Welcome to an overview of our Medicare offerings in Oregon. Alaska If you are already a member, you can log In to your Member Dashboard. If you have questions or need help, please don't hesitate to contact us.
Plans that combine Medicare Part A, Part B, with Part D drug coverage options, and several extra benefits that Original Medicare does not offer.
Plans that reimburse your Medicare Part A & B cost-shares, and provide limited extra benefits above Original Medicare
We provide plan member support for Oregon PERS members.
Here are key differences between Medicare plans. If you're new to Medicare and would like to learn more about the program, please visit our Understanding Medicare page.
Here are key differences between Original Medicare and Medicare Supplement plans.
Features | Part A | Part B | Medicare Advantage (Part C) |
Medicare Supplement | Prescription Drug Plan (Part D) |
---|---|---|---|---|---|
Also Known As |
Original Medicare Traditional Medicare |
MedAdvantage MA (Medicare Advantage - no Part D) MAPD (Medicare Advantage Prescription Drug) |
MediGap MedSupp |
Stand-alone Prescription Drug Plan (PDP) | |
Administered through | The Centers for Medicare and Medicaid Services (CMS), a federal agency | Private Insurance companies with contracts with CMS | Private Insurance companies with contracts with CMS, and States | Private Insurance companies with contracts with CMS | |
Eligibility |
65+ Disability Usually automatic and no premium required |
65+ Disability Must elect coverage and pay additional premium |
Must be enrolled in parts A and B to elect coverage. Cannot be covered on both Medicare Advantage and Medicare Supplement. | Must be enrolled in parts A and B to elect coverage. Cannot be covered on both Medicare Advantage and Medicare Supplement. | Must have Parts A and/or B to elect coverage. Can combine a PDP with Original Medicare, PFFS, MSA or MedSupp, but not MAPD. |
Benefits | Hospital Coverage | Outpatient Services | Plans may offer a richer benefit than Medicare, and additional coverage that Medicare doesn't cover. See the Medicare Advantage link above for plan details offered through Moda. | Generally covers your out-of-pocket expenses after Original Medicare pays, with some additional covered benefits. See the Medicare Supplement link above for plan details offered through Moda. | Coverage for Part D drugs. While Moda doesn't offer a PDP, Moda offers combined MAPD plans. See the Medicare Advantage link above for plan details offered through Moda. |
Network | Providers must accept Medicare. | Must see participating providers in the MA/MAPD network. HMO (Health Maintenance Organization) plans may require referrals. PPO (Preferred Provider Organization) plans generally have a broader network and include out of network benefits. POS (Point of Service) plans offer out of network benefits. Providers must accept Medicare. | Providers must accept Medicare. | Must use participating Pharmacies in the MA/MAPD network. | |
Drug Coverage | Limited number of drugs under certain conditions | Included in MAPD plans. | Not covered. Option to buy additional PDP plan. | Covered. | |
Other coverage (Routine dental, hearing, and vision) | Not covered. | Usually included. Visit the link above for details on what Moda offers. | May be included. Visit the link above for details on what Moda offers. | Not covered. | |
Added Benefits and Services | Not included. | May include additional programs and services (such as a fitness benefit) for no cost. Will vary by insurance company. Visit the link above for details on what Moda offers. | May include additional programs and services (such as a fitness benefit) for no cost. Will vary by insurance company. Visit the link above for details on what Moda offers. | Not covered. |
Features | Part A | Part B | Medicare Supplement |
---|---|---|---|
Also Known As |
Original Medicare Traditional Medicare |
MediGap MedSupp |
|
Administered through | The Centers for Medicare and Medicaid Services (CMS), and federal agency | Private Insurance companies with contracts with CMS, and States | |
Eligibility | 65+ Disability Usually automatic and no premium required | 65+ Disability Must elect coverage and pay additional premium | Must be enrolled in parts A and B to elect coverage. Cannot be covered on both Medicare Advantage and Medicare Supplement. |
Benefits | Hospital Coverage | Outpatient Services | Generally covers your out-of-pocket expenses after Original Medicare pays, with some additional covered benefits. See the Medicare Advantage link above for plan details offered through Moda. |
Network | Providers must accept Medicare. | Providers must accept Medicare. | |
Drug Coverage | Limited number of drugs under certain conditions | Generally covers your cost-share for any drugs covered under Original Medicare Option to buy additional PDP plan. | |
Other coverage (Routing dental, hearing, and vision) | Not covered. | May be included. Visit the link above for details on what Moda offers. | |
Added Benefits and Services | Not included. | May include additional free programs and services (such as a fitness benefit) for no cost. Will vary by insurance company. Visit the link above for details on what Moda offers. |
If you have questions or need help, please don't hesitate to contact us.
We have exciting news to share. ODS is changing its name to Moda Health.
Moda comes from the latin term "modus" and means "a way". We picked it because that's what we are here to do: help our communities find a way to better health.
Together, we can be more, be better.
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Please select the state you live in, or the state where your employer is headquartered, so we can tailor your experience:
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