Medicare Advantage Plans in Oregon

Medicare Advantage (Medicare Part C) in Oregon is one plan that is bundled and includes the following parts:

Medicare Part A: Hospital insurance

Medicare Part B: Medical insurance

Medicare Part D: Prescription drug insurance


– Original Medicare comprises Part A and Part B. Medicare Advantage, as noted above, is made up of three parts Part A, Part B, and often Part D.

– Part C(Medicare Advantage) can include a prescription drug coverage plan (Medicare Part D). Private insurance companies offer Medicare Advantage Plans and provide healthcare providers with a network for Medicare beneficiaries.

– A Part C plan with prescription drug plans is known as an “MAPD” plan.

– If you have a disability or End-stage Renal Disease, you qualify for Medicare coverage even if you are younger than 65.

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Top-rated Medicare Advantage Providers in Oregon

  • Humana
  • Health Net
  • Humana
  • Regence BlueAdvantage
  • FamilyCare
  • Cigna
  • Aetna

Popular Medicare Advantage Plan Types in Oregon

Below are what we consider the best plans for each category of in-network service area freedom, lowest out-of-pocket, and best for those with a low income.

Best for network freedom: Medicare Advantage PPO

PPO plans have benefits such as more extensive networks and do not require Medicare beneficiaries to obtain referrals to see specialists. A monthly premium will cost $0 to $100.

Best for lowest out-of-pocket: Medicare Advantage HMO Plan

HMO benefits include HMO Premiums that usually cost $0 per month. They also have lower out-of-pocket costs since they utilize an HMO referral network.

Best for low income or health conditions: Medicare Advantage D-SNP

For those with low income or health conditions, the Special needs plan (SNP) will help with costs associated with Part B premium, copays/coinsurance, deductibles, and monthly premiums. With this plan, you have Medicare and Medicaid to help with expenses.

Oregon Enrollment Facts:

1. Number of people enrolled in Medicare Advantage in Oregon: 410,951

2. Number enrolled by plan, specifically the three plans below:

Local HMO: 236,747

Local PPO: 124,995

Regional PPO: 0

3. Percentage of Medicare beneficiaries enrolled in Medicare Advantage in Oregon: 47%

4. Number of people enrollment in Medicare Advantage nationwide: Expected to reach 29.5 million in 2022

5. Percentage of Medicare beneficiaries enrolled in Medicare Advantage nationwide: 42%

How much does Medicare Advantage in Oregon cost?

In most states, HMO and PPO plans have a $0 per month premium. For PPO plans, though, it is becoming more common for them to have a monthly premium. Plan availability varies from county to county in Oregon. The average Medicare plan with a prescription drug plan costs about $63.44. The average 2022 MAPD premium nationwide is $62.66 per month

How much do Advantage Plans cost in Oregon?

PPO Plan $0.00 to $63.44

HMO Plan $0.00

When can I enroll in a Medicare Advantage plan?

There are several enrollment periods during the year at which you can join Medicare, and they are:

– Initial Enrollment Period

– Open Enrollment Period

– Medicare Advantage Open Enrollment Period

– Special Enrollment Period/Special Circumstances

– 5 Star Enrollment Period

– Special Enrollment Period/Extra Help

Note: The Centers for Medicare and Medicaid Services will not inform you that you are eligible for enrollment.

Initial Enrollment Period

– Eligibility occurs are 65 for Medicare Part A and Medicare Part B

Open Enrollment Period – AKA Annual Election Period

– October 15th until December 7th/Coverage starts January 1st

– During this time, you can join, drop, or make changes to an Oregon Medicare Advantage Plan. The plan must be complete by December 7th for coverage to start 1/1.

Medicare Advantage Open Enrollment Period

– January 1st until March 31st

-During this period, you can switch plans or join Original Medicare or a Medicare Supplement plan in Oregon.

Special Enrollment Periods/Special Circumstances

-Special circumstances are any of the following:

  • Address change
  • The plan changes with Medicare
  • Current coverage is lost
  • Coverage with an employer (VA/Tricare/PACE)

Other special considerations may also include eligibility for both Medicare and Medicaid or Extra Help, State Pharmaceutical Assistance Program enrollment, dropping a Medigap plan, special needs, or a disability.

5-star Special Enrollment Period

December 8th until November 30th

– This five-star rating enrollment period can be used once

– These plans are rated with satisfaction surveys to determine quality and performance

– The five-star rating is the highest rating to be given.

Special Enrollment Periods/Extra Help

– Extra Help is defined as qualifying for extra help, eligibility for Medicare or Medicaid, or enrollment into the State Pharmaceutical Assistance Program.

Medicare Advantage Highlights:

Insurance carriers provide Part C plans and benefits within a network of providers that include:

– Hospitals

– Health care wellness facilities

– Primary care physicians

Over the past few years, there has been a rise in Medicare Advantage Plans in Oregon. So much so that they have surpassed Original Medicare.

The popularity of this plan is primarily due to the additional coverage provided. Specific Medicare Advantage health insurance plans have other benefits such as:

  • Vision and hearing
  • Dental
  • Gym memberships – SilverSneakers
  • Telehealth visits

Ready to Learn More?

We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.

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