Oregon Medicare Supplement Insurance Options:
We feel that the best care is received when you have your choice of Doctors, and you and your Doctor make your medical decisions. Medigap plans are available with no medical underwriting during your open enrollment period. This is when you become eligible for Medicare Part B. You may however, apply to a company and fill out the medical underwriting questions at any time.
Oregon Birthday Rule
Additional “Guaranteed Issue” enrollment period for Medicare Supplement enrollees: A new “birthday rule” allows an enrollee the opportunity to change Medicare Supplement plans (as long as the new policy has the same or lesser benefits) with guaranteed issue and nondiscrimination in rating once per year for a period of thirty days beginning on the individual’s birth month. Please refer to the OID’s chart that outlines the specific “replacement options.” NOTE: This rule does not apply to Medicare Supplement policies issued or delivered before January 1, 1990. Click here to view more information.
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|Part B Premiums - Higher income||Click here for more information|
|Part D Information||Click here for more information|
|Medigap changes||Click here for more information|
|** If you bought Plan E, H, I, or J before June 1, 2010, you can keep that plan.|
Medicare Supplemental Insurance (Medigap or MedSup) is specifically designed to supplement Medicare's benefits and is regulated by federal and state law, It must be clearly identified as Medicare supplemental insurance and it must provide specific benefits that help fill the gaps in your Medicare coverage. Other kinds of insurance may help you with out-of-pocket health care costs but they do not qualify as Medigap plans.
How much does Medigap coverage cost?
"The Cost of Medigap policies can vary widely. There can be big
differences in the premiums that insurance companies charge for exactly the
From the Choosing A Medigap Policy Brochure
In Oregon there are more than 25 companies that sell Medigap Plans. We represent many of them. It is important to us that we can offer the best value to our clients.
Standard Medigap Plans:
To make it easier for you to compare Medigap insurance policies, all states (except Minnesota, Massachusetts and Wisconsin), U.S. territories and the District of Columbia limit the number of different Medigap policies that can be sold in any of those jurisdictions. The plans were developed by the National Association of Insurance Commissioners and incorporated into state and federal law. They have letter designations," with Plan A being the "basic" benefit package. Each of other plans includes package plus different combination additional benefits. Insurance companies are not permitted to change benefits letter designations of any of the plans.
What is Medicare?
Medicare is a national health insurance program for people 65 years of age and older, certain younger disabled people and people with permanent kidney failure. Medicare is run by the Centers for Medicare & Medicaid Services . The Social Security Administration helps CMS by enrolling people in Medicare and by collecting Medicare premiums.
Medicare is divided into two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part A helps pay for care in a hospital, skilled nursing facility, some home health care, and hospice care. Part B helps pay for doctor bills, outpatient hospital care and other medical services not covered by Part A. Your Medicare card shows the Medicare coverage you have--Hospital Insurance (Part A), Medical Insurance (Part B), or both--and the date your coverage started.
The 2015 Medicare Part A deductible is $1,260 and the 2015 Part B deductible is $147. Part B annual increases are based on Part B medical cost increases and are related to income levels.
Medicare Premiums for 2015:
Part A: (Hospital Insurance) Premium
- Most people do not pay a monthly Part A premium because they or a spouse has 40 or more quarters of Medicare-covered employment.
- The Part A premium is $224.00 per month for people having 30-39 quarters of Medicare-covered employment.
- The Part A premium is $407.00 per month for people who are not otherwise eligible for premium-free hospital insurance and have less than 30 quarters of Medicare-covered employment.
Part B: (Medical Insurance) Premium
Existing beneficiaries will be $104.90 in 2015. Beneficiaries who currently have the Social Security Administration (SSA) withhold their Part B premium and have incomes of $85,000 or less (or $170,000 or less for joint filers) will not have an increase in their Part B premium in 2015.
For all others, the standard Medicare Part B monthly premium will be $104.90 in 2015. If your income is above $85,000 (single) or $170,000 (married couple), then your Medicare Part B premium may be higher than $104.90 per month.
Medicare Deductible and Coinsurance Amounts for 2015:
Part A: (pays for inpatient hospital, skilled nursing facility, and some home health care) For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2015 = $1,260) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days.
For each benefit period you pay:
- A total of $1,260 for a hospital stay of 1-60 days.
- $315 per day for days 61-90 of a hospital stay.
- $630 per day for days 91-150 of a hospital stay (Lifetime Reserve Days).
- All costs for each day beyond 150 days
Skilled Nursing Facility Coinsurance
- $157.50 per day for days 21 through 100 each benefit period.
Part B covers Medicare eligible physician services, outpatient hospital services, certain home health services, durable medical equipment
- $147.00 per year. (Note: You pay 20% of the Medicare-approved amount for services after you meet the $147.00 deductible.)
(please see the CMS information on this)
Enrollment in Medicare is handled in two ways: either you are automatically enrolled or you must apply. If you are getting Social Security or Railroad Retirement Board benefits before you turn 65, you are automatically enrolled and your Medicare card will be mailed to you about three months before your 65th birthday. If you are not receiving retirement benefits, you must apply by contacting a Social Security Administration office or, if appropriate, the Railroad Retirement Board. You should apply three months before your 65th birthday to avoid a possible delay in the start of your coverage. If you have been a disabled beneficiary under Social Security or Railroad Retirement for 24 months, you will automatically get a Medicare card in the mail.