Oregon Medicare Supplement Plans: What You Need to Know
Oregon stands out among states for offering strong Medicare supplement (Medigap) consumer protections. With major metropolitan areas like Portland, Salem, Eugene, and Bend, plus vast rural regions, having the right Medicare coverage is essential. That's where unbiased, fee-only guidance makes a difference.
Like all states except Massachusetts, Minnesota, and Wisconsin, Medigap plans in Oregon are standardized by letter (A, B, C, D, F, G, K, L, M, N). This means a Plan G from one company covers exactly the same benefits as a Plan G from another company. The only differences are the premium you pay and the company's customer service.
Oregon's Birthday Rule - Your Annual Freedom to Switch
Oregon has a "birthday rule" that gives you a 30-day window starting on your birthday each year to switch Medigap plans without medical underwriting. This is a huge benefit that many Oregon residents don't know about!
What you CAN do during your birthday window:
- Switch to a plan with equal or lesser coverage
- Switch to the same plan letter with a different company (to save money)
- Move from Plan G to Plan N, or Plan F to Plan G
What you CANNOT do during your birthday window:
- Switch to a plan with more coverage (e.g., Plan N to Plan G)
- This protection only applies to equal or lesser coverage switches
Why this matters: You're never locked into high rates! Every year on your birthday, you can shop for better pricing on an equivalent or lower-coverage plan. This gives Oregon beneficiaries ongoing flexibility that most states don't offer.
Oregon Medigap Open Enrollment Period
Like all states, Oregon provides a crucial 6-month Medigap Open Enrollment Period that begins on the first day of the month you turn 65 and are enrolled in Medicare Part B. This initial window is critical because:
- Insurance companies cannot deny you coverage for any reason
- They cannot charge you more due to health conditions
- You have guaranteed issue rights to any Medigap plan sold in Oregon
- You can choose any plan letter without medical underwriting
After this initial enrollment period ends, Oregon's birthday rule becomes your annual opportunity to make changes. Together, these protections ensure you always have options.
Most Popular Medigap Plans in Oregon
While 10 standardized Medigap plans are available in Oregon, the most popular choices are:
| Plan | Coverage Level | Best For | OR Monthly Premium* |
|---|---|---|---|
| Plan G | Comprehensive | Most new enrollees (best value) | $140 - $220 |
| Plan N | High with copays | Those wanting lower premiums | $100 - $170 |
| Plan F | Most comprehensive | Those eligible before 2020 | $170 - $280 |
*Premium ranges are estimates and vary by age, location within Oregon, gender, and tobacco use. Contact us for personalized quotes.
Plan G vs Plan N in Oregon
For most Oregon residents new to Medicare, the choice comes down to Plan G or Plan N:
- Plan G covers everything except the Part B deductible ($240 in 2024). No copays, no surprises. Ideal if you want predictable costs and visit doctors frequently.
- Plan N has lower premiums but requires up to $20 copays for office visits and up to $50 for ER visits (waived if admitted). Good choice if you're healthy and want to save on monthly costs.
Thanks to Oregon's birthday rule, if you start with Plan G and later decide Plan N is a better fit, you can make that switch during your birthday window without medical underwriting.
Oregon-Specific Medicare Considerations
Portland Metro vs Rural Oregon Coverage
Oregon has diverse geography, from the densely populated Portland metro area to rural communities east of the Cascades. If you live in or frequently travel to rural Oregon, Medigap offers a significant advantage: any doctor or hospital that accepts Medicare will accept your Medigap plan. This is critical in areas where Medicare Advantage plan networks may be limited or require long drives to in-network providers.
SHIBA - Oregon's Free Counseling Program
Oregon offers a free counseling program called SHIBA (Senior Health Insurance Benefits Assistance) through the Department of Consumer and Business Services. While SHIBA counselors can provide general Medicare information and help you understand your options, they cannot recommend specific plans or companies. That's where a fee-only Medicare advisor adds value: we can make specific recommendations based on your individual situation and help you use Oregon's birthday rule effectively.
Pacific Northwest Lifestyle Considerations
Many Oregon residents are active outdoors enthusiasts who enjoy hiking, skiing, fishing, and other activities throughout the Pacific Northwest. If you travel frequently within Oregon or to neighboring states like Washington, Idaho, or California, Medigap provides nationwide coverage with no network restrictions. Your plan works the same whether you're in Portland, Bend, Seattle, or anywhere else in the country.
Cross-Border with Washington
Many Oregon residents live near the Washington border and may receive care in both states. While both states have consumer-friendly Medigap rules, Washington offers even stronger protections with year-round guaranteed issue rights for all Medigap plans. If you're choosing where to establish residency, this could be a factor worth considering. With Medigap, you can see any Medicare-accepting provider in either state regardless of where you live.
Making the Most of Oregon's Birthday Rule
The birthday rule is one of Oregon's most valuable but underutilized Medicare benefits. Here's how to use it strategically:
- Mark your calendar: The 30-day window begins on your birthday each year. Set a reminder to review your rates 60 days before.
- Compare rates annually: Even if you're happy with your current company, check if another insurer offers the same plan for less.
- Consider coverage adjustments: If you're rarely using your coverage, switching from Plan G to Plan N during your birthday window can save hundreds per year.
- No medical questions: Unlike most plan changes, birthday rule switches require no health screening for equal or lesser coverage.
Frequently Asked Questions: Oregon Medicare
In Oregon, you have three main opportunities: (1) During your initial 6-month Medigap Open Enrollment Period when you turn 65 and enroll in Part B, (2) During the 30-day window starting on your birthday each year (birthday rule), or (3) During specific guaranteed issue situations like losing employer coverage. The birthday rule is unique to Oregon and gives you annual flexibility.
Starting on your birthday each year, you have a 30-day window to switch to a Medigap plan with equal or lesser coverage without medical underwriting. This means you can switch from Plan G to Plan N, or from your current Plan G to another company's Plan G, without answering health questions. However, you cannot use the birthday rule to upgrade to more coverage (like Plan N to Plan G) - that would require medical underwriting.
No, the birthday rule only allows you to switch to equal or lesser coverage. You cannot switch to a plan with more comprehensive benefits during this window. For example, you can switch from Plan G to Plan N (lesser coverage) or from Plan G with Company A to Plan G with Company B (equal coverage), but you cannot switch from Plan N to Plan G (more coverage) without medical underwriting.
SHIBA (Senior Health Insurance Benefits Assistance) is Oregon's free, state-run counseling program that provides unbiased information about Medicare options. SHIBA volunteers can explain how Medicare works, help you understand your coverage options, and answer questions about enrollment. However, they cannot recommend specific plans or insurance companies. For personalized plan recommendations, a fee-only Medicare advisor can complement SHIBA's educational role.
Medigap premiums in Oregon typically range from $100-$280+ per month depending on the plan letter, your age, location (Portland metro area tends to be higher than rural areas), gender, and tobacco use. Plan G typically costs $140-$220/month, Plan N costs $100-$170/month, and Plan F (if eligible) costs $170-$280/month. Thanks to the birthday rule, you can shop for better rates on your birthday each year.