Medicare is the federal health insurance program for people 65 or older, some younger people with disabilities, and people with end-stage renal disease or ALS. It is run by the Centers for Medicare & Medicaid Services (CMS), and Social Security handles most enrollment. The federal program works the same way in Oregon as in every other state; what differs in Oregon is which private plans are offered in each county, Oregon's Medigap rules, and how Medicare works with the Oregon Health Plan. As of July 2026, CMS counted 973,880 people with Medicare in Oregon.
A brief history
Medicare became law in 1965 and at first had only Part A (hospital) and Part B (medical). Private Medicare health plans became Part C in 1997 and were renamed Medicare Advantage in 2003. Part D prescription drug coverage began in 2006. The Inflation Reduction Act of 2022 capped yearly out-of-pocket Part D drug costs starting in 2025 and began Medicare drug price negotiation.
Who's eligible for Medicare in Oregon
You generally qualify when one of these applies:
- You are 65 or older and a U.S. citizen, or a lawful permanent resident who has lived in the U.S. for at least 5 years in a row.
- You are under 65 and have received Social Security or Railroad Retirement disability benefits for 24 months.
- You have end-stage renal disease (ESRD): permanent kidney failure that needs dialysis or a transplant.
- You have ALS (Lou Gehrig's disease): Medicare starts the month your disability benefits begin, with no 24-month wait.
Read more about Medicare for Oregonians under 65 with disabilities.
The four parts of Medicare
Part A — hospital insurance
Inpatient hospital stays, skilled nursing facility care after a qualifying hospital stay, hospice care, and some home health care. Most people pay no Part A premium because they or a spouse earned 40 quarters of work credits. Part A in Oregon
Part B — medical insurance
Doctor visits, outpatient hospital services, durable medical equipment, preventive services, ambulance, mental health care and most therapy. In 2026 Part B has a standard monthly premium of $202.90, a yearly deductible of $283, and generally 20% coinsurance after that, with no yearly limit. Part B in Oregon
Part C — Medicare Advantage
Another way to get Parts A and B, through a private plan approved by Medicare, usually with Part D drug coverage included. Plans use networks and are sold by county: for 2027, CMS lists 61 Medicare Advantage plans open to everyone somewhere in Oregon, from 14 companies, but Multnomah County has 32 and some counties have none. 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. Part C in Oregon
Part D — prescription drug coverage
Drug coverage from stand-alone plans that pair with Original Medicare, or built into a Medicare Advantage plan. In 2026 the deductible can be no more than $615, and out-of-pocket costs for covered drugs are capped at $2,100 a year. Part D in Oregon
Where does Medigap fit? Medigap (Medicare Supplement Insurance) isn't one of the four parts. It is a private policy that works with Original Medicare (Parts A and B) and pays much of what Medicare leaves to you, like the Part B coinsurance and the Part A deductible. It can't be used with Medicare Advantage. Medigap in Oregon
What Medicare costs in 2026
Federal Medicare amounts are the same nationwide. CMS publishes the 2027 Part A and Part B amounts each fall; until then, these are the 2026 amounts:
| Item | 2026 amount |
|---|---|
| Part A premium (most people) | $0 |
| Part A premium if you buy it (fewer than 30 quarters of work) | $565 a month |
| Part A inpatient deductible (each benefit period) | $1,736 |
| Part B standard premium | $202.90 a month |
| Part B yearly deductible | $283 |
| Part D out-of-pocket cap | $2,100 |
See the full cost breakdown, including IRMAA, and what is known so far about 2027.
What's specific to Oregon
- Plan choices depend on your county. For 2027, Multnomah County has 32 Medicare Advantage plans open to everyone, Washington County 32 and Clackamas County 32, while Grant, Harney, Lake, Umatilla and Union counties have none and Curry County has only a special needs plan (CMS 2027 Landscape). See your county.
- Medicare Advantage and Original Medicare are close to even. In July 2026, 523,528 Oregonians were in Medicare Advantage or other health plans and 450,352 were in Original Medicare (CMS Medicare Monthly Enrollment).
- The Oregon Health Plan (OHP) works with Medicare for people who qualify for both, and the Medicare Savings Programs have no asset limit in Oregon.
- Oregon's Medigap rules include a yearly birthday rule (OAR 836-052-0143) and guaranteed Medigap for people under 65 with Medicare (OAR 836-052-0138).
- PEBB and OEBB retiree medical coverage ends when you become eligible for Medicare; PEBB and OEBB explain what to do.
Next steps
- Read the Learn Medicare guide for more on each part.
- Compare Original Medicare with Medicare Advantage.
- Understand enrollment timing, especially if you're approaching 65.
- Get help: call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048), Social Security at 1-800-772-1213, or, to compare plans from the companies they work with, you can request a call from a licensed insurance agent.
Related guides
- Medicare Part A in Oregon
- Medicare Part B in Oregon
- Working past 65 in Oregon
- Medicare vs. Medicaid in Oregon
Sources
- Medicare.gov — Get started with Medicare
- Medicare.gov — Parts of Medicare
- Social Security Administration — Medicare
- CMS — 2026 Medicare Parts A & B premiums and deductibles
- Medicare.gov — Medicare costs
- CMS — Medicare Advantage and Part D contract and enrollment data (CY2027 Landscape, Oregon plan counts)
- CMS — Medicare Monthly Enrollment (Oregon)
- Oregon Health Authority — OHP and Medicare
- Oregon Secretary of State — OAR 836-052-0143, Medigap annual birthday opportunity
- Oregon Secretary of State — OAR 836-052-0138, Medigap open enrollment
Frequently asked questions
Do I have to enroll in Medicare at 65?
If you already get Social Security or Railroad Retirement benefits, you're enrolled in Part A and Part B automatically. If you don't, you sign up through Social Security during your Initial Enrollment Period. If you or your spouse have health coverage from current work, you can usually delay Part B without a penalty.
Does Medicare cost anything?
Most people pay no premium for Part A because they or a spouse paid Medicare taxes for at least 10 years. Part B has a monthly premium ($202.90 standard in 2026, more at higher incomes) and a yearly deductible ($283 in 2026). Part D, Medigap and some Medicare Advantage plans have their own premiums.
What's the difference between Medicare and Medicaid?
Medicare is a federal program based mainly on age or disability. Medicaid is a joint federal and state program based on income, and in Oregon it is called the Oregon Health Plan (OHP). Some people qualify for both and are called dual eligibles; OHP can then help pay Medicare costs.
Can I have Medicare and employer coverage at the same time?
Yes. Many people do, especially if they're working past 65. Whether Medicare or the employer plan pays first depends mainly on whether the coverage comes from current work and on the employer's size (20 or more employees for people 65 and older).
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 →
