My Oregon Health Insurance
Speak with an Oregon Health Insurance Agent Oregon Health Insurance Image
My Oregon Health InsuranceIndividual Health InsuranceGroup Health InsuranceDental InsuranceLife InsuranceMedicare Supplement InsuranceAccident InsuranceTravel InsuranceContact us in Portland


Oregon Medicare Advantage Plans

Medicare advantage is a combination of your Part A and Part B options and must cover all medically needed services. the plans work somewhat like traditional health insurance. You typically have a list of providers in which you can use for services. Many advantage plans offer extra benefits that traditional Medicare does not offer, such as; dental, preventative and even gym memberships. Below you will find an illustration on how the plan works in relation to Medicare, a list of Pros and Cons to consider, the enrollment periods and types of Advantage plans.

medicare advantage


What to consider when selecting an Advantage plan

Medicare Advantage Pros Medicare Advantage Cons
  • Typically, covers Medicare Part A, B and D (Rx) all in one simple to use plan
  • There is typically a copay for each service performed until you meet the Out of Pocket Maximum
  • Preventative and routine services covered
  • Higher copays or no coverage for out of network providers
  • Premiums as low as $0 per month
  • You must live within the plan's service area
  • Extra benefits inclued dental, vision, alternative care and hearing may be covered
  • You may require a referral for specialists (HMOs).
  • Premiums do not increase based on age, gender or health
  • You can switch to any other Advantage plan during the open enrollment period

Enrollment periods for Advantage plans

Below is a list of common enrollment periods that a member will want to keep in mind. These apply to Advantange plan members. Contact us is you have a specific situation that you do not see below. You can find the Medicare enrollment publication here.

Type of enrollment period Medicare Advantage enrollment dates Your restrictions
Initial Enrollment (IEP/ICEP)
  • Three months prior, the month of, and three months after your birthmonth.
  • You can enroll in any Advantage plan, Part D (Rx) or MediGap plan.
  • The plans are guarantee issue regardless of health.
General Enrollment (GEP)
  • Jan 1st - Mar 31st
  • For those that did not enroll in Part A, Part B or both.
  • Coverage begins July 1st
Annual Enrollment (AEP)
  • Nov 1th - Dec 31st
  • Can move to any other Advantage plan
  • Can add or drop Part D (Rx)
  • Can move between orginal medicare and Advantage plan
  • One change allowed
  • Coverage begins Jan 1st
Open Enrollment (OEP)
  • Jan 1st - Mar 31st
  • Can move between Advantage plans or Orginal Medicare
  • Cannot make changes to Part D
  • Coverage starts the following month
Special Enrollment (SEP)
  • Varies

Some examples are:

  • You move to another service area
  • Your Advantage plan is involuntarily cancelled
  • You retire from a group plan
  • Enrolled in Part A and B during GEP

Types of Advantage plans

Type of Plan: Your restrictions:
Orignal Medicare with Medigap
  • You can go to any provider that accepts medicare
  • Common examples are: Mutual of Omaha, Gerber Life,

Preferred Provider Organization (PPO)

  • Higher copays or no coverage if you use physicians outside the network
  • Typically, no referrals needed for specialists
Health Maintenence Organization (HMO)
  • You can only use doctors within the HMO network
  • A referral is usually needed for specialist
Private Fee for Service (PFFS)
  • The doctor or specialist must accept the PFFS’s fees, terms, and conditions
  • No referral is needed
  • A doctor may drop off the plan at any time


Health Insurance Quote
Oregon Health Insurance Curve
Individual Health Coverage Group Insurance Dental Insurance Life Insurance Medicare Supplement Accident Insurance ContactUs in Portland Affliates Blog
Copyright 2009 My Oregon Health Insurance, +1-503-608-7768, 25 NW 23rd Pl Suite 6156, Portland, OR 97210 . All Rights Reserved.