If you are approaching 65, you might have started exploring the world of Medicare. Choosing the right healthcare plan is especially important as you get older. With so many Medicare parts, plans, and choices, it can all be pretty overwhelming! In this post, we’ll give you the rundown on Medicare Supplement (also known as Medigap) plans in Oregon, so you’re prepared for Medicare enrollment.
Medicare Supplement plans fill the gaps in Original Medicare coverage, reducing your out-of-pocket expenses. This guide will help you understand the different types of Medigap plans in Oregon and how you can choose the best one for your needs.
Medigap plans are standardized across the country, so plans of the same type are identical.
There are three pricing structures insurance carriers use to price their plans: community-rated, issue-age-rated, or attained-age-rated structures.
Oregon uses the birthday rule, a special Medicare Supplement enrollment option that allows people to change Supplement plans.
Take a look at our Oregon Medicare Guide for information on how to enroll in a plan, compare coverage options, and save money on healthcare costs.
While Original Medicare provides essential healthcare for many seniors, it doesn’t cover all of your healthcare costs. Generally, Original Medicare covers about 80% of the costs for covered services, and you’re responsible for paying the remaining 20%. With no out of pocket maximum, Original Medicare alone may leave you with expensive medical bills.
Medicare Supplement plans complement Original Medicare and help you cover the 20% of costs that Original Medicare doesn’t pay for.
Medigap plans are standardized, meaning the benefits of each type of plan are the same regardless of the insurance provider. For example, all Medigap Plan Ds provide identical coverage, regardless of insurance carrier.
Here are the ten Medicare Supplement plans you can choose from in Oregon, with links to detailed descriptions:
Medigap Plan C and Medigap Plan F are unavailable for beneficiaries who turn 65 after January 1, 2020.
Our Medigap comparison chart can help you to understand the differences between each plan type.
Although plans labeled with the same letter have identical benefits, your individual monthly premium will vary depending on the policy you choose and certain personal factors. So, once you choose the best plan for your needs, you should consider which makes the most sense for your budget.
In Oregon, the most popular Medigap plans are Plan G, Plan N, and Plan F. Each offers different levels of coverage:
Plan G: Offers comprehensive coverage, but does not cover the Part B deductible. Plan G is the most popular choice for those who turned 65 after January 2020.
Plan N: Similar to Plan G, but requires copayments for some services and doesn’t cover Part B excess charges. Generally, Plan N has lower monthly premiums than Plan G.
Plan F: Offers the most comprehensive coverage, including the Part B deductible. However, it's only available to beneficiaries who turned 65 before January 1, 2020.
While these plans are the most popular options, you should still compare all of the plan types. The right Medigap plan for you will address your medical needs, budget, and lifestyle. One of our licensed Medicare Advisors can help you find the right fit for you.
The cost of Medigap plans in Oregon can vary based on several factors including age, location, gender, tobacco use, and the specific policy you choose. On average, you can expect to pay between $150-200 each month, but the costs range from $40 (for a high-deductible Plan G) to $470 (for the highest-cost Plan D).
Medicare’s plan comparison tool lists all of the Medicare Supplement plans available in Oregon along with premium estimates. You can plug in your specific information to see your cost estimates.
It’s unlikely that you and your neighbor will pay the same monthly premium even if you’re both enrolled in the same plan. Other factors that can affect the price of your premium include:
When you enroll
Whether or not you live with someone who is also eligible for Medicare
Economic factors like inflation
Your policy’s pricing structure
There are three approaches insurance carriers can use to set their Medigap premiums. Depending on how the carrier prices the premium, your policy can either be attained-age rated, issue-age rated, and community rated. Since Oregon does not mandate insurers use a specific structure, most carriers use the attained-age rating structure to set their monthly premium. These plans use your current age to determine your monthly cost, which means premiums are lower when you first purchase the policy and increase as you get older.
In general, the best time to enroll in a Medicare Supplement plan is during your Medigap Open Enrollment Period, which is a six-month window after your Medicare Part B coverage begins. During this window, insurers can’t ask you questions about your medical history or deny you coverage for any reason. If you enroll outside of this timeframe you may have to undergo medical underwriting, which could result in higher premiums or denial for coverage.
Changing Medigap plans isn’t always easy. In many cases you will have to undergo medical underwriting to change plans. Luckily, Oregon uses the birthday rule, which allows Medigap recipients to make changes to their plan each year on their birthday and the following 30 days afterwards. During this period, insurance providers cannot deny your application.
Selecting the right Medicare Supplement plan requires careful consideration of your healthcare needs and budget. You may feel stressed by the many options and factors to consider. A Chapter Medicare Advisor can give you personalized advice and help you compare plans. Our advice is always free and our advisors always have your best interest at heart—give us a call at 855-900-2427 or schedule a chat to get started.