Medicare Advantage Plans


 

Medicare Advantage plans (Part C) are growing in popularity in Oregon due to lower premiums and the additional benefits offered under these plans. In 2015, 44% of the Medicare plans sold in Oregon were Medicare Advantage plans. This ranked Oregon as the 2nd highest state in the nation.

Under a Medicare Advantage plan, the member receives his or her benefits through a private insurer. In Oregon, there are numerous companies offering competitive Medicare Advantage plans. Because the plans are being offered by private insurance carriers, each carrier has the ability to offer additional benefits not covered by Original Medicare, such as routine vision and preventive dental services.

 

How Medicare Advantage Works: 

   Enrollees receive the same benefits as in Original Medicare, often with the addition of benefits not included in Original Medicare, such as nominal deductibles for services and an annual out-of-pocket maximum. 

 

   Medicare recipients are still responsible for the Part B premium, in addition to the insurance carriers premium, deductible, copayments, and co-insurance (if applicable). 

 

   Medicare Advantage plans renew their contracts annually with the Centers for Medicare and Medicaid Services (CMS). The policies are not guaranteed renewable. However, if you join a plan and that plan decides not to renew its contract with CMS, you have protection under the law that enables you to join another plan or purchase a Medicare Supplement policy.

               Rates charged by the carriers range from $0 (no premium) to approximately $200. 

               Most carrier plans include a pharmacy benefit. You can purchase a plan that does not have a pharmacy benefit if you                    have allowed prescription coverage elsewhere. 


When to Sign Up: 

The initial open enrollment period spans seven months, beginning three months prior to the month you turn 65, and extending to three months after the month you turn 65.

The Open Enrollment Period begins October 15 and ends December 7 each year. 

Please visit https://www.medicare.gov/Pubs/pdf/11219-Understanding-Medicare-Part-C-D.pdf for detailed information on enrollment periods.