Quick answers
- What does Original Medicare cover?
- Part A covers inpatient hospital care, skilled nursing after a qualifying stay, hospice and some home health. Part B covers doctors, outpatient care, preventive services, equipment and ambulance.
- What doesn't Medicare cover?
- Original Medicare doesn't cover most routine dental care, eye exams for glasses, hearing aids, or long-term custodial care such as assisted living or memory care.
- Does Medicare cover prescription drugs?
- Part B covers some drugs given in a doctor's office or clinic. Most prescriptions you fill at a pharmacy are covered by a Part D plan or a Medicare Advantage plan with drug coverage.
- Does Medicare work outside Oregon?
- Original Medicare works with any provider in the U.S. who accepts Medicare. Medicare Advantage plans use networks and service areas, so check the plan's out-of-area rules.
- Is preventive care covered?
- Yes. Part B covers many screenings and shots, such as mammograms, colorectal cancer screening and flu shots, at no cost to you when the provider accepts assignment.
This is the starting line for anyone new to Medicare in Oregon. Each link below opens a focused guide. The federal rules are the same in every state; what is Oregon-specific is which plans are sold in your county, Oregon's Medigap rules, and how Medicare works with the Oregon Health Plan, PEBB, OEBB and PERS retiree coverage. As of July 2026, CMS counted 973,880 people with Medicare in Oregon.
The four parts of Medicare
Part A — hospital
Inpatient hospital care, skilled nursing after a qualifying hospital stay, hospice, and some home health. Most people pay no premium because they or a spouse worked and paid Medicare taxes for at least 10 years (40 quarters).
Part B — medical
Doctor visits, outpatient care, durable medical equipment, preventive services, ambulance and most therapies. The standard 2026 premium is $202.90 a month.
Part C — Medicare Advantage
Plans from private companies approved by Medicare that cover everything Parts A and B cover, usually with Part D drug coverage. Networks and plan choices vary by Oregon county.
Part D — prescription drugs
Drug coverage from stand-alone plans that pair with Original Medicare, or built into a Medicare Advantage plan. The 2026 out-of-pocket cap is $2,100.
Medigap (Medicare Supplement)
Private policies that pay much of what Original Medicare leaves to you: deductibles, coinsurance, and hospital costs after Part A days run out. Oregon has a yearly birthday rule.
Original Medicare vs. Medicare Advantage
The biggest decision you make. We compare the two paths in plain language for Oregon residents.
What Original Medicare covers, and what it doesn't
| Usually covered | Not covered by Original Medicare |
|---|---|
| Inpatient hospital stays (Part A) | Most routine dental care, cleanings and dentures |
| Doctor visits, outpatient surgery, lab tests and imaging (Part B) | Routine eye exams for glasses (except after cataract surgery) |
| Preventive services: Welcome to Medicare visit, yearly wellness visit, many cancer screenings, flu and pneumonia shots | Hearing aids and exams for fitting them |
| Durable medical equipment such as walkers, oxygen and CPAP | Long-term custodial care in assisted living, memory care or a nursing home |
| Emergency room care, and ambulance when other transport would be unsafe | Most care outside the U.S. |
| Outpatient mental health care, including licensed counselors and marriage and family therapists | Routine foot care (except for some conditions such as diabetic nerve damage) |
Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage.
For specific services, see our answers on dental, hearing aids, vision, nursing homes, home health and mental health, or browse all Oregon Medicare questions.
Oregon-specific topics
- The Oregon Health Plan (OHP) and Medicare: dual eligibility and what OHP pays
- Coordinated Care Organizations (CCOs): your CCO doesn't change when you get Medicare
- Medicare Savings Programs in Oregon: Oregon has no asset limit for them
- PEBB and Medicare, for retired state employees
- OEBB and Medicare, for retired Oregon educators
- Wildfire and disaster Special Enrollment Periods
- The Death with Dignity Act and Medicare hospice
- Tribal health and Medicare in Oregon
- Veterans, VA care and Medicare in Oregon
- Rural Oregon and Medicare access
- Medicare plans ending in Oregon for 2027
The four big decisions you'll make
- Original Medicare or Medicare Advantage? Original Medicare lets you see any provider in the U.S. who accepts Medicare. Medicare Advantage plans use networks and service areas set by county, and include a yearly limit on in-network costs. In Oregon, five counties (Grant, Harney, Lake, Umatilla and Union) have no Medicare Advantage plan open to everyone for 2027, so check your county first.
- If Original Medicare: which Medigap plan? Medigap plans are standardized by letter (G, N, K and others). Plans C and F can't be sold to people who became eligible for Medicare on or after January 1, 2020. Oregon's birthday rule lets you switch to a plan with the same or fewer benefits each year without health questions.
- Which Part D plan? If you take regular medications, check each plan's formulary (drug list) and pharmacies against your prescriptions. Every Part D plan caps what you pay for covered drugs each year ($2,100 in 2026).
- When to enroll. If you're not getting Social Security benefits yet, you must sign up for Medicare yourself. Missing your Initial Enrollment Period can mean lifelong late penalties for Part B and Part D.
To talk through these choices for your county and prescriptions, you can request a call from a licensed insurance agent, or meet licensed insurance agents in Oregon.
Timing and enrollment
If you're approaching 65, the window that matters most is your Initial Enrollment Period: seven months that start three months before the month you turn 65. Late enrollment penalties for Part B and Part D can last for as long as you have Medicare. Open Enrollment for 2027 coverage runs October 15 to December 7, 2026.
Read the enrollment guide or, if you're still working, how Medicare works with employer coverage.
Related guides
- What is Medicare?
- Medicare costs in Oregon
- Working past 65 in Oregon
- Oregon Medicare resources and phone numbers
Sources
- Medicare.gov — Parts of Medicare
- Medicare.gov — Travel outside the U.S.
- Medicare.gov — Welcome to Medicare preventive visit
- Medicare.gov — Yearly wellness visits
- Medicare.gov — Lung cancer screenings
- Medicare.gov — Eyeglasses and contact lenses
- Medicare.gov — Foot care
- Medicare.gov — Therapeutic shoes and inserts
- Medicare.gov — Emergency department services
- CMS — Medicare Advantage and Part D contract and enrollment data (CY2027 Landscape, Oregon plan counts)
- CMS — Medicare Monthly Enrollment (Oregon)
- Oregon Secretary of State — OAR 836-052-0143, Medigap annual birthday opportunity
- Oregon Secretary of State — OAR 836-052-0138, Medigap open enrollment (including under 65)
Every question in this guide
- Does Medicare cover acupuncture in Oregon?
- Does Medicare cover ambulance service in Oregon?
- Does Medicare cover annual physicals in Oregon?
- Does Medicare cover assisted living in Oregon?
- Does Medicare cover bone density tests in Oregon?
- Does Medicare cover cataract surgery in Oregon?
- Does Medicare cover chiropractic care in Oregon?
- Does Medicare cover a colonoscopy in Oregon?
- Does Medicare cover CPAP machines in Oregon?
- Does Medicare cover dental care in Oregon?
- Does Medicare cover diabetic supplies in Oregon?
- Does Medicare cover flu shots in Oregon?
- Does Medicare cover hearing aids in Oregon?
- Does Medicare cover home health care in Oregon?
- Does Medicare pay for in-home caregivers in Oregon?
- Does Medicare cover mammograms in Oregon?
- Does Medicare cover me when I travel or spend winters outside Oregon?
- Does Medicare cover medical marijuana in Oregon?
- Does Medicare cover memory care in Oregon?
- Does Medicare cover mental health care in Oregon?
- Does Medicare cover naturopathic doctors in Oregon?
- Does Medicare cover nursing home care in Oregon?
- Does Medicare cover oxygen therapy in Oregon?
- Does Medicare cover physical therapy in Oregon?
- Does Medicare cover prostate cancer screening in Oregon?
- Does Medicare cover psilocybin therapy in Oregon?
- Does Medicare cover skilled nursing care in Oregon?
- Does Medicare cover the shingles vaccine in Oregon?
- Does Medicare cover transportation to medical appointments in Oregon?
- Does Medicare cover vision care in Oregon?
- Does Medicare cover wheelchairs in Oregon?
Frequently asked questions
What is the difference between Medicare Part A and Part B?
Part A is hospital insurance: inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice and some home health care. Part B is medical insurance: doctor visits, outpatient care, preventive services, durable medical equipment and ambulance. Most people pay no Part A premium, while almost everyone pays a monthly Part B premium ($202.90 standard in 2026).
Does Medicare cover care outside the United States?
Generally no. Original Medicare covers care outside the U.S. only in rare cases, such as an emergency when the nearest hospital that can treat you is in Canada or Mexico. Medigap Plans C, D, F, G, M and N pay 80% of foreign travel emergency care after a deductible, up to a lifetime limit, and some Medicare Advantage plans include some coverage abroad.
What is the Welcome to Medicare preventive visit?
It is a one-time visit with your doctor during the first 12 months you have Part B to review your health, risks and needed screenings. After that, Part B covers a yearly wellness visit. You pay nothing for either visit if your doctor accepts assignment, though tests or other services during the visit may have costs.
Does Medicare cover lung cancer screening?
Yes. Part B covers a yearly low-dose CT scan for people 50 to 77 who have no symptoms, currently smoke or quit within the last 15 years, have a tobacco history of at least 20 pack-years, and get an order from their provider. You pay nothing if the provider accepts assignment.
Does Medicare pay for glasses after cataract surgery?
Yes, once per surgery. After cataract surgery that implants an intraocular lens, Part B helps pay for one pair of eyeglasses with standard frames or one set of contact lenses from a Medicare-enrolled supplier. You pay 20% of the Medicare-approved amount, and the Part B deductible applies.
Does Medicare cover foot care for diabetes?
Part B covers foot exams and treatment if you have diabetes-related nerve damage, and helps pay each year for therapeutic shoes or inserts if you have diabetes and severe diabetic foot disease. Routine foot care such as nail trimming is generally not covered.
Does Medicare cover emergency room visits?
Yes. Part B covers emergency department visits; you pay a copayment for the hospital visit and 20% of the Medicare-approved amount for the doctor, after the Part B deductible. If you're admitted to the same hospital for a related condition within 3 days, the visit counts as part of your inpatient stay under Part A.
How is Medicare in Oregon different from Washington or California?
The federal program is the same in every state. What changes is which plans are offered in your county, the networks they use, each state's Medigap rules (Oregon has a yearly birthday rule and guaranteed Medigap for people under 65 with Medicare), and the state Medicaid program, which in Oregon is the Oregon Health Plan.
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
