Oregon Medicare Advantage enrollment reached approximately 525,000 beneficiaries in 2026, about 55% of the state's roughly 954,000 Medicare-eligible residents, matching the national MA penetration rate of 55% reported by CMS. Sixteen private carriers sell Medicare Advantage somewhere in Oregon in 2026, but the statewide count of distinct plans dropped to 102, down from 109 in 2025, a contraction that mirrors a broader national pullback in plan offerings for the 2026 plan year. The statewide weighted average monthly premium is about $26 in 2026, higher than California's unusually low $11 average and above the national MA average of $14, though CMS data shows that 93.5% of Oregon Medicare beneficiaries still have access to at least one $0 premium Medicare Advantage plan in their county. Portland metro counties like Multnomah and Washington offer the deepest plan selection, sometimes 55 or more plans, while rural coastal and eastern Oregon counties like Tillamook and Baker have as few as five.
Kaiser Permanente operates in Oregon, one of only nine states where the closed-network HMO model does business, concentrated in the Portland metro area across Multnomah, Washington, and Clackamas counties. Providence Health Assurance and Regence BlueCross BlueShield of Oregon compete for the broader statewide HMO and PPO market, while PacificSource Medicare holds a strong foothold in Central and Southern Oregon around Bend and Medford. Moda Health, UnitedHealthcare, Humana, and Devoted Health round out the field with smaller but growing footprints, particularly along the Willamette Valley. Confirm your doctors are in-network before enrolling, since Oregon carrier networks can vary sharply between the I-5 corridor and the rural frontier counties east of the Cascades. Oregon is also among the states KFF flags where some Medicare beneficiaries, concentrated in the most sparsely populated eastern counties, have no Medicare Advantage plan available at all in 2026, leaving Original Medicare plus a standalone Part D plan as their only option.
Oregon's 2026 Medicare Advantage market is the focus of this guide: how many plans, which carriers, what to look for when shopping, and the key enrollment dates. The Annual Election Period runs October 15 to December 7, 2026, with coverage starting January 1, 2027, and the Medicare Advantage Open Enrollment Period follows January 1 to March 31, 2026, for beneficiaries who want a second look at their existing plan.
2026 Medicare Advantage Market Overview in Oregon
In 2026, Oregon has 102 Medicare Advantage plans available, with 525,000 beneficiaries enrolled (55% MA penetration). The average monthly premium is $26 and the statewide average Star Rating is 3.9.
Top Medicare Advantage carriers in Oregon (2026)| Carrier | Plans | Avg Star Rating | Avg Premium |
|---|
| Kaiser Permanente | 10 | 4.5 | $35/mo |
| Providence Health Assurance | 18 | 4.0 | $45/mo |
| Regence BlueCross BlueShield of Oregon | 20 | 3.5 | $28/mo |
| PacificSource Medicare | 15 | 4.5 | $22/mo |
| UnitedHealthcare | 16 | 3.5 | $18/mo |
| Humana | 12 | 3.5 | $15/mo |
| Moda Health | 8 | 3.5 | $30/mo |
| Devoted Health | 6 | 4.0 | $10/mo |
Source: KFF Medicare Advantage 2026 Oregon Spotlight, CMS Medicare Plan Finder Q4 2025
Plan Types in Oregon: HMO vs PPO vs SNP
Medicare Advantage plan-type breakdown in Oregon| Plan Type | Plans Available | Avg Premium | Best For |
|---|
| HMO | 60 | $18/mo | Lower premiums, willing to use network providers |
| PPO | 25 | $45/mo | Flexibility to see out-of-network providers |
| Special Needs Plan (SNP) | 15 | $0/mo | Dual-eligible (OHP + Medicare), chronic conditions (C-SNP), institutional care |
| Medical Savings Account (MSA) | 2 | $0/mo | High-deductible plan with bank account; uncommon in Oregon |
HMO plans dominate Oregon: about 59% of all 2026 MA plans. Oregon also has an unusually high share of Chronic Condition Special Needs Plans (C-SNPs), representing 40% or more of the state's SNP enrollment per KFF.
Source: KFF Medicare Advantage 2026 Oregon Spotlight, CMS Medicare Plan Finder
County-Level Variance in Oregon
Plan availability varies sharply by Oregon county in 2026. Portland metro counties like Multnomah and Washington offer 55 or more plans to choose from; rural coastal and eastern counties like Tillamook and Baker may have only five. Premiums also vary, with rural Oregon areas typically $30 to $40 higher per month due to lower carrier competition.
Plan count and average premium by county in Oregon| County | Plans Available | Avg Premium |
|---|
| Multnomah County | 59 | $15/mo |
| Washington County | 55 | $16/mo |
| Lane County | 33 | $22/mo |
| Deschutes County | 24 | $28/mo |
| Tillamook County | 5 | $48/mo |
| Baker County | 5 | $52/mo |
Plan counts and premiums are drawn from CMS Medicare Plan Finder Q4 2025 and the Oregon SHIBA 2026 Guide to Medicare Insurance Plans. Run a personalized search at medicare.gov to see exact plans for your ZIP code.
Source: CMS Medicare Plan Finder Q4 2025, Oregon county data
What to Look For in a Medicare Advantage Plan in Oregon
Picking a Medicare Advantage plan in Oregon is not just about premium. Here is what matters for shopping in 2026:
- Provider network. Confirm your primary care physician, specialists, and preferred hospital are all in-network before enrolling. Oregon networks vary sharply between the Portland metro I-5 corridor and rural counties east of the Cascades.
- Prescription drug coverage (formulary). Most Oregon MA plans include Part D. Check that your specific medications are on the plan's formulary at the tier you can afford. The 2026 Part D out-of-pocket cap is $2,100 across all plans.
- Star Ratings. CMS rates plans 1 to 5 stars annually on quality of care, member experience, and customer service. 4-star and 5-star plans get bonus payments from CMS that fund richer benefits. In Oregon, Kaiser Permanente and PacificSource consistently score 4.5 stars.
- Extras (dental, vision, hearing, fitness, transportation). Oregon MA plans differ widely on supplemental benefits. Providence and Kaiser offer generous dental and hearing aid coverage; several carriers offer SilverSneakers fitness; some plans cover rides to medical appointments, especially valuable in rural Oregon counties with limited public transit.
- Maximum out-of-pocket (MOOP). MA plans cap your annual in-network out-of-pocket spending. The 2026 federal MOOP ceiling for in-network MA is $9,250, down $100 from $9,350 in 2025; many Oregon plans set it lower ($3,500 to $6,750). Original Medicare has no MOOP.
- Prior authorization burden. Oregon MA plans can require prior authorization for surgeries, advanced imaging, and specialist referrals. If you have a chronic condition or expect significant care, ask how often the plan requires PA and check denial rates published by CMS.
Key Medicare Dates in Oregon
Oregon Medicare and Medicare Advantage have several enrollment windows in 2026. Miss them and you may face delays or late penalties.
- Annual Election Period (AEP): October 15 - December 7, 2026 — Switch between Original Medicare and MA, change MA plans, or change Part D plans. Coverage starts January 1, 2027.
- Medicare Advantage Open Enrollment Period (MA OEP): January 1 - March 31, 2026 — If you're already in an Oregon MA plan, you can switch to a different MA plan or return to Original Medicare. One switch only.
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday — Starts 3 months before your 65th birthday month, includes the birth month, and runs 3 months after. Enroll in Medicare Parts A and B, then choose Oregon MA or Original Medicare plus Part D.
- Special Enrollment Periods (SEPs): Varies by qualifying event — Triggered by moving out of your plan's Oregon service area, losing employer coverage, qualifying for the Oregon Health Plan (dual eligible), or other life events. Typically a 2-3 month window.
Notable Extras in Oregon Plans
Oregon Medicare Advantage plans have several state-specific features worth knowing about in 2026:
- Oregon Health Plan (OHP) dual-eligible D-SNPs: Oregon residents who qualify for both the Oregon Health Plan (Oregon's Medicaid program) and Medicare are dual eligible and can enroll in a Dual Special Needs Plan (D-SNP). These typically carry $0 premiums, $0 copays for primary care, and zero out-of-pocket prescription costs. Coordination between OHP and Medicare Advantage varies by county, so check the medicare.gov Plan Finder for the D-SNPs offered where you live.
- Unusually high Chronic Condition SNP (C-SNP) share: Oregon stands out nationally for how much of its Special Needs Plan enrollment is in Chronic Condition SNPs rather than Dual SNPs. KFF reports that C-SNPs make up 40% or more of Oregon's SNP enrollment, plans built for beneficiaries with diabetes, heart failure, or other qualifying chronic conditions.
- Rural Oregon Medicare Advantage access gaps: Oregon is one of thirteen states, alongside Alaska, Montana, and Nevada, where some Medicare beneficiaries have no Medicare Advantage plan available in their county for 2026, concentrated in Oregon's most sparsely populated eastern and frontier counties. Residents there rely on Original Medicare plus a standalone Part D plan, or a Medigap policy.
- Oregon SHIBA free Medicare counseling: The Oregon Senior Health Insurance Benefits Assistance (SHIBA) program, run by the state Department of Consumer and Business Services, offers free, unbiased one-on-one Medicare counseling to help Oregon residents compare Medicare Advantage plans and understand the Oregon Health Plan interaction.
Medicare Advantage vs Original Medicare in Oregon
Original Medicare (Parts A and B) plus a Medigap supplement and a standalone Part D drug plan gives Oregon residents nationwide provider freedom and no prior authorization for most services, but the combined Medigap plus Part D premium in Oregon typically runs $220 to $420 per month. Medicare Advantage plans bundle hospital, medical, and usually drug coverage into one plan with average premiums of about $26 per month statewide in 2026, but the trade-off is a defined network and prior authorization for many services.
Oregon residents who split time between the Willamette Valley and out of state, or who need access to a specialist outside their county, are usually better served by Original Medicare plus Medigap. Oregon residents who stay put and want lower premiums plus extras like dental, vision, and transportation typically come out ahead with Medicare Advantage, particularly in Portland metro counties where 55 or more plans compete for their business.
One Oregon-specific quirk: under federal rules, you can switch from Medicare Advantage back to Original Medicare during AEP or MA OEP, but Medigap carriers are not required to sell you a policy at that point unless you have a guaranteed issue right. Oregon offers a limited annual Medigap open enrollment window for people already enrolled in a Medigap policy who want to switch to an equal or lesser plan without medical underwriting, but the right to buy Medigap for the first time after leaving Medicare Advantage is still restricted in most cases. Plan ahead before you drop Medigap for an Oregon MA plan.
How Star Ratings work in Oregon
Oregon Medicare Advantage Star Ratings, like every state's, are published by CMS every October, rating plans 1 to 5 stars based on roughly 40 quality measures: how well plans manage chronic conditions, customer service ratings, member complaints, and Part D drug safety. Plans rated 4 stars or higher receive quality bonus payments from CMS, which often translate to richer benefits the next plan year.
Oregon's statewide weighted-average Star Rating for 2026 is 3.9, slightly above the national average of about 3.8. Kaiser Permanente and PacificSource Medicare are Oregon's highest-rated carriers, both averaging 4.5 stars, while Providence Health Assurance and Devoted Health post solid 4.0-star averages. A handful of Oregon plans hold the rare 5-star rating in a given year, which triggers a Special Enrollment Period allowing beneficiaries to switch into them any time outside AEP.
How to enroll in Oregon Medicare Advantage
Oregon residents enrolling in Medicare Advantage in 2026 follow the same federal process as the rest of the country, but with Oregon-specific carrier and county options to weigh. Use medicare.gov/plan-compare as your starting point: CMS publishes a personalized plan-finder tool keyed to your ZIP code that shows every Oregon MA plan available where you live, along with premium, Star Rating, and estimated annual cost.
- Step 1: Confirm Medicare Part A and Part B eligibility. You must already be enrolled in both before you can join an Oregon MA plan. If you're newly turning 65, your Initial Enrollment Period covers this.
- Step 2: Gather your documents. You will need: Medicare card (showing your Medicare number and Part A/B effective dates), ZIP code (for plan availability), list of current prescriptions (for formulary lookup), list of current doctors and hospitals (for network check), and your Oregon Health Plan card if you are dual-eligible.
- Step 3: Compare plans at medicare.gov/plan-compare. Filter by your ZIP code. Sort by Star Rating, monthly premium, total estimated annual cost, or maximum out-of-pocket. Oregon residents should also check the Oregon SHIBA program for free, unbiased counseling before deciding.
- Step 4: Apply. You can enroll directly through medicare.gov, by calling 1-800-MEDICARE (1-800-633-4227), or through the carrier directly. Most Oregon MA enrollments take 10 to 15 minutes online.
- Step 5: Confirm your coverage start date. AEP enrollments start January 1, 2027. SEP enrollments typically start the first of the month after you enroll. You will receive a member ID card and Evidence of Coverage from the Oregon carrier within 7 to 10 business days.
- Common reasons Oregon Medicare Advantage applications are delayed or denied: late Part B enrollment, a ZIP code outside the plan's Oregon service area, missing Oregon Health Plan documentation for D-SNP applicants, identity verification issues, and choosing a plan you are not eligible for, such as a C-SNP without a qualifying chronic condition or a D-SNP without dual status.
$0 premium plans in Oregon for 2026
Oregon has dozens of $0 monthly premium Medicare Advantage plans available in 2026, concentrated in Portland metro counties (Multnomah, Washington, Clackamas) and pockets of Central Oregon around Bend. CMS reports that 93.5% of Oregon Medicare beneficiaries have access to at least one $0 premium plan. A $0 premium does not mean $0 cost: you still pay the Part B premium ($202.90 per month in 2026) plus any drug copays, deductibles, and out-of-pocket costs the plan charges.
$0 premium plans in Oregon for 2026 detail| Carrier | Plan Type | Star Rating | Counties Available |
|---|
| Kaiser Permanente | HMO | 4.5 | Multnomah, Washington, Clackamas |
| UnitedHealthcare | HMO | 3.5 | Multnomah, Washington, Lane, Marion |
| Providence Health Assurance | HMO | 4.0 | Multnomah, Washington, Clackamas, Yamhill |
| PacificSource Medicare | HMO | 4.5 | Deschutes, Jackson, Klamath |
| Humana | PPO | 3.5 | Statewide (select counties) |
Oregon $0 premium plan availability sample. Full list at medicare.gov/plan-compare keyed to your ZIP code. Star Ratings reflect the 2026 plan year.
Source: Oregon CMS Medicare Plan Finder Q4 2025
Oregon Health Plan (OHP) and dual eligibility in Oregon
Oregon residents who qualify for both the Oregon Health Plan and Medicare at the same time are dual eligible. Dual-eligible Oregonians can enroll in a Dual Special Needs Plan (D-SNP), which coordinates OHP and Medicare Advantage into one plan and typically carries $0 premiums, $0 copays, and zero prescription costs. Oregon also stands out for its high share of Chronic Condition SNPs (C-SNPs), built for beneficiaries managing diabetes, heart failure, or chronic lung disease, which make up 40% or more of Oregon's total SNP enrollment per KFF.
Dual eligibility in Oregon also unlocks a special enrollment right: dual-eligible beneficiaries can change MA plans, or move between MA and Original Medicare, once per quarter in Q1, Q2, and Q3, plus another time during AEP. If your Oregon Health Plan status changes, you also get a Special Enrollment Period.
Frequently Asked Questions
How many Medicare Advantage plans are available in Oregon in 2026?
Oregon has 102 Medicare Advantage plans available statewide in 2026, down from 109 in 2025. The exact number available to you depends on your county and ZIP code. Portland metro counties like Multnomah and Washington offer 55 or more plans; rural counties like Tillamook and Baker may have only five. Run a ZIP-code search at medicare.gov to see your exact Oregon options.
What is the average Medicare Advantage premium in Oregon for 2026?
The statewide weighted-average Medicare Advantage premium in Oregon is about $26 per month in 2026, above the national MA average of $14. Even so, CMS reports that 93.5% of Oregon Medicare beneficiaries have access to at least one $0 premium plan, concentrated in Portland metro and pockets of Central Oregon. Premiums tend to run higher ($30 to $50 per month) in rural Oregon counties with fewer competing carriers.
When can I sign up for Medicare Advantage in Oregon?
The main enrollment window is the Annual Election Period (AEP) from October 15 to December 7, 2026, for coverage starting January 1, 2027. Oregon residents can also enroll during their 7-month Initial Enrollment Period around their 65th birthday, or during a Special Enrollment Period triggered by events like moving, losing employer coverage, or qualifying for the Oregon Health Plan. Existing Oregon MA enrollees can switch plans during the MA Open Enrollment Period (January 1 to March 31, 2026).
Who has the best Medicare Advantage plans in Oregon?
Kaiser Permanente and PacificSource Medicare lead Oregon in Star Ratings, both averaging 4.5 stars in 2026. Providence Health Assurance and Devoted Health post solid 4.0-star averages. Regence BlueCross BlueShield of Oregon and UnitedHealthcare offer the broadest statewide networks for Oregon residents who don't want a closed HMO. The best plan depends on your doctors, your medications, and whether you value low premium or wide network access.
Can I switch from Medicare Advantage back to Original Medicare in Oregon?
Yes. Oregon residents can switch back during the Annual Election Period (October 15 to December 7) or the Medicare Advantage Open Enrollment Period (January 1 to March 31). Returning to Original Medicare does not automatically guarantee you can buy a Medigap policy: Oregon Medigap insurers are generally not required to sell you a plan outside your initial Medigap open enrollment window, except under specific guaranteed issue rights. Oregon's limited annual Medigap window helps existing policyholders switch plans, but it doesn't apply the first time you leave Medicare Advantage. Plan ahead.
What is the difference between an HMO and a PPO in Oregon Medicare Advantage?
HMOs (about 60 of Oregon's 102 plans, roughly 59%) require you to use in-network providers and usually need a referral to see a specialist. They offer lower premiums (average $18 per month) and Kaiser Permanente and Providence are the dominant Oregon HMOs. PPOs (about 25 plans, roughly 25%) let you see out-of-network providers at a higher cost share and don't require referrals, but they charge higher premiums (average $45 per month). Choose HMO for lower cost within Oregon's networks; choose PPO for flexibility.
Does Medicare Advantage cover prescription drugs in Oregon?
Most Oregon Medicare Advantage plans include Part D prescription drug coverage built in. These are called MA-PD plans. The 2026 Part D annual out-of-pocket maximum is $2,100 across all plans, set by the Inflation Reduction Act signed August 16, 2022. Always check the Oregon plan's formulary to confirm your specific medications are covered, and at what tier.
Are dental, vision, and hearing covered by Medicare Advantage in Oregon?
Most Oregon Medicare Advantage plans include some level of dental, vision, and hearing benefits, which Original Medicare does not cover. Coverage varies widely: some Oregon plans cover only cleanings and exams, while others cover crowns, hearing aids, and prescription eyewear. Kaiser Permanente and Providence Health Assurance offer some of the more generous packages in Oregon. Always check the Evidence of Coverage for annual limits and what's actually covered.
What is a Special Needs Plan (SNP) and who qualifies in Oregon?
A Special Needs Plan is a type of Medicare Advantage plan restricted to beneficiaries with specific needs. Oregon offers all three types in 2026: Dual Special Needs Plans (D-SNPs) for people who qualify for both Medicare and the Oregon Health Plan, Chronic Condition Special Needs Plans (C-SNPs) for beneficiaries managing conditions like diabetes or heart failure, and Institutional Special Needs Plans (I-SNPs) for people in nursing facilities. Oregon has an unusually high C-SNP share, 40% or more of statewide SNP enrollment per KFF, reflecting the state's chronic-disease population.
