicare (Part A and Part B), and continue to pay any applicable monthly premiums, in order to enroll in a Medicare Supplement (Medigap) Plan or a Medicare Advantage Plan. In 2023, the standard Part B premium amount is $164.90 per month (or higher depending on your income). For 2024, the standard Part B premium amount will be $174.70 per month.
Original Medicare (Part A and Part B):
Medicare Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery, home health care, etc.
Medicare Part B (Medical Insurance) covers doctor and other health care providers' services, outpatient care, durable medical equipment, home health care, and some preventive services.
Medicare does not cover everything and there is no limit on out-of-pocket costs. If you need services that Medicare does not cover, you will have to pay for those services out-of-pocket unless you have other insurance or a Medicare health plan that covers them. Some of the items and services Medicare does not cover include: Long-Term Care (also called custodial care), most dental care, eye exams related to prescribing glasses, dentures, cosmetic surgery, acupuncture, hearing aids and exams for fitting them, and routine foot care.
You can use any doctor or hospital that accepts Medicare, anywhere in the U.S. Medicare does not cover services provided outside of the United States, except in limited circumstances.
Medicare Supplement Insurance (Medigap):
Medicare Supplement Insurance helps fill "gaps" in Original Medicare and is sold by private insurance companies. Policies are standardized and in most states, named by letters, like Plan G or Plan K. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. A Medicare Supplement (Medigap) Insurance policy can help pay some of the remaining health care costs, like: Copayments, Coinsurance, and Deductibles.
The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. During that time, you can buy any Medigap policy sold in your state, even if you have health issues. This period automatically starts the month you turn 65 and are enrolled in Medicare Part B, and it can’t be changed or repeated. After this enrollment period, you may not be able to buy a Medigap policy.
PLEASE NOTE: Medigap plans sold to people new to Medicare can no longer cover the Part B deductible. Because of this, Plans C and F are no longer available to people new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020, but not yet enrolled, you may be able to buy one of these plans that cover the Part B deductible (Plan C or F). If you already have or were covered by Plan C or F (or the Plan F high deductible version) before January 1, 2020, you can keep your plan.
Oregon’s Medigap Birthday Rule:
Medicare beneficiaries have a yearly opportunity to compare Medicare supplement plan prices and switch companies. They must keep the same plan type or choose one with lesser benefits (i.e. Plan F to Plan F or Plan F to Plan G; NOT Plan G to Plan F).
The change is guaranteed, regardless of health, as long as premium payment is up-to-date with the existing carrier. The opportunity to compare prices and apply for a new Medigap plan generally starts on your Birthday and ends 30 days later. This rule does not apply to Medicare supplement policies issued before January 1, 1990.
Medicare Part D (Prescription Drug Coverage):
Medicare Part D helps cover the cost of prescription drugs (including many recommended shots or vaccines). You can enroll in a Medicare drug plan in addition to Original Medicare or you can join a Medicare Advantage Plan with drug coverage (MA-PD). Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.
Medicare Part C (Medicare Advantage Plans):
Medicare Advantage Plans are Medicare-approved plans offered by private insurance companies that offer an alternative to Original Medicare for health and drug coverage. Medicare pays a fixed amount for your care each month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.
These “bundled” plans include Part A, Part B and usually Part D. If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. In most cases, you’ll need to use doctors who are in the plan’s network. Plans may have lower out-of-pocket costs than Original Medicare. Plans may offer some extra benefits that Original Medicare does not cover, such as vision, hearing, and dental services. Plans can choose not to cover the costs of services that are not “medically necessary” under Medicare. If you’re not sure whether a service is covered, check with your provider before you get the service.
AEP (Annual Enrollment Period): October 15-December 7
The Annual Enrollment Period (AEP) for Medicare Advantage Plans and Prescription Drug Plans takes place October 15th through December 7th each year, with changes effective January 1st.
During AEP, you can make changes to your coverage, such as:
- Switching from Original Medicare to a Medicare Advantage Plan or switching from a Medicare Advantage Plan back to Original Medicare.
- Switching from one Medicare Advantage Plan to another Medicare Advantage Plan.
- Enroll in a Medicare Prescription Drug Plan.
- Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
- Switch from a Medicare Advantage Plan that does not cover prescriptions to one that does.
- Switch from a Medicare Advantage Plan that covers prescription drugs to one that does not.
- Drop your Medicare Prescription Drug Plan completely.
