by Russell Noga | Updated March 6th, 2024
If you’re navigating Medicare supplement plans in Portland, quick and accurate answers are essential. What plans will cover your healthcare gaps? How much will they cost? Can you find a plan that aligns with your budget? In the following guide, we break down the specifics of Portland’s Medigap offerings, detail the costs you can expect, and provide insights on selecting the best Medicare supplement plans in Portland for your situation without relying on sales fluff or overwhelming jargon.
Key Takeaways
- Medicare Supplement plans in Portland (Medigap) fill gaps in Original Medicare, providing consistent benefits across private insurers, and Oregon offers strong consumer protections for these plans.
- Plan G is a popular choice in Portland for its comprehensive coverage and may include a high-deductible version; while Plan F continues to interest existing beneficiaries due to its extensive coverage after the deductible is met.
- The cost of Medigap plans in Portland varies based on factors such as age, gender, and tobacco use, with average premiums ranging from $90 to $170 per month, and the enrollment period beginning at age 65 when enrolled in Medicare Part B.
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Understanding Medicare Supplement Plans in Portland
Medicare Supplement plans, often referred to as Medigap, serve a significant function in the healthcare sector. They are offered by Medicare-approved private insurance companies and complement Original Medicare by filling in the gaps of cost-sharing requirements. More specifically in Portland, these plans cover:
- Out-of-pocket costs that are not fully covered by Original Medicare Parts A and B
- Deductibles
- Copays
- Coinsurance for medical services and hospitalization.
Regardless of the private insurance provider or location, each standardized Medigap policy provides consistent benefits across diverse areas. Oregon, in particular, provides strong consumer protections for Medigap plan holders, including the right to change plans and guaranteed coverage for individuals under 65 with disabilities without increased premiums.
Key Benefits of Portland’s Medicare Supplement Plans
Medigap plans in Portland aim to cover Part A coinsurance and hospital expenses not entirely included in Original Medicare. They also cover Part B coinsurance or copayment, and the first three pints of blood needed for a medical procedure, thereby filling gaps left by Original Medicare. However, the benefits don’t stop there. Some Medigap policies offer coverage for Part B excess charges and emergency health services when traveling abroad, providing essential protection for unforeseen events.
Moreover, Plans K and L offer partial coverage, with Plan K covering 50% and Plan L covering 75% of costs like coinsurance and deductibles.
Navigating Through Plan Options in Portland
Portland residents have a wealth of options for Medicare Supplement plans, with ten standardized Medigap plans tailored to different health needs and financial circumstances. Each Medigap plan is coded by a letter, and even though these plans are offered by private insurance companies, they provide uniform benefits nationally as mandated by the federal government.
One key element to consider while choosing a Medigap plan in Portland is the pricing style, which can be:
- Attained-age: premiums are based on the beneficiary’s current age and could increase with age
- Issue-age: premiums do not increase with age after enrollment
- Community-rated: premiums are the same for all members of a community regardless of age
Understanding these pricing styles and estimating specific premiums for Medicare Supplement coverage in Portland can help you grasp the potential financial impact.
Popular Medicare Supplement Plans Among Portland Beneficiaries
In Oregon, beneficiaries can choose from 10 standardized Medigap plans, each offering unique price and coverage benefits. Among these, Plan F and Plan G are the most sought-after, with Plan F having the highest number of enrollees at over 100,000 and Plan G following with 32,939 beneficiaries.
The popularity of Plans F and G can be attributed to their comprehensive coverage, which includes regular and high-deductible versions to cater to different needs. Let’s delve a little deeper into these popular plans and their allure.
The Allure of Medigap Plan G in Portland
Medigap Plan G offers extensive Medicare coverage benefits, including:
- Part A coinsurance
- Part B coinsurance or copayment
- Skilled nursing facility care coinsurance
- 80% coverage for foreign travel emergency services
It excludes only the Part B deductible, making it quite attractive for new Medicare beneficiaries. The average monthly premium for Medigap Plan G in Portland ranges between $133.28 and $372.85, with premium costs varying based on several factors and insurers.
Medigap Plan F is favored by those eligible before January 2020 due to its coverage of the Part B deductible, but Plan G has become the popular comprehensive alternative for new beneficiaries. Interestingly, Plan G also includes a high-deductible option with a $2,700 deductible in 2023.
The Continued Interest in High Deductible Plan F
High Deductible Plan F offers extensive coverage after meeting the deductible, which includes Part A and B deductibles, Part B excess charges, and 80% of foreign travel exchange. Despite it being unavailable to new Medicare enrollees post-2019, existing beneficiaries in Portland continue to show interest in this plan.
High Deductible Plan F appeals to those who:
- Don’t frequently visit doctors or hospitals but seek extensive coverage
- Want a safety net against high-cost emergencies
- Want coverage for Medicare Part B excess charges, which is not widely available in other plans
This plan can significantly reduce the monthly premium to approximately $76, with a 2023 deductible of $2,490, compared to the average monthly cost of standard Plan F at $264.54.
For 2023, the annual deductible for High Deductible Plan F enrollees is $2,700, after which the plan covers Medicare-eligible expenses, also known as Medicare covered costs.
Cost Analysis: Medicare Supplement Plans in Portland
The cost of a Medicare Supplement plan in Oregon is influenced by several factors, including:
- Age
- Gender
- Tobacco use
- Payment terms
On average, it ranges from $90 to $170 per month. For example, for a 70-year-old male enrollee in Oregon, the average high-end premium for Plan G is $372 per month.
Moreover, a 65-year-old female beneficiary can enjoy some of the lowest average monthly premiums for Plan N, around $97 per month. Alternatively, choosing a high-deductible version like High Deductible Plan G (HDG) in Oregon can lower monthly premiums to as little as $27 per month. But remember, high-deductible Medicare Supplement plans reduce the monthly premium in exchange for a higher annual deductible.
What Influences Your Monthly Premium?
Your monthly Medigap premium in Oregon can be influenced by several factors. Medigap policies can be rated in three ways:
- Community-rated: These plans charge the same premium to everyone regardless of age, with the possibility of increases due to inflation and other factors.
- Issue-age-rated: These policies base the premium on the individual’s age at the time of policy purchase, with premiums not increasing due to age but potentially due to inflation and other factors.
- Attained-age-rated: These policies have premiums that increase as the individual grows older, along with potential increases from inflation and other factors.
Other individual factors such as age, gender, smoking status, and chosen payment terms also affect the average cost for a Medicare Supplement plan in Oregon, with monthly premiums typically ranging from $90 to $170. Premiums for High Deductible Plan F can vary widely but are generally more affordable than standard Plan F, with costs impacted by age, gender, location, and tobacco use. Your specific insurer and the state of residence are additional factors that affect the costs and availability of Medigap plans in Oregon.
Comparing Costs Across Different Plans
Comparing average monthly premiums for different Medigap plans in Portland can help residents make an informed decision. Here are the average monthly costs for Medicare Supplement plans in Portland:
- For 65-year-olds: $139
- For 75-year-olds: $242
- Plan G: $150.90 per month for 65-year-olds
- Plan N: $139.30 per month for 65-year-olds
Monthly premiums for Plan G for a 65-year-old female non-smoker range from $129 to $330.
Manhattan Life offers some of the lowest average premiums for Medicare Supplement plans in Oregon:
- Plan F: $146 per month for a 65-year-old female beneficiary
- Plan G: $121 per month for a 65-year-old female beneficiary
- Plan N: Approximately $97 per month for a 65-year-old female beneficiary
These affordable options make Manhattan Life a great choice for Medicare Supplement coverage in Oregon.
High Deductible Plan G (HDG) in Oregon offers lower monthly premiums at potentially as little as $27 per month, but with a significantly higher annual deductible.
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Enrollment and Eligibility for Portland Residents
To be eligible for a Medicare Supplement plan in Oregon, you must:
- Be enrolled in both Medicare Part A and Part B
- Live in the state where the Medicare Supplement plan is being sold to qualify for enrollment
- The initial six-month Medigap open enrollment period in Oregon begins when you are at least 65 years old and are enrolled in Medicare Part B as well as Part A.
If you enroll in a new Medigap plan, it will automatically cancel your enrollment in any Medicare Advantage plan you are currently part of, and you should inform your current provider about the switch. Insurance companies in Oregon have the right to conduct medical underwriting, which can affect the eligibility and premiums of Medicare Supplement plans.
Remember, you are only allowed to have one Medicare Supplement plan at a time in Oregon. The best time to purchase Medicare Supplement Insurance in Portland is as soon as you become eligible for Medicare and are enrolled in Parts A and B.
When to Enroll in Medicare Supplement Plans
The Medigap Open Enrollment Period in Portland is the optimal time to enroll in a Medicare Supplement plan. This period starts on the first day of the month you turn 65 and are enrolled in Medicare Part B and lasts for six months. An insurance company is not allowed to deny coverage or charge higher premiums based on an individual’s health problems during this period. This regulation helps ensure that individuals can access necessary insurance without facing discrimination..
If you miss the Open Enrollment Period, you may be subject to medical underwriting when applying for a Medicare Supplement plan and could face potential denial of coverage or higher premiums, especially if you have pre-existing conditions.
Qualifying for a Medicare Supplement Plan
To qualify for a Medicare Supplement plan in Portland, you must:
- Be enrolled in both Medicare Part A and Part B
- Oregon offers stronger consumer protections for Medigap plans compared to other states
- In certain situations, you have guaranteed issue rights to purchase a Medigap policy, regardless of your health or preexisting conditions
- This means you are entitled to buy a Medigap policy without being denied coverage or charged higher premiums due to your health status
What’s more, Oregon Medicare Supplement plans require insurance companies to offer Medicare Supplement plans to those under 65 who qualify for Medicare due to disability or End-Stage Renal Disease (ESRD), ensuring coverage without higher premiums.
Choosing an Insurance Provider for Your Medicare Supplement Plan
Selecting an appropriate insurance provider for your Medicare Supplement plan is a fundamental step. Top-rated insurance companies in Portland, like:
- UnitedHealthcare
- Aetna
- Blue Cross Blue Shield
- Humana
Our company offers Medicare Supplement plans that stand out for their benefits and customer satisfaction, as well as Medicare Advantage plans tailored to your needs. We also provide Medicare Supplement insurance plans to ensure you have the best coverage options available.
These companies offer a variety of medical insurance plans, each with its unique features and benefits. Therefore, it’s essential to assess your individual healthcare needs and financial situation and choose a plan that best suits them.
Assessing Top Insurance Companies in Portland
Evaluating leading insurance companies in Portland can aid you in identifying the most favorable Medigap rates and coverage. Companies like UnitedHealthcare provide a Select Plan G option in Portland with a monthly premium averaging $146.01, offering affordability with network restrictions. Manhattan Life and State Farm present the least expensive average monthly premiums for Plan N in Oregon, approximately $97 for a 65-year-old female beneficiary.
Moreover, Manhattan Life offers the most affordable average premiums for Plan F and G, at $146 and $121 respectively per month for a 65-year-old female in Oregon. Other carriers that offer competitive rates for Plan F, G, and N in Oregon include:
- AARP
- State Farm
- Moda Health
- Cigna
These carriers cater to various demographics in Oregon.
Making an Informed Decision on Providers
It is vital to make a well-informed decision regarding Medicare Supplement providers, and fortunately, Oregon residents have the benefit of consulting with impartial, trained counselors. These professionals can assist you in understanding the various plans and providers, helping you make the best decision based on your individual needs.
In Oregon, licensed insurance agents assist individuals by comparing rates for free from all Oregon Medicare Supplement providers. This service helps individuals make informed decisions about their insurance options. By leveraging these resources, you can ensure that you are getting the best coverage at the best price.
Enhancing Your Coverage with Additional Benefits
One might question whether you can augment your Medicare Supplement plan with supplementary benefits. The answer is yes. Some Medicare Supplement plans in Portland offer coverage for Part B excess charges, which occur when healthcare providers legally charge more than the Medicare-approved amount for services.
Moreover, some Medicare Supplement plans in Portland may include coverage for emergency medical care when traveling outside the United States, a feature that is particularly valuable since Original Medicare usually doesn’t provide coverage for healthcare services abroad.
Understanding Extended Coverage Options
Medigap plans in Oregon typically extend coverage for Medicare Part A hospital inpatient costs for up to an additional year after Medicare benefits are exhausted and often cover Part B coinsurance for services like doctor office visits. Plan N is available in Portland and covers Part A coinsurance and hospital costs, Part B coinsurance or copayment, and 80% of foreign travel exchange emergencies, but it does not include coverage for Part B deductibles or Part B excess charges.
Medigap Plan G is highly regarded for offering an out-of-pocket limit that protects Portland beneficiaries from incurring excessive medical expenses. Plans K and L pay 100% of covered services for the rest of the calendar year once the yearly limit and Part B deductible are met. If you frequently travel abroad, consider Medicare Supplement plans that offer foreign travel emergency coverage, as Original Medicare generally does not cover medical services received abroad.
Evaluating the Need for Extra Benefits
The necessity for extra benefits, such as coverage for Part B excess charges, may be contingent on one’s health conditions. For instance, if you frequently travel abroad, you may benefit from Medigap plans that offer foreign travel emergency coverage. Similarly, if your healthcare providers often charge more than the Medicare-approved amount for services, you might need a Medigap plan that offers coverage for these Part B excess charges.
Evaluating your individual needs and lifestyle can help you choose the most suitable Medigap plan. Whether you need basic coverage or additional benefits like foreign travel emergency coverage, there is a Medigap plan out there that fits your needs.
Summary
Choosing a Medicare Supplement plan in Portland doesn’t have to be a daunting task. By understanding the key benefits and options of different plans, assessing top insurance companies, and evaluating the need for extra benefits, you can find the plan that best suits your health needs and financial situation. Remember, it’s all about ensuring you have the coverage you need to enjoy a healthy, worry-free life.
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Frequently Asked Questions
What is the most popular Medicare Supplement plan for 2023?
The most popular Medicare Supplement plan for 2023 is Medigap Plan G, offering standardized coverage and payment after Medicare pays.
How much does Plan G cost in Oregon?
The monthly cost of Medicare Plan G in Oregon varies from $72 to over $300 based on factors like age and tobacco use.
What is the average monthly cost of a Medicare Supplement plan?
The average monthly cost of a Medicare Supplement plan varies based on the specific plan and the beneficiary’s age. For example, the average cost of Medicare Supplement Plan G ranges from $128.44 to $215.37 per month based on the beneficiary’s age.
Which Medicare Supplement plan has the highest level of coverage?
Medicare Supplement Plan F is the highest level of coverage, providing 100% coverage of Medicare-covered medical expenses after Original Medicare pays its portion.
What is a Medicare Supplement plan?
A Medicare Supplement plan, also known as Medigap, is an insurance plan offered by Medicare-approved private insurance companies to fill in the gaps of cost-sharing requirements in Original Medicare.
Speak to the Professionals about Medigap Plans and Original Medicare
If you find understanding the benefits involved with Original Medicare and Medigap Plans challenging, you’re not alone. Whether it’s a Medigap plan, or you want to know more about the best Medicare Supplement Plans in Portland, we can help. Call our team at 1-888-891-0229 for a free consultation or complete the contact form on this site, and an expert will call you back at a convenient time.
We have decades of experience advising our clients on the complexities of Medicare and Medigap plans, the benefits, cost and deductibles. We’ll ensure you get the best rate in your state and advice you can trust.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.