September 16th 2024
By Ari Parker
Learn what you need to know to choose the best Oregon Medicare Advantage plan for your needs based on your needs and personal factors.
By Ari Parker
When you enroll in Medicare, you can stay on Original Medicare (made up of Part A & Part B), or you can switch to a Medicare Advantage plan (also called Part C). If you stay on Original Medicare, you may also enroll in a Medicare Supplement plan. You should consider the pros and cons of Medicare Advantage and Original Medicare before choosing your coverage. This Oregon Medicare Advantage guide will give you a complete summary of the Medicare Advantage plans in Oregon, the pros and cons of Medicare Advantage, and how to choose between the best Oregon Medicare Advantage plans.
59% of Medicare beneficiaries in Oregon choose to enroll in Medicare Advantage plans.
There are 105 Medicare Advantage plans in Oregon, but plan availability varies by county.
Medicare Advantage plans are popular because of the extra benefits they provide.
One of the biggest disadvantages of Medicare Advantage plans is that they can limit your access to care with limitations like prior authorization requirements and provider networks.
The best Medicare Advantage plan is different for everyone. We recommend speaking with a Chapter Medicare agent to compare plans.
In 2024, 59% of people on Medicare are enrolled in Medicare Advantage plans.
Medicare Advantage enrollment varies by county. The county with the lowest enrollment percentage is Gilliam County, OR (6%).
The county with the highest Medicare Advantage enrollment is Clackamas County, OR (72%).
There are a total of 105 Medicare Advantage plans in Oregon, but plan availability varies from county to county.
Three counties, Clackamas, Multnomah, and Washington Counties, each have 57 Medicare Advantage plans available—the highest number you’ll see in one county in Oregon.
Lincoln County, Oregon, has the fewest number of Medicare Advantage plans (3).
Like every health insurance option, no Medicare plan is perfect. Understanding the pros and cons of Medicare Advantage plans is important for deciding if you want to enroll in Medicare Advantage. This information will also help you pick the best Oregon Medicare Advantage plan for your needs and avoid any Medicare Advantage nightmares.
The biggest pro that comes with Medicare Advantage plans is that they provide extra benefits, which can include:
Coverage for dental, vision, and hearing care
Get a more comprehensive list of the benefits that may come with a Medicare Advantage plan in our Medicare Part C guide.
Medicare Advantage plans also come with maximum out-of-pocket amounts that limit how much you’ll pay for covered healthcare services in a given year. This is a key factor because Original Medicare does not have a maximum out-of-pocket amount. This means that, with Original Medicare, you’ll owe 20% of all costs for services once you’ve met your Part B deductible.
More benefits and a cap on your out-of-pocket costs are exciting benefits, but Medicare Advantage plans have big disadvantages too. The two biggest disadvantages lead to limited or delayed access to care. First, Medicare Advantage plans often require prior authorization. Furthermore, denials are all too common. Doctors and patients grow increasingly frustrated with prior authorization requirements and denials because they lead to people receiving care later than they should—or skipping care because it’s too expensive without coverage.
The other factor that can limit access to care is plan provider networks. Medicare Advantage plans operate with local provider networks. These networks can make it more difficult to find a doctor to provide the care you need.
The best Medicare Advantage plan is different for everyone. In the section below, we’ll go into more detail about what to consider when choosing a plan. That said, a plan’s star rating is one factor to consider when choosing the best Oregon Medicare Advantage plan for you. The Centers for Medicare and Medicaid Services (CMS) assigns Medicare Advantage plans a rating out of five stars each year. A one-star plan is the lowest-quality plan, and a five-star plan is the highest-quality plan.
The availability of 4 and 5-star plans will vary by county, but if we zoom in on Clackamas County, OR, which has 45 Medicare Advantage plans, Humana offers one five-star Medicare Advantage plan. The following carriers provide 4.5-star plans in Clackamas County, OR:
Humana
UnitedHealthcare
As we said before, a plan’s star rating is just one thing to consider.
There are three key things to consider when choosing a Medicare Advantage plan.
Make a note of your preferred doctors and other healthcare providers. This list will help you ensure the plan you choose has all of your preferred providers in its network.
Jot down all of the prescriptions you take, including the frequency and dose. This will help ensure that, if your Medicare Advantage plan includes prescription coverage, you’ll get the most savings from your plan.
Think through the different extra benefits that Medicare Advantage plans can provide, and make a note of those that are the most valuable to you.
Once you’ve jotted down all your needs and preferences, give us a call at 855-900-2427 to get help comparing your options. We’ll look at all the Oregon Medicare Advantage plans that cover your needs, then maximize the value you get from extra benefits and cost savings. Not ready to give us a call? You can also schedule a time to talk through your Medicare here.
