Compare affordable Oregon medical coverage from top companies. Individual, family, Group, and Senior plans are available. Open Enrollment provides guaranteed benefits with pre-existing conditions covered. Policies (Medicare and under-65) are also offered outside of the OE period. View free instant quotes and review prices, benefits, and network providers. Advantage, Supplement, and Part D prescription drug plans are offered to applicants that have reached age 65.
OregonHealthcare.gov is operated by DCBS (Oregon Department of Consumer and Business Services) and utilizes the federal platform. Oregon Health Plan (OHP) is the state’s Medicaid program. Comprehensive benefits include doctor’s visits, hospitalization, dental, emergency care, medical supplies and equipment, speech and occupational therapy, prescriptions, lab tests, x-rays, and mental health services.
Comprehensive, catastrophic, and short-term plans provide customized coverage with an easy application process. Regardless if you are currently uninsured, or shopping for better benefits at a lower rate, within minutes, you can find a quality policy that meets your budget. Preventive and routine physician office visits, prescription drugs, emergency room, hospitalization, Urgent Care, and other major medical services are available. More than 150,000 persons enrolled for under-65 coverage last year.
Companies offering 2024 ACA-compliant plans include BridgeSpan, Kaiser, Moda, PacificSource, Providence, and Regence. Carriers offering small group plans are Health Net, Kaiser, Moda, PacificSource, Providence, Regence, Samaritan, UnitedHealthcare, and UnitedHealthcare of Oregon. A reinsurance program also helps reduce premiums.
Counties with the most available carriers (six) are Clackamas, Columbia, Hood River, Lane, Marion, Multnomah, Polk, Washington, and Yamhill. All remaining counties have five available carriers, with the exception of Deschutes and Lincoln counties (four carriers).
2024 Rate Changes (Private Plans)
BridgeSpan – 8.36% increase (Standard EPO)
Kaiser – 7.78% increase (HMO Individual On Exchange)
Moda – 3.92% increase (EPO plans)
PacificSource – 3.29% increase (PPO With Acupuncture)
Providence – 8.90% increase (Providence Standard, Connect, Oregon Direct, and HSA)
Regence BCBS – 4.94% increase (EPO and Standard EPO)
2024 Rate Changes (Small Group)
Health Net – 4.45% increase (PPO)
Kaiser – 7.65% increase (HMO, POS, and NONPOS)
Moda – 1.94% increase (PPO, Standard Bronze, Value, Standard GS, and Select SMGR)
PacificSource – 9.39% increase (PPO)
Providence – 12.27% increase (Standard Gold, Standard Silver, HSA, Connect, Balance, Total Enhanced, and Choice)
Regence BCBS – 5.95% increase (Direct, Accountable Health, and Standard Silver)
UnitedHealthcare – 7.15% increase (Choice Plus, Select Plus Essential, and Select Essential)
Oregon Under-65 Health Insurance Plans
Catastrophic Tier
No available plans.
Bronze Tier
Regence BCBS Bronze Virtual Value 8500 Legacy – $8,500 deductible with 20% coinsurance. Preferred generic and generic drug copays are $15 and $45 (mail order).
Regence BCBS Bronze Essential 8500 With 4 Copay No Deductible – $8,500 deductible with 10% coinsurance. $60 copay for first four office and Urgent Care visits. $60 Urgent Care copay. Preferred generic and generic drug copays are $15 and $45 (mail order).
Regence BCBS Standard Bronze Plan Legacy – $9,450 deductible with 0% coinsurance. $50 ($5 first three) and $150 office visit copays. $100 Urgent Care copay. Generic drug copay is $25 ($75 mail order).
Regence BCBS Bronze HSA 7000 Legacy – $7,500 deductible with 50% coinsurance. HSA-eligible.
Regence BCBS Bronze Bronze Virtual Value 8500 – $8,500 deductible with 20% coinsurance. Generic drug copays are $15 and $45 (mail order).
Kaiser KP Oregon Standard Bronze Plan – $9,450 deductible with 0% coinsurance. $50 (First three visits $5 copay) and $150 office visit copays. $100 Urgent Care copay. Generic drug copay is $25 ($50 mail order).
Kaiser KP OR Bronze 9100/75 – $9,100 deductible with 0% coinsurance. $75 office visit copay. Generic drug copay is $30 ($60 mail order).
Kaiser KP OR Bronze 7100/0% HSA – HSA-eligible option with $7,100 deductible and 0% coinsurance.
Kaiser KP OR Bronze 5500/50 – $5,500 deductible with 35 coinsurance. $50 office visit copay. Generic drug copay is $30 ($60 mail order).
Pacific Source Navigator Bronze HSA 7500 – HSA-eligible option with $7,500 deductible and 0% coinsurance.
Pacific Source Navigator Bronze 7000 – $7,000 deductible and 40% coinsurance with office visit copays of $50 and $100. Urgent Care also has a $50 copay.
Pacific Source Navigator Bronze 9400 – $9,400 deductible with 0% coinsurance.
Pacific Source OR Standard Bronze Plan NAV – $9,450 deductible with 0% coinsurance. $50 (First three visits $5 copay) and $150 office visit copays. $100 Urgent Care copay. Generic drug copay is $25 ($50 mail order).
Providence Connect 9000 Bronze – $60 and $80 office visit copays. $80 Urgent Care copay. $9,000 deductible with 0% coinsurance. Tier 1 and Tier 2 drug copays are $0 and $35.
Providence Health Plan HSA Qualified 7000 Bronze – HSA-eligible option with $7,050 deductible and 0% coinsurance.
Providence Health Plan Oregon Standard Bronze – $50 and $100 office visit copays. Urgent Care copay is $100. Tier 1 and Tier 2 drug copays are $20. $8,800 deductible with 0% coinsurance.
Moda Health Beacon Bronze 8700 – $75 and $120 office visit copays. Urgent Care copay is $120. Value tier and Select tier drug copays are $2 and $25 ($6 and $75 mail order). $8,700 deductible with 0% coinsurance.
Moda Health Beacon Bronze 7000 – $75 and $120 office visit copays ($10 for virtual care visits). $120 Urgent Care copay ($10 virtual care). $7,000 deductible with 40% coinsurance. Value Tier drug copays are $2 and $6 (mail order).
Moda Health Oregon Standard Bronze – $50 and $100 office visit copays ($50 for virtual care visits). $100 Urgent Care copay ($50 virtual care). $8,800 deductible with 0% coinsurance. Value Tier drug copays are $20 and $60 (mail order).
Moda Health Beacon Bronze HSA 6900 – HSA-eligible option with $6,900 deductible and 0% coinsurance.
BridegeSpan Standard Bronze – $50 and $100 office visit copays. $100 Urgent Care copay. $8,800 deductible with 0% coinsurance. Preferred generic and generic drug copays are $20 and $60 (mail order).
Silver Tier
Kaiser KP OR Silver 4000/40 – $40 and $70 office visit copays. $60 Urgent Care copay. $4,000 deductible with 35% coinsurance. Generic and preferred brand drug copays are $25 and $65 ($50 and $130 mail order). $60 copay for diagnostic tests.
Kaiser KP OR Silver 3500/40 – $40 and $65 office visit copays. $60 Urgent Care copay. $3,500 deductible with 35% coinsurance. Generic and preferred brand drug copays are $25 and $65 ($50 and $130 mail order). $50 copay for diagnostic tests.
Kaiser KP OR Standard Silver Plan – $40 and $80 office visit copays. $70 Urgent Care copay. $4,800 deductible with 30% coinsurance. Generic and preferred brand drug copays are $15 and $60 ($30 and $120 mail order).
Kaiser KP OR Silver 750/30 – $30 and $60 office visit copays. $60 Urgent Care copay. $750 deductible with 40% coinsurance. Generic and preferred brand drug copays are $20 and $100 ($40 and $200 mail order). Lab and x-ray copays are $50 and $100. $750 imaging copay.
Pacific Source OR Standard Silver Plan NAV – $40 and $80 office visit copays. $70 Urgent Care copay. $4,800 deductible with 30% coinsurance. Tier 1 and Tier 2 drug copays are $15 and $60 ($30 and $180 mail order).
Pacific Source Navigator Silver 3500 – $40 pcp office visit copay. $40 Urgent Care copay. $3,500 deductible with 40% coinsurance. Tier 1 and Tier 2 drug copays are $20 and $40 ($50 and $150 mail order).
Pacific Source Navigator Silver 4000 – $30 and $60 office visit copays. $30 Urgent Care copay. $4,000 deductible with 30% coinsurance. Prescriptions subject to 30% coinsurance and deductible.
Providence Health Plan Connect 4500 Silver – $40 and $60 office visit copays. $60 Urgent Care copay. $4,500 deductible with 35% coinsurance. Tier 1, Tier 2, and Tier 3 drug copays are $0, $20, and $65.
Providence Health Plan Oregon Standard Silver – $40 and $80 office visit copays. $70 Urgent Care copay. $3,650 deductible with 30% coinsurance. Tier 1, Tier 2, and Tier 3 drug copays are $15, $15, and $60.
Moda Health Beacon Silver 3500 – $35 and $70 office visit copays. $10 virtual visit copay. $70 Urgent Care copay. $3,500 deductible with 35% coinsurance. Value Tier drug copays are $2 and $6 (mail order). Select Tier copays are $20 and $60 (mail order).
Moda Health Beacon Silver 3000 – $35 and $70 office visit copays. $70 Urgent Care copay. $10 virtual visit copay. $3,000 deductible with 35% coinsurance. Value Tier drug copays are $2 and $6 (mail order). Select Tier copays are $20 and $60 (mail order).
Moda Health Oregon Standard Silver – $40 and $80 office visit copays. $70 Urgent Care copay. $40 virtual visit copay. $3,650 deductible with 30% coinsurance. Value, Select, and Preferred Tier copays are $15, $15, and $60 ($45, $45, and $180 mail order).
Moda Health Beacon Silver 4500 – $35 and $70 office visit copays. $70 Urgent Care copay. $3,000 deductible with 35% coinsurance. Value Tier drug copays are $2 and $6 (mail order). Select Tier copays are $20 and $60 (mail order).
BridgeSpan Standard Silver Plan EPO Legacy LHP – $40 and $80 office visit copays. $70 Urgent Care copay. $3,650 deductible with 30% coinsurance. Preferred generic and generic drug copays are $15 and $30. The preferred brand drug copays are $60 and $120.
Regence BCBS Alliance Silver 6500 Legacy LHP – $25 and $85 office visit copays with $85 Urgent Care copay. $3,650 deductible with 10% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order). Preferred brand drugs are subject to coinsurance and deductible.
Regence BCBS OHSU Health Silver 7000 – $25 and $75 office visit copays with $75 Urgent Care copay. $7,000 deductible with 30% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order). Preferred brand drug copays are $75 and $150.
Regence BCBS OHSU Health Silver 5000 – $25 and $80 office visit copays with $80 Urgent Care copay. $5,000 deductible with 30% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order). Preferred brand drug copays are $80 and $160.
Regence BCBS Alliance Silver Virtual Value 4000 Legacy LHP – $4,000 deductible with 20% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order). Preferred brand drug copays are $80 and $160.
Regence BCBS Silver 6500 – $25 and $85 office visit copays with $85 Urgent Care copay. $6,500 deductible with 10% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order).
Regence BCBS Alliance Silver 4000 Legacy LHP – $20 and $80 office visit copays with $80 Urgent Care copay. $4,000 deductible with 30% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order).
Regence BCBS Standard Silver Plan Legacy LHP – $40 and $80 office visit copays with $70 Urgent Care copay. $3,650 deductible with 30% coinsurance. Preferred generic and generic drug copays are $15 and $30 (mail order). Preferred brand drug copays are $60 and $120.
Regence BCBS Silver Virtual Value 4000 Legacy LHP – $4,000 deductible with 20% coinsurance. Preferred generic and generic drug copays are $15 and $30 (mail order).
Regence BCBS Silver 4000 – $20 and $80 office visit copays with $80 Urgent Care copay. $4,000 deductible with 30% coinsurance. Preferred generic and generic drug copays are $10 and $20 (mail order).
Regence BCBS Standard Silver Plan – $40 and $80 office visit copays with $70 Urgent Care copay. $3,650 deductible with 30% coinsurance. Preferred generic and generic drug copays are $15 and $30 (mail order). Preferred brand drug copays are $60 and $120.
Gold Tier
Kaiser KP OR Gold 1500/30 – $30 and $50 office visit copays. $30 Urgent Care copay. $1,500 deductible with 30% coinsurance. Generic, preferred brand, and non-preferred brand drug copays are $15, $40, and 50% ($30, $80, and 50% mail order). X-rays and blood tests subject to $50 copay.
Kaiser KP OR Standard Gold Plan – $20 and $40 office visit copays. $60 Urgent Care copay. $1,500 deductible with 20% coinsurance. Generic, preferred brand, and non-preferred brand drug copays are $10, $30, and 50% ($20, $60, and 50% mail order).
Kaiser KP OR Gold 0/20 – $20 and $50 office visit copays. $40 Urgent Care copay. $0 deductible with 30% coinsurance. Generic and preferred brand drug copays are $10 and $30 ($20 and $60 mail order). X-rays and blood tests subject to $50 copay.
PacificSource OR Standard Gold Plan NAV – $20 and $40 office visit copays. $60 Urgent Care copay. $1,500 deductible with 20% coinsurance. Tier 1, Tier 2, and Tier 3 drug copays are $10, $30, and 50% ($20, $90, and 50% mail order).
PacificSource Navigator Gold 1500 – $20 and $40 office visit copays. $20 Urgent Care copay. $1,500 deductible with 20% coinsurance. Tier 1, Tier 2, and Tier 3 drug copays are $15, $60, and 20% ($30, $180, and 20% mail order).
Providence Health Plan Oregon Standard Gold – $20 and $40 office visit copays. $60 Urgent Care copay. $1,500 deductible with 20% coinsurance. Tiers 1, 2, and 3 drug copays are $10, $10, and $30.
Providence Health Plan Connect 1500 Gold – $30 and $50 office visit copays. $50 Urgent Care copay. $1,500 deductible with 20% coinsurance. Tiers 1, 2, and 3 drug copays are $0, $10, and $50.
Moda Health Beacon Gold 1500 – $25 and $50 office visit copays ($10 virtual care). $25 Urgent Care copay. $1,500 deductible with 25% coinsurance. Value Tier drug copays are $2 and $6 (mail order). Select Tier copays are $10 and $30 (mail order).
Moda Health Beacon Gold 1000 – $15 and $30 office visit copays ($10 virtual care). $15 Urgent Care copay. $1,000 deductible with 15% coinsurance. Value Tier drug copays are $2 and $6 (mail order). Select Tier copays are $10 and $30 (mail order).
Moda Health Oregon Standard Gold – $20 and $40 office visit copays ($10 virtual care). $60 Urgent Care copay. $1,500 deductible with 20% coinsurance. Value Tier drug copays are $10 and $30 (mail order). Select Tier copays are also $10 and $30 (mail order). Preferred tier copays are $30 and $90.
BridgeSpan Standard Plan EPO OHSU Plus – $20 and $40 office visit copays. $60 Urgent Care copay. $1,000 deductible with 20% coinsurance. Preferred generic, generic, and preferred brand drug copays are $10, 25%, and $30 ($20, 20%, and $60 mail order).
Sample Monthly Oregon Health insurance Rates (Approved by Department Of Insurance)
Portland Area Age 30 With Household Income Of $27,000
$53 – Kaiser KP OR Bronze 6900/0% HSA
$58 – Providence Health Plan Connect 8150 Bronze
$58 – BridgeSpan Bronze Care On Demand 8000 EPO OHSU Plus
$70 – BridgeSpan Bronze Essential 7500 EPO OHSU Plus
$144 – Providence Health Plan Connect 4500 Silver
Medford Area Age Married Couple Age 40 And One Child With Household Income Of $67,000
$221 – Moda Health Oregon Standard Bronze
$221 – Moda Health Beacon Bronze 6500
$291 – Providence Health Plan HSA Qualified 6750 Bronze
$306 – Providence Health Plan Oregon Standard Bronze
$474 – Moda Health Beacon Silver 3500
Salem Area Age 45 With Household Income Of $32,000
$65 – Kaiser KP OR Bronze 6900/0% HSA
$100 – Kaiser KP OR Bronze 5000/50
$110 – Kaiser KP OR Standard Bronze Plan
$110 – Moda Health Beacon Bronze 6500
$210 – Moda Health Beacon Silver 3500
Eugene Area Married Couple Age 50 And Two Children With Household Income Of $80,000
$84 – Kaiser KP OR Bronze 6900/0% HSA
$152 – BridgeSpan Bronze Care On Demand 8000 EPO RealValue
$206 – Kaiser KP OR Bronze 5000/50
$209 – BridgeSpan Bronze Essential 7500 EPO RealValue
$614 – Moda Health Oregon Standard Silver
Bend Area Age Married Couple Age 62 With Household Income Of $67,000
$0 – BridgeSpan Essential 7500 EPO RealValue
$9 – BridgeSpan Bronze Care On Demand 8000 EPO RealValue
$16 – BridgeSpan Bronze HDHP 6000 EPO RealValue
$75 – Pacific Source Navigator Bronze HSA 6750
$95 – Pacific Source OR Standard Bronze Plan NAV
Short-Term Plans
Temporary coverage is designed to provide benefits between 1-12 months. The cost of coverage is inexpensive, and available through several carriers. Shown below are monthly rates (Multnomah County) for several scenarios. Cost of coverage may be different in other counties. Policies can be canceled at any time by the customer. Policy renewals may require medical underwriting.
30-Year-Old-Male
$59 – $10,000 deductible and $500,00 maximum benefits (Companion Life Economy 10000)
$69 – $5,000 deductible and $500,00 maximum benefits (Companion Life Economy 5000)
$72 – $5,000 deductible and $1 million maximum benefits (Everest Reinsurance Flex $5,000 50/50%)
$84 – $2,500 deductible and $1 million maximum benefits (National General 2500 80/20)
$103 – $1,000 deductible and $1 million maximum benefits (Everest Reinsurance Flex $1,000 50/50%)
40-Year-Old-Married Couple
$157 – $10,000 deductible and $500,00 maximum benefits (Companion Life Economy 10000)
$191 – $5,000 deductible and $500,00 maximum benefits (Companion Life Economy 5000)
$196 – $5,000 deductible and $1 million maximum benefits (Everest Reinsurance Flex $5,000 50/50%)
$231 – $2,500 deductible and $1 million maximum benefits (Everest Reinsurance Flex $2,500 50/50%)
$288 – $1,000 deductible and $1 million maximum benefits (Everest Reinsurance Flex $1,000 50/50%)
40-Year-Old-Married Couple With Two Children
$219 – $10,000 deductible and $500,00 maximum benefits (Companion Life Economy 10000)
$270 – $5,000 deductible and $500,00 maximum benefits (Companion Life Economy 5000)
$271 – $5,000 deductible and $1 million maximum benefits (Everest Reinsurance Flex $5,000 50/50%)
$321 – $2,500 deductible and $1 million maximum benefits (Everest Reinsurance Flex $2,500 50/50%)
$402 – $1,000 deductible and $1 million maximum benefits (Everest Reinsurance Flex $1,000 50/50%)
50-Year-Old-Female
$126 – $10,000 deductible and $500,00 maximum benefits (Companion Life Economy 10000)
$152 – $5,000 deductible and $500,00 maximum benefits (Companion Life Economy 5000)
$180 – $5,000 deductible and $1 million maximum benefits (Companion Life Choice 5000)
$223 – $2,500 deductible and $1 million maximum benefits (Everest Reinsurance Flex $2,500 50/50%)
$268 – $2,000 deductible and $1 million maximum benefits (Companion Life Choice 2000)
60-Year-Old-Married Couple
$378 – $10,000 deductible and $500,00 maximum benefits (Companion Life Economy 10000)
$467 – $5,000 deductible and $500,00 maximum benefits (Companion Life Economy 5000)
$531 – $5,000 deductible and $1 million maximum benefits (UnitedHealthcare Medical Value)
$561 – $5,000 deductible and $1 million maximum benefits (Companion Life Choice 5000)
$664 – $2,500 deductible and $1 million maximum benefits (UnitedHealthcare Medical Value)
Senior Oregon Medicare Plan Options
The initial enrollment period (IEP) is a seven-month period that is three months before your 65th month of birth, the month of your 65th birthday, and the three months after your 65th month of birth. Legal US residents (five years or longer) are eligible to apply for benefits. Medicare Supplement plans, (Medigap), Part D prescription drug, and Advantage plans are offered to help pay out-of-pocket expenses and provide other benefits. Senior enrollment begins in October.
Medicare Supplement Plans – Estimated Monthly Male Rates For Multnomah, Washington, and Clackamas Counties (Age 65)
Plan A
$95 – UnitedHealthcare (AARP)
$108 – United American
$143 – United World Life
$158 – Regence BCBS
$177 – Lumico Life
$187 – Allstate
$194 – Humana
$214 – Continental Life
$239 – Cigna
$252 – GPM Health
Plan B
$154 – UnitedHealthcare (AARP)
$170 – Humana
$198 – United American
$269 – Continental Life
Plan C
$178 – UnitedHealthcare (AARP)
$201 – United American
$219 – Regence BCBS
$235 – Humana
Plan F
$153 – AARP-UnitedHealthcare
$183 – Lumico Life
$193 – Regence BCBS
$196 – Loyal American Life
$200 – Humana
$210 – Mutual Of Omaha
$223 – Transamerica
$233 – Manhattan Life
$276 – Continental Life
Plan F (HD)
$44 – Mutual Of Omaha
$51 – Humana
$106 – Continental Life
Plan G
$127 – AARP-UnitedHealthcare
$145 – Lumico Life
$150 – Mutual Of Omaha
$151 – Loyal American Life
$164 – Regence BCBS
$171 – Manhattan Life
$174 – Transamerica
$188 – Humana
$223 – Continental Life
Plan G (HD)
$41 – Mutual Of Omaha
$48 – Humana
Plan N
$102 – AARP-UnitedHealthcare
$107 – Mutual Of Omaha
$116 – Humana
$117 – Lumico Life
$131 – Loyal American Life
$139 – Manhattan Life
$140 – Regence BCBS
$172 – Transamerica
$187 – Continental Life
Medicare Supplement Plans – Estimated Monthly Male Rates For Lane County (Age 65)
Plan A
$81 – AARP-UnitedHealthcare
$128 – Loyal American
$132 – Transamerica
$132 – Regence BCBS
$132 – Lumico Life
$133 – Humana
$144 – Mutual Of Omaha
$163 – Manhattan Life
$169 – Continental Life
Plan B
$132 – AARP-UnitedHealthcare
$145 – Humana
$149 – Loyal American
$213 – Continental Life
Plan C
$152 – AARP-UnitedHealthcare
$183 – Loyal American
$192 – Regence BCBS
$196 – Humana
$216 – Manhattan Life
Plan F
$153 – AARP-UnitedHealthcare
$176 – Lumico Life
$185 – Loyal American
$193 – Regence BCBS
$200 – Humana
Plan F (HD)
$43 – Mutual Of Omaha
$51 – Humana
$97 – Continental Life
Plan G
$127 – AARP-UnitedHealthcare
$139 – Lumico Life
$142 – Loyal American
$144 – Mutual Of Omaha
$160 – Manhattan Life
$164 – Regence BCBS
$174 – Transamerica
$188 – Humana
$205 – Continental Life
Plan G (HD)
$37 – Mutual Of Omaha
$48 – Humana
Plan N
$90 – AARP-UnitedHealthcare
$91 – Cigna
$98 – Mutual Of Omaha
$103 – Lumico Life
$107 – Loyal American
$113 – Manhattan Life
$116 – Humana
$140 – Regence BCBS
$149 – Continental Life
Medicare Advantage Plans
Contracts are offered by the following carriers: Aetna, AllCare, ATRIO, Health Net, Humana, Kaiser Permanente, Moda Health Plan, PacificSource, Providence, Regence BCBS, Samaritan, and UnitedHealthcare. Shown below are plans (and monthly rates) offered in Multnomah County. Advantage contracts are offered in all counties, although rates and plan availability will vary.
AARP Medicare Advantage Plan 1 – $61 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $10, and $47. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $25. The inpatient hospital copay is $285 for days 1-7. The Plan Star Rating is 3.5. Maximum in-network out-of-pocket expenses are $3,500.
AARP Medicare Advantage Choice – $32 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $10, and $45. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $30. The inpatient hospital copay is $300 for days 1-5. The Plan Star Rating is 4.0. Maximum in-network out-of-pocket expenses are $4,500.
AARP Medicare Advantage Plan 2 – $0 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $12, and $47. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $400 for days 1-4. The Plan Star Rating is 3.5. Maximum in-network out-of-pocket expenses are $4,500.
AARP Medicare Advantage Walgreens – $0 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $0, and $47. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $45. The inpatient hospital copay is $400 for days 1-4. The Plan Star Rating is 4.0. Maximum in-network out-of-pocket expenses are $5,600.
AARP Medicare Advantage Patriot – $0 per month and no drug coverage. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $45. The inpatient hospital copay is $400 for days 1-4. The Plan Star Rating is 4.0. Maximum in-network out-of-pocket expenses are $5,600.
Aetna Medicare Choice Plan – $20 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $10, and $47. Urgent Care and ER copays are $45 and $90. Office visit copays are $0 and $45. The inpatient hospital copay is $420 for days 1-4. The Plan Star Rating is 3.5.
Aetna Medicare Elite Plan – $0 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $0, and $47. Urgent Care and ER copays are $25 and $90. Office visit copays are $0 and $25. The inpatient hospital copay is $295 for days 1-4. The Plan Star Rating is 3.0.
Aetna Medicare Value Plan – $0 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $5, and $47. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $400 for days 1-4. The Plan Star Rating is 3.0.
Aetna Medicare Eagle Plan – $0 per month and and no prescription drug benefits. Urgent Care and ER copays are $35 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $450 for days 1-4. No Plan Star Rating yet. The Plan Star Rating is 3.5.
AgeRight Advantage Health Plan – $40.50 per month and $480 deductible. Tiers 1, 2, and 3 prescription drug copays are 25%. Urgent Care and ER copays are 20% and $90. Office visit copays are $0 and $30. Not enough data to rate plan.
AgeRight Advantage Plus Health Plan – $42.00 per month and $300 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $15, and $45. Urgent Care and ER copays are 20% and $90. Office visit copays are $0 and $20. Not enough data to rate plan.
AgeRight Advantage Premier Health Plan – $42.00 per month and $300 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $15, and $45. Urgent Care and ER copays are 20% and $90. Office visit copays are $0 and $20. Not enough data to rate plan.
Health Net Ruby – $0 per month and $125 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $8, and $37. Urgent Care and ER coinsurance are $25 and $90. Office visit copays are $0 and $45. The inpatient hospital copay is $465 for days 1-4. The Plan Star Rating is 3.5.
Health Net Violet 1 – $120 per month and $95 deductible. Tiers 1, 2, and 3 prescription drug copays are $5, $10, and $37. Urgent Care and ER copays are $35 and $120. Office visit copays are $12 and $25. The inpatient hospital copay is $225 for days 1-7. The Plan Star Rating is 3.0.
Health Net Violet 2 – $19 per month and $150 deductible. Tiers 1, 2, and 3 prescription drug copays are $5, $15, and $37. Urgent Care and ER copays are $35 and $90. Office visit copays are $15 and $30. The inpatient hospital copay is $375 for days 1-4. The Plan Star Rating is 3.0.
Health Net Violet 3 – $0 per month and $200 deductible. Tiers 1, 2, and 3 prescription drug copays are $5, $15, and $37. Urgent Care and ER copays are $35 and $90. Office visit copays are $20 and $50. The inpatient hospital copay is $450 for days 1-4. The Plan Star Rating is 3.0.
Health Net Medicare Complement – $12 per month and $445 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $20, and $47. Urgent Care and ER copays are $25 and $90. Office visit copays are $0 and $40. The inpatient hospital copay is $465 for days 1-4. The Plan Star Rating is 3.5.
Health Net Aqua – $0 per month and no prescription drug benefits. Urgent Care and ER copays are $120 and $25. Office visit copays are $12 and $25. The inpatient hospital copay is $175 for days 1-8. The Plan Star Rating is 3.0.
Humana Gold Plus – $0 per month and $150 deductible. Tiers 1, 2, and 3 prescription drug copays are $2, $8, and $47. Urgent Care and ER copays are $0-$35 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $390 for days 1-4. The Plan Star Rating is 4.5.
HumanaChoice – $201 per month and $320 deductible. Tiers 1, 2, and 3 prescription drug copays are $16, $18, and $47. Urgent Care and ER copays are $0-$30 and $90. Office visit copays are $0 and $30. The inpatient hospital copay is $325 for days 1-4. The Plan Star Rating is 4.0.
Humana Honor – $0 per month and no prescription drug benefits. Urgent Care and ER copays are $0-$35 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $360 for days 1-5. The Plan Star Rating is 4.0.
Kaiser Permanante Senior Advantage Enhanced – $127 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $5, $10, and $45. Urgent Care and ER copays are $25 and $120. Office visit copays are $5 and $25. The inpatient hospital copay is $200 for days 1-6. The Plan Star Rating is 5.0.
Kaiser Permanante Senior Advantage Standard – $44 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $5, $10, and $45. Urgent Care and ER copays are $35 and $90. Office visit copays are $5 and $35. The inpatient hospital copay is $265 for days 1-6. The Plan Star Rating is 5.0.
Kaiser Permanante Senior Advantage Value – $0 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $5, $10, and $45. Urgent Care and ER copays are $45 and $90. Office visit copays are $5 and $45. The inpatient hospital copay is $335 for days 1-6. The Plan Star Rating is 5.0.
Moda Health PPO – $18 per month and no prescription drug benefits. Urgent Care and ER copays are $35 and $65. Office visit copays are $15 and $35. The inpatient hospital copay is $250 for days 1-5. The Plan Star Rating is 3.0.
Moda Health PPORX Enhanced – $196 per month and $175 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $20, and $47. Urgent Care and ER copays are $35 and $90. Office visit copays are $0 and $20. The inpatient hospital copay is $150 for days 1-5. The Plan Star Rating is 3.0.
PacificSource Medicare MyCare Rx 40 – $0 per month and $200 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $12, and $37. Urgent Care and ER copays are $40 and $90. Office visit copays are $0 and $0-$35. The inpatient hospital copay is $370 for days 1-5. The Plan Star Rating is 4.0.
PacificSource Medicare MyCare Rx 39 – $68 per month and $50 deductible. Tiers 1, 2, and 3 prescription drug copays are $2, $12, and $37. Urgent Care and ER copays are $25 and $90. Office visit copays are $0 and $0-$25. The inpatient hospital copay is $295 for days 1-5. The Plan Star Rating is 4.0.
Providence Medicare Select Medical – $67 per month and no prescription drug benefits. Urgent Care and ER copays are $50 and $90. Office visit copays are $15 and $30. The inpatient hospital copay is $300 for days 1-6. Plan Star Rating is 4.5.
Providence Medicare Prime + RX – $0 per month and $270 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $10, and $47. Urgent Care and ER copays are $50 and $90. Office visit copays are $0 and $40. The inpatient hospital copay is $450 for days 1-4. Plan Star Rating is 4.5.
Providence Medicare Choice + RX – $88 per month and $240 deductible. Tiers 1, 2, and 3 prescription drug copays are $4, $13, and $47. Urgent Care and ER copays are $50 and $90. Office visit copays are $15 and $30. The inpatient hospital copay is $300 for days 1-6. Plan Star Rating is 4.5.
Providence Medicare Bridge 1 + RX – $35 per month and $200 deductible. Tiers 1, 2, and 3 prescription drug copays are $0, $10, and $47. Urgent Care and ER copays are $50 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $325 for days 1-6. Plan Star Rating is 4.5.
Regence BlueAdvantage HMO – $0 per month and $200 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $12, and $40. Urgent Care and ER copays are $40 and $90. Office visit copays are $15 and $45. The inpatient hospital copay is $430 for days 1-4.
Regence BlueAdvantage HMO Plus – $34 per month and $100 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $8, and $40. Urgent Care and ER copays are $35 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $375 for days 1-4.
Regence MedAdvantage + Rx Primary – $0 per month and $300 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $13, and $40. Urgent Care and ER copays are $40 and $90. Office visit copays are $5 and $40. The inpatient hospital copay is $400 for days 1-4.
Regence MedAdvantage + Rx Classic – $47 per month and $250 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $13, and $40. Urgent Care and ER copays are $40 and $90. Office visit copays are $10 and $40. The inpatient hospital copay is $395 for days 1-4.
Regence MedAdvantage + Rx Enhanced – $174 per month and $0 deductible. Tiers 1, 2, and 3 prescription drug copays are $3, $8, and $40. Urgent Care and ER copays are $25 and $90. Office visit copays are $5 and $25. The inpatient hospital copay is $315 for days 1-5.
Regence BlueAdvantage HMO No Rx – $0 per month and no prescription drug benefits. Urgent Care and ER copays are $35 and $90. Office visit copays are $0 and $35. The inpatient hospital copay is $375 for days 1-4.
Regence MedAdvantage Basic – $0 per month and no prescription drug benefits. Urgent Care and ER copays are $40 and $90. Office visit copays are $10 and $40. The inpatient hospital copay is $390 for days 1-4.
Oregon Medicare Part D Prescription Drug Plans
There are 21 available plans available for 2024, compared to 24 last year. 13 plans are enhanced (EA), and 8 plans are basic (AE, DS, or BA). The three $0 deductible plans available are WellCare Medicare Rx Value Plus, AARP Medicare Rx Preferred from UHC, and Asuris Medicare Script Enhanced. The monthly rates for these plans are $78.90, $98.40, and $127. About 24% of all plans cost under $25 per month. The least expensive plan is Wellcare Value Script ($0), and the most costly plan is Asuris Medicare Script Enhanced ($127). This year, 3 plans had premium decreases and 18 plans had premium increases.
AARP MedicareRx Walgreens from UHC – $48.80 per month premium and $410 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $2, $8, $40, 50%, and 27%. 3,253 formulary drugs are available. Some additional gap coverage offered. 3.0 Summary Star Rating.
AARP Medicare Rx Basic from UHC – $39.70 per month premium and $545 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $2, $8, 16%, 41%, and 25%. 3,009 formulary drugs are available. No additional gap coverage offered. 3.0 Summary Star Rating.
AARP MedicareRx Preferred – $98.40 per month premium and $0 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $7, $12, $47, 40%, and 33%. 3,622 formulary drugs are available. No additional gap coverage available. 3.5 Summary Star Rating.
Asuris Medicare Script Basic – $111.50 per month premium and $455 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $4, $13, $40, 40%, and 25%. 2,997 formulary drugs are available. No additional gap coverage offered. 3.5 Summary Star Rating.
Asuris Medicare Script Enhanced – $127.00 per month premium and $0 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $3, $10, $47, 40%, and 33%. 3,502 formulary drugs are available. Some additional gap coverage available. 3.5 Summary Star Rating.
Cigna Essential Rx – $44.20 per month premium and $480 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $6, 18%, 46%, and 25%. 3,170 formulary drugs are available.
Cigna Secure Rx – $36.40 per month premium and $480 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $2, $33, 50%, and 25%. 3,190 formulary drugs are available.
Cigna Extra Rx – $50.60 per month premium and $100 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $4, $10, $42, 50%, and 31%. 3,271 formulary drugs are available.
Clear Spring Health Premier Rx – $16.20 per month premium and $480 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $5, $42, 45%, and 25%. 3,160 formulary drugs are available.
Clear Spring Health Value Rx – $33.50 per month premium and $480 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $3, $42, 39%, and 25%. 3,147 formulary drugs are available.
Elixir RxPlus – $20.30 per month premium and $480 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $6, $43, 45%, and 25%. 3,157 formulary drugs are available.
Elixir RxSecure – $37.60 per month premium and $480 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $4, 15%, 34%, and 25%. 3,085 formulary drugs are available.
Humana Walmart Value Rx Plan – $13.20 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $4, $47, 35%, and 25%. 3,071 formulary drugs are available.
Humana Basic Rx Plan – $13.20 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $1, 25%, 41%, and 25%. 3,071 formulary drugs are available.
Humana Premier Rx Plan – $56.60 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $4, $42, 44%, and 25%. 2,992 formulary drugs are available.
Mutual Of Omaha Rx Value – $24.00 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $2, $25, 43%, and 25%. 2,810 formulary drugs are available.
Mutual Of Omaha Rx Plus – $56.30 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $6, $42, 48%, and 25%. 3.189 formulary drugs are available.
SilverScript Choice – $31.30 per month premium and $245 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $1, $47, 38%, and 28%. 3,005 formulary drugs are available.
SilverScript Plus – $85.00 per month premium and $0 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $2, $47, 50%, and 33%. 3,005 formulary drugs are available.
WellCare Value Script – $18.30 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $4, $43, 47%, and 25%. 3,337 formulary drugs are available.
WellCare Classic – $30.20 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $1, $29, 33%, and 25%. 2,999 formulary drugs are available.
WellCare Medicare Rx Select – $20.10 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $3, $47, 42%, and 25%. 2,999 formulary drugs are available.
WellCare Wellness Rx – $15.70 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $5, $40, 46%, and 25%. 2,999 formulary drugs are available.
WellCare Medicare Rx Saver – $32.60 per month premium and $435 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $0, $2, $28, 38%, and 25%. 2,999 formulary drugs are available.
WellCare Medicare Rx Value Plus – $67.30 per month premium and $0 deductible. Tier 1, 2, 3, 4, and 5 30-day drug copays are $1, $4, $47, 48%, and 33%. 2,999 formulary drugs are available.
Oregon PDP Statistics
Number of drug plans – 21
Number of plans that cost less than $25 per month – 5
Number of $0 deductible plans – 3
Least expensive $0 deductible plan – $78.90 per month
Lowest cost monthly premium – $0
Most expensive monthly premium – $127
Average monthly premium – $58.16
Percentage of plans with gap coverage – 29%
Oregon Health Plan
Oregon Health Plan (OHP) is the Medicaid program offered to state residents. OHP with Limited Drug is available for adults that qualify for Medicare Part D and Medicaid. OHP Plus Supplemental covers pregnant females age 21 or over. And OHP Plus covers adults (ages 19-64) and children (ages 0-18). Applications can be submitted online or with a paper application at any time of the year since there is no designated Open Enrollment period.
Covered benefits include chemical dependency care, dental, hearing, home health, hospice care, hospital care, immunizations, vaccines, labor and delivery, x-rays, lab tests, labor, delivery, postpartum care, physician and nurse practitioner office visits, medical supplies and equipment, mental therapy and treatment, occupational, speech, and physical therapy, prescription drugs, and vision. CAWEM also covers emergency dental, medical, and transport services.
Benefits need to be renewed each year. Renewal notices will be sent at different times, depending on the policy effective date. The client customer services departments can assist with finding a provider, and setting appointments. If you go on Medicare, the OHB benefits will change or terminate. The local Area Agency on Aging or Aging and People With Disabilities office should be notified since they can help with the changes.
Maximum household income requirements are listed below:
Adults (ages 19-64) – $1,436 – single person. $1,945 – two-person family. $2,961 – four-person family.
Children (ages 0-18) – $4,298 – two-person family. $6,545 – four-person family.
Households with pregnant women – $2,677 – single pregnant woman. $4,077 – four-person family. $5,477 – six-person family.