Oregon Medicare beneficiaries have access to a range of coverage options, state-specific protections, and free counseling services. This comprehensive Oregon Medicare guide covers your SHIP office contacts, Medigap plan availability, birthday rule protections, Medicare Savings Program eligibility, Medicare Advantage options, and how to compare plans. Whether you are turning 65, helping a parent navigate Medicare, or re-evaluating your coverage, understanding Oregon Medicare rules is essential for making informed decisions.
All information in this guide has been verified against official state sources, CMS data, and NAIC reports as of April 2026.
In This Oregon Medicare Guide:
Oregon SHIP — Free Medicare Counseling
Every state has a State Health Insurance Assistance Program (SHIP) that provides free, unbiased Medicare counseling. Oregon’s SHIP program can help you understand your coverage options, compare plans, resolve billing issues, and navigate enrollment periods at no cost.
| SHIP Program | Senior Health Insurance Benefits Assistance (SHIBA) |
| Phone | 1-800-722-4134 |
| Website | https://shiba.oregon.gov |
SHIP counselors are trained volunteers and staff who are not affiliated with any insurance company. They do not sell plans. Contact your Oregon SHIP office before making any major Medicare decisions.
Oregon Medigap (Medicare Supplement) Plans
Medigap plans in Oregon help cover out-of-pocket costs not paid by Original Medicare, including the Part A deductible, Part B coinsurance, and skilled nursing facility copays. Medigap plans are standardized by federal law, meaning Plan G from one carrier covers the same benefits as Plan G from another carrier. The difference is premium cost.
Plans available in Oregon: A, B, C, D, F, G, K, L, M, N (plus high-deductible versions of Plan F and Plan G)
Most popular plan: Plan G is the most popular for new enrollees. Plan F has the highest total enrollment (31.38 percent of Oregon Medigap enrollees) but has been closed to new Medicare beneficiaries since January 1, 2020. Plan N is the leading budget alternative. is the most popular Medigap plan in Oregon. Plan G covers all gaps in Original Medicare except the annual Part B deductible ($240 in 2026). Plan N is the most popular lower-premium alternative, with small copays for some doctor visits and ER visits.
Pricing method: Oregon uses community-rated Medigap pricing. This is the most favorable method for consumers because premiums are the same regardless of age. Your premium will not increase simply because you get older.
The average monthly Plan G premium for a 65-year-old in Oregon is approximately 185 to 224. Plan N averages approximately 128 to 165 per month. Actual premiums vary by carrier, age, gender, tobacco use, and zip code. Always compare quotes from at least three carriers.
Oregon Medigap Birthday Rule
Oregon is one of the few states with a Medigap birthday rule. Oregon’s birthday rule (effective January 1, 2013) gives Medigap enrollees a guaranteed-issue window from 30 days before their birthday month through 30 days after to switch to any Medigap plan with equal or lesser benefits from any carrier, with no medical underwriting. Applies to policies issued after January 1, 1990.
This annual switching window gives Oregon Medicare beneficiaries an opportunity to change Medigap plans without medical underwriting, potentially finding lower premiums or better coverage. Not all states offer this protection.
Oregon guaranteed issue protections: Beyond the federal 6-month OEP: (1) Annual birthday rule window for switching to equal or lesser Medigap plans without underwriting; (2) Guaranteed Medigap access for Medicare beneficiaries under 65 with disabilities at age-65 premium rates; (3) Guaranteed issue for individuals moving to Oregon from states without under-65 Medigap protections; (4) 63-day guaranteed issue when employer or other qualifying coverage ends.
Oregon Medicare Advantage (Part C)
Approximately approximately 954000 people in Oregon are enrolled in Medicare. About approximately 51 percent of Oregon Medicare beneficiaries choose Medicare Advantage plans, with the remainder on Original Medicare with or without Medigap supplement coverage.
Medicare Advantage plans in Oregon are offered by private insurers as an alternative to Original Medicare. Most MA plans include prescription drug coverage (Part D) and often add dental, vision, and hearing benefits. However, MA plans use provider networks, which can limit your choice of doctors and hospitals.
Key Medicare Advantage considerations in Oregon:
- Networks matter: HMO plans require you to use in-network providers except in emergencies. PPO plans allow out-of-network care at higher cost.
- $0 premium plans: Many Oregon MA plans have $0 monthly premiums (you still pay your Part B premium).
- Maximum Out-of-Pocket (MOOP): MA plans cap your annual spending, unlike Original Medicare which has no cap.
- Star ratings: CMS rates MA plans 1-5 stars. Higher-rated plans often have lower costs and better coverage.
Top Medicare Advantage carriers in Oregon by enrollment:
- UnitedHealthcare
- Providence Health Plan
- Kaiser Permanente
- Humana
- Regence BlueCross BlueShield
Oregon Medicare Financial Help Programs
Oregon offers Medicare Savings Programs (MSPs) that help low-income Medicare beneficiaries pay for premiums, deductibles, and copays. The four programs are:
- QMB (Qualified Medicare Beneficiary): Pays Part A and Part B premiums, deductibles, coinsurance, and copays.
- SLMB (Specified Low-Income Medicare Beneficiary): Pays Part B premiums only.
- QI (Qualifying Individual): Pays Part B premiums (limited funding, first-come first-served).
- QDWI (Qualified Disabled Working Individual): Pays Part A premiums for disabled workers.
Oregon MSP eligibility: QMB: 1350/month single, 1824/month couple. SLMB (called SMB in Oregon): 1616/month single, 2184/month couple. QI (called SMF in Oregon): UNVERIFIED exact amount. No asset/resource limits in Oregon for MSP programs. Limits effective March 2026 through February 2027.
Apply through your local SHIP office or your state Medicaid agency for free help determining eligibility.
Top Medicare Insurance Companies in Oregon
Top Medigap carriers in Oregon:
- AARP/UnitedHealthcare
- Moda Health
- Humana
- Transamerica
- State Farm
When comparing carriers, focus on premium cost (for identical standardized Medigap plans, benefits are the same — only price differs), financial strength ratings from AM Best (A or higher), customer satisfaction ratings, and claims processing speed.
Oregon Medicare Enrollment Periods
Understanding Medicare enrollment deadlines prevents costly late enrollment penalties:
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday (3 months before, birthday month, 3 months after). Enroll in Parts A and B during this period.
- Medigap Open Enrollment: Standard federal 6-month period beginning the first day of the month Medicare Part B is effective at age 65 or older. During this window, insurers cannot deny coverage or charge higher premiums due to health conditions.. During this period, insurance companies cannot deny you Medigap coverage or charge higher premiums based on health conditions.
- Annual Enrollment Period (AEP): October 15 through December 7 each year. Switch between Original Medicare and Medicare Advantage, change MA plans, or add/change Part D drug plans.
- Medicare Advantage Open Enrollment Period (OEP): January 1 through March 31. Switch MA plans or return to Original Medicare (and add a Medigap plan, subject to underwriting).
- Special Enrollment Periods (SEP): Available when you lose employer coverage, move, or qualify for other life events.
Additional Oregon Medicare protections: Birthday rule allows annual Medigap plan switching without underwriting. Guaranteed Medigap access for under-65 disabled Medicare beneficiaries at age-65 premium rates. Guaranteed issue window for people moving to Oregon from states without under-65 Medigap protections. Oregon law requires insurers selling Medigap to offer plans to all Medicare-eligible residents regardless of age. 21 insurers offer Medigap Plan A and Plan G in the state. Oregon has no asset or resource limits for Medicare Savings Programs.
Compare Oregon Medicare Plans
Ready to compare Medicare options in Oregon? Use the official Medicare Plan Finder or contact your local SHIP counselor for free, unbiased help.
Official Sources & Resources
- Medicare.gov: medicare.gov
- Oregon Division of Financial Regulation (under the Department of Consumer and Business Services): https://dfr.oregon.gov
- Senior Health Insurance Benefits Assistance (SHIBA): https://shiba.oregon.gov
- CMS.gov: cms.gov
- NAIC: naic.org
This Oregon Medicare guide was last verified against official sources in April 2026. If you notice outdated information, please contact us.