Original Medicare is a valuable resource when it comes to taking care of your health and finances. However, it still falls short of fully covering the bills that can pile up from even routine preventative care. For example, the 20% coinsurance for Medicare Part B and other out-of-pocket expenses associated with Original Medicare might end up being too much for you. As it is for many Medicare recipients. Your best bet in this case is to look into an Oregon Medicare Supplement Plan.
These plans are offered by private insurance companies, but all the plans they offer must be in compliance with government regulations and offer the same basic level of coverage. In fact, according to the rules set forth by the Centers for Medicare & Medicaid Services (CMS), all Medicare Supplement Plans bearing the same letter name must offer the same coverage to enrollees.
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But since premiums can vary widely from insurance company to insurance company, we highly recommend that you shop around before settling on a plan and an insurance provider. Our Oregon Medicare Supplement Plans Buyer’s Guide will make it easy for you to select the plan that best fits your needs. Once you’ve read it, give EZ a call and we’ll help you find the right plan at the right price for you.
Oregon Medicare Supplement Plans
If you need more coverage than what is provided by Original Medicare, you should look into purchasing a Medicare Supplement Plan.
There are ten of these plans to choose from (A, B, C, D, F, G, K, L, M, N). Whether or not all insurance companies in Oregon offer each of these plans, the state mandates that everyone have access to at least Plan A. Medicare Supplement Plans C and F are no longer available to new enrollees who became eligible for Medicare after January 1, 2020.
Below, we’ve compiled a list of all ten plans available to Oregon residents. Along with details about what each one covers and the associated monthly premiums.
Plan A
Plan A is the most basic of plans, and is available from every insurance company. It’s basic, but it covers the 20% of Medicare Part B outpatient costs that you are required to pay out-of-pocket when you access care.
In Oregon, insurance providers are required to offer Medicare Supplement Plan A to beneficiaries over 65, but they are not required to cover Medicare beneficiaries who are younger than 65.
Plan A costs between $91 and $399 a month in Oregon.
Plan B
Medicare Supplement Plan B covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Medicare Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period; after that, you are required to pay coinsurance for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day, days 91-150 (after you use your Lifetime Reserve days) have a coinsurance of $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
What makes Plan B a better choice for many people than Plan A is that it covers Medicare Part A deductibles, which Plan A does not. This deductible is high – $1,600 in 2023 – and it is possible that you will have to pay the Medicare Part A deductible more than once a year. That’s because the deductible is calculated on a 60-day basis rather than annually. Because of this, having coverage for this as part of your plan could be extremely useful.
Oregon residents can expect to pay between $148 and $344 monthly for their Plan B insurance premiums.
Plan C
Part C is one of the most all-encompassing Medicare Supplement Plans. But it is not available to all Medicare recipients. Except for Medicare Part B excess charges, all other out-of-pocket expenses are covered. Plan C covers the coinsurance for Parts A and B and the deductibles for both, along with everything else.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Plan C is no longer available to Medicare beneficiaries who became eligible after January 1, 2020. You can keep Plan C if you had it prior to that date. Additionally, if you were eligible for Medicare but didn’t enroll at that time, you may still be able to buy it.
Plan C premiums in Oregon range from $166 to $398 per month.
Plan D
Medicare Supplement Plan D covers the majority of out-of-pocket expenses associated with Original Medicare including:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023. Plan D covers this coinsurance.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
Plan D covers a lot, but it does not cover copayments or deductibles for Medicare Part B, and it does not cover Part B excess charges. If your doctor refuses to accept Medicare assignment and bills you for more than Medicare will cover, you will be responsible for the difference, known as Part B excess charges. Since excess charges are not covered by Plan D, you should look into another plan if you think you might be seeing doctors who do not accept Medicare assignment.
Oregon’s Plan D prices range from $128 to $312 per month.
Plan F
Plan F has been the best selling plan for a long time because of its comprehensive coverage. The monthly premium for Plan F is all you’ll have to pay out-of-pocket for this coverage. All of the following are covered by this plan:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
Medicare beneficiaries who became eligible after January 1, 2020 no longer have access to Plan F. These plans are available to anyone who became Medicare-eligible before 2020. Those who currently have Plan F can keep it indefinitely.
Plan F premiums in Oregon range from $146 to $438 per month.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
Plan G only excludes the Medicare Part B deductible. Making it a plan that covers a huge amount without breaking the bank. In fact, Plan G premiums are typically between $121 and $372 per month. Making it less expensive than Plan F.
Plan K
Medicare Supplement Plan K reduces your out-of-pocket expenses. However, it does not completely fill the gaps in Original Medicare. Plan K only covers half of the following costs:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% coinsurance. For example, if your doctor charges $100 for a service, Medicare Part B will cover $80, Plan K will cover $10, and you will pay the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800.
Plan K has some higher out-of-pocket expenses than other plans do. However, it has one great feature that they do not: an out-of-pocket maximum. This out-of-pocket maximum is $6,620 (as of 2023). Once you have spent this much on healthcare in a year, your Plan K will cover all of your approved expenses. Your yearly limit will be reset at the start of each calendar year.
And, although Plan K only covers half of your out-of-pocket expenses, it does cover the Medicare Part A coinsurance in full. So, if you do end up having a hospital stay longer than 60 days, you will be covered.
Plan K premiums in Oregon are lower than those of most other plans, ranging from $45 to $137 a month.
Plan L
Medicare Supplement Plan L helps cover some but not all of your out-of-pocket expenses. However, it covers them at a higher percentage than Plan K does. Plus, Plan L is the only other plan with an out-of-pocket maximum, which is lower than Plan K’s ($3,310 in 2023). So, you’ll have to pay less out-of-pocket to get your insurance company to fully cover your medical expenses.
Plan L fully covers Part A deductibles and copayments. It also includes:
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period . You must still meet your Medicare Part B deductible, which is $226 per year in 2023, if you choose Plan L.
Medicare Supplement Plan L premiums cost between $92 and $243 a month in Oregon.
Plan M
Plan M covers the majority of your Original Medicare out-of-pocket expenses, but not all, although it fully covers more than either Plan K or Plan L do. It covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A hospital expenses and coinsurance
- Part A deductible – While Medicare Supplement Plan M covers most Part A costs, it will only cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
The cost of plan M premiums in Oregon is typically between $137 and $283 per month.
Plan N
Plan N is another great comprehensive choice. The only things not covered by Plan N are the Medicare Part B deductible ($226 in 2023) and Medicare Part B excess charges. Which are portions of medical bills that exceed the Medicare-approved amount. With that being said, though, Plan N does have copayments for some Medicare Part B services, which most other plans do not.
Medicare Supplement Plan N covers the majority of the costs associated with the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
The price for Plan N ranges from $96 to $301 a month in Oregon.
When to Enroll
There is no one universal Medicare Supplement Plan annual enrollment period. However, once you turn 65 and enroll in Medicare Part B, you will be given guaranteed-issue rights for Medicare Supplement Plans under federal law. This means that, during your personal Medicare Supplement Open Enrollment Period (which lasts for six months), insurance companies cannot deny you or charge you more for coverage based on your health.
People who want to change Medicare Supplement Plans are generally subject to medical underwriting. Which means that healthy people can easily switch plans. However, those with pre-existing medical conditions may not be able to. To address this, Oregon enacted a “birthday rule” in 2013 that gives Medicare Supplement Plan enrollees an annual opportunity to switch to a plan with equal or fewer benefits within 30 days of their 65th birthday each year.
Oregon also gives Medicare beneficiaries under 65 a six-month window (after enrolling in Medicare Part B) to obtain a Medicare Supplement Plan with guaranteed-issue rights. In addition, premiums for those under 65 cannot exceed the premiums charged to enrollees over 65. It’s important to note that, under federal rules, people under the age of 65 who are eligible for Medicare due to a disability or have end-stage renal disease or ALS are not guaranteed access to Medicare Supplement Plans.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and give you all the information you need. EZ can assist you in enrolling in Medicare, looking for an Oregon Medicare Supplement Plan, or simply weighing your options. Our agents work with the best insurance companies in the country. They can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs with you and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
