Quick answers
- How many Medicare Advantage plans are in Oregon for 2027?
- CMS's 2027 data lists 61 Medicare Advantage plans open to everyone somewhere in Oregon, from 14 companies, plus 26 special needs plans. How many you can join depends on your county.
- Is Medicare Advantage available in every Oregon county?
- No. For 2027, Grant, Harney, Lake, Umatilla and Union counties have no Medicare Advantage plan open to everyone, only employer group plans, and Curry County has only a special needs plan (CMS 2027 Landscape).
- Do I still pay the Part B premium with Medicare Advantage?
- Yes. You keep paying your Part B premium ($202.90 standard in 2026) plus any premium the plan charges.
- Can I keep my doctor with Medicare Advantage?
- Only if your doctor is in the plan's network, or the plan is a PPO that covers out-of-network care at a higher cost. Check each doctor in the plan's directory before you join.
- When can I join or leave a Medicare Advantage plan?
- During Open Enrollment, October 15 to December 7 (for coverage starting January 1), during the Medicare Advantage Open Enrollment Period from January 1 to March 31 if you're already in a plan, or with a Special Enrollment Period.
Medicare Part C, Medicare Advantage, is another way to get your Medicare benefits. Instead of getting Parts A and B directly from the federal government, you join a private plan approved by Medicare that covers everything Original Medicare covers, almost always with Part D drug coverage included (called an MA-PD). In July 2026, 523,528 of Oregon's 973,880 people with Medicare were in Medicare Advantage or other Medicare health plans (CMS Medicare Monthly Enrollment).
How Medicare Advantage works
You keep paying your Part B premium ($202.90 standard in 2026; CMS publishes the 2027 amount each fall), plus any premium the plan charges, and the plan pays for your covered care. The plan must cover everything Parts A and B cover, but it sets its own copayments, network, prior authorization rules and yearly out-of-pocket limit.
- Networks: you generally use the plan's doctors, hospitals and pharmacies. Emergency and urgent care are covered anywhere in the U.S.
- Yearly limit: every plan has a limit on what you pay for in-network Part A and B services. For 2027, CMS caps it at $9,850 in network and $14,800 for in- and out-of-network services combined in PPOs; a plan may set a lower limit.
- Service area: plans are offered county by county, and you must live in the plan's service area.
- Extra benefits: 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.
- No Medigap: you can't use a Medigap policy with a Medicare Advantage plan.
HMO, PPO, PFFS and SNP: the plan types
HMO (Health Maintenance Organization)
You usually choose a primary care doctor, may need referrals to see specialists, and use the plan's network except for emergencies and urgent care. Some HMOs have a point-of-service option that covers some out-of-network care.
PPO (Preferred Provider Organization)
The plan has a network, but it also covers out-of-network care at a higher cost, and referrals usually aren't needed. PPOs have a combined in- and out-of-network yearly limit as well as the in-network one.
PFFS (Private Fee-for-Service)
The plan sets what it pays providers, and you can see any Medicare-approved provider who agrees to the plan's terms. Not every provider accepts PFFS plans.
SNP (Special Needs Plan)
Plans limited to people with specific needs. For 2027, CMS lists 26 special needs plans in Oregon.
- D-SNP: for people who have both Medicare and the Oregon Health Plan. Oregon requires each CCO to work with Medicare Advantage plans that serve its members who have both. See dual eligibles in Oregon and what is a D-SNP?
- C-SNP: for people with certain chronic conditions, such as diabetes, chronic heart failure or end-stage renal disease
- I-SNP: for people who live, or are expected to live, in a nursing facility or need that level of care at home
2027 Medicare Advantage costs: what's set by Medicare
| Cost | Amount |
|---|---|
| Part B premium (you still pay it) | $202.90 a month standard in 2026; the 2027 amount comes from CMS each fall |
| Highest in-network out-of-pocket limit a plan may set, 2027 | $9,850 |
| Highest combined in- and out-of-network limit (PPOs), 2027 | $14,800 |
| Part D out-of-pocket cap for covered drugs, 2027 | $2,400 |
| Plan premiums, deductibles and copayments | Set by each plan; see the plan's Summary of Benefits |
To see plans and their costs for your ZIP code, compare plans on PlanMatch, or use Medicare.gov's Plan Finder.
Medicare Advantage plans by Oregon county, 2027
Plans are approved county by county. The number of Medicare Advantage plans open to everyone (not counting special needs and employer group plans) ranges widely across Oregon for 2027:
| County | Medicare Advantage plans open to everyone | Special needs plans |
|---|---|---|
| Multnomah | 32 | 13 |
| Washington | 32 | 15 |
| Clackamas | 32 | 15 |
| Lane | 26 | 10 |
| Marion | 22 | 11 |
| Jackson | 5 | 6 |
| Deschutes | 3 | 1 |
| Coos | 1 | 0 |
| Curry | 0 | 1 |
| Grant, Harney, Lake, Umatilla, Union | 0 | 0 |
Source: CMS CY2027 Medicare Advantage Landscape. Every county's count is on its page; see all Oregon counties and is Medicare Advantage available in every Oregon county?
Plans ending for 2027. Some companies stop offering Medicare Advantage plans in some Oregon counties for 2027. If your plan is ending, you should have received a non-renewal letter. You can choose a new plan by December 31, 2026 for no gap in coverage, and you have a Special Enrollment Period through February 28, 2027 and a Medigap guaranteed-issue right for 63 days after your plan ends. See Oregon plans ending in 2027.
Trade-offs vs. Original Medicare
| Medicare Advantage | Original Medicare + Medigap + Part D | |
|---|---|---|
| Monthly premiums | Part B premium plus the plan's premium, if any | Part B premium plus Medigap and Part D premiums |
| Doctors and hospitals | Plan network; PPOs cover out-of-network at a higher cost | Any U.S. provider who accepts Medicare |
| Yearly limit on costs | Yes, up to $9,850 in network in 2027 | None in Original Medicare; Medigap pays most or all of what's left, depending on the plan |
| Drug coverage | Usually included | Separate Part D plan |
| Referrals and prior authorization | Common, especially in HMOs | Rare |
| Where it's available | Depends on your county; none open to everyone in five Oregon counties | Everywhere in Oregon |
Read the full Original Medicare vs. Medicare Advantage comparison.
Joining, switching and leaving
- Open Enrollment (October 15 to December 7): join, switch or drop a Medicare Advantage plan; changes start January 1. Open Enrollment for 2027 is under way now.
- Medicare Advantage Open Enrollment Period (January 1 to March 31): if you're in a Medicare Advantage plan, you can switch plans or go back to Original Medicare and join a Part D plan, once.
- Special Enrollment Periods: for example, if you move, your plan leaves your county, you have both Medicare and OHP, or a disaster such as a wildfire is declared where you live. See when can I switch Medicare plans in Oregon?
- Medigap trial right: if you joined a Medicare Advantage plan within 6 months after your Part B started, or dropped a Medigap policy to try Medicare Advantage for the first time, you can leave within the first 12 months and buy a Medigap policy without health questions (OAR 836-052-0142).
Outside these rights, a Medigap company in Oregon can ask health questions and turn you down when you leave Medicare Advantage. Oregon's birthday rule is only for people who already have Medigap. See can I switch from Medicare Advantage to Medigap in Oregon?
To compare Medicare Advantage plans from the companies they work with in your county, you can request a call from a licensed insurance agent, or meet licensed insurance agents in Oregon.
Related questions
- How many Medicare Advantage plans are in Oregon for 2027?
- Can I keep my doctor with Medicare Advantage in Oregon?
- Can I use my Medicare Advantage plan outside Oregon?
- How do I choose a Medicare plan in Oregon?
Sources
- Medicare.gov — Health plans (Medicare Advantage plan types)
- Medicare.gov — Compare Original Medicare and Medicare Advantage
- Medicare.gov — Special Enrollment Periods
- 42 CFR 422.111 — Disclosure requirements, including notice of provider network changes (Cornell LII)
- CMS — Medicare Advantage and Part D contract and enrollment data (CY2027 Landscape, Oregon plan counts)
- CMS — Medicare Monthly Enrollment (Oregon)
- CMS — Medicare Advantage rate announcements and documents (CY2027 out-of-pocket limits)
- Oregon Health Authority — Affiliated Medicare Advantage Plan Guidance (CCOs and dual eligibles)
- Oregon Health Authority — Coordinated Care Organization (CCO) plans
- Oregon Secretary of State — OAR 836-052-0142, Medigap guaranteed issue for eligible persons
Every question in this guide
Frequently asked questions
Is Medicare Advantage the same as Medicare Part C?
Yes. Part C is the name in the Medicare law, and Medicare Advantage is the name Medicare uses for the same plans.
What is the difference between an HMO and a PPO Medicare Advantage plan?
An HMO generally covers care only from doctors and hospitals in its network, except emergencies and urgent care, and often requires a referral to see a specialist. A PPO also has a network, but it covers out-of-network care at a higher cost and usually doesn't require referrals. Both must cover everything Original Medicare covers and have a yearly out-of-pocket limit.
Do I still pay my Part B premium with Medicare Advantage?
Yes. You must keep Part A and Part B and keep paying the Part B premium ($202.90 standard in 2026), plus any monthly premium your plan charges. If a Medicare Savings Program pays your Part B premium, it keeps doing so.
Do I need a referral to see a specialist with Medicare Advantage?
It depends on the plan. Many HMO plans require a referral from your primary care doctor before you see a specialist, while PPO plans usually don't. Some services also need prior authorization. Check the plan's Evidence of Coverage.
What happens if my doctor leaves my Medicare Advantage network?
Federal rules (42 CFR 422.111(e)) require the plan to notify you in writing at least 45 days before a primary care or behavioral health provider leaves the network, and at least 30 days before for other specialists you see regularly. You may need to pick a new in-network doctor. If CMS finds a network change significant, members may get a Special Enrollment Period to change plans.
Can I leave Medicare Advantage if I don't like it?
Yes. From January 1 to March 31 you can switch to another Medicare Advantage plan or go back to Original Medicare (and join a Part D plan) once. During Open Enrollment, October 15 to December 7, you can make any change for January 1. Buying a Medigap policy after you leave may require health questions unless you have a guaranteed-issue right, such as Oregon's trial right.
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 →
