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Medicare Guide 2017: During enrollment, the decision is in the details

Brent Hunsberger | For The Oregonian/OregonLive

The market for working-age Americans buying health insurance on their own is in critical condition.


Congress tried, then failed — several times — to repeal and replace the Affordable Care Act. Next year, double-digit premium increases await many shoppers looking for coverage on Oregon’s health insurance marketplace.


But Medicare, the federal health insurer for seniors? It’s as fit as a triathlete by comparison. 


     SEE: Downloadable PDF of managed care plans in the Portland area 


With the annual open enrollment period starting next week, Oregon’s private Medicare market, with a few exceptions, appears to be as stable and robust as any in the country.


Premiums are holding steady. Enrollment continues to grow at about 3 percent per year. And, unlike some states, residents in every county can go to a private insurer for their Medicare coverage.


“The plans aren’t really making any major changes,” said Drew Shavere, a health insurance broker at Columbia Benefits Group in Wilsonville. “That’s always kind of a relief.”


But even if you or a loved one already has what’s known as a Medicare Advantage plan, it’s important to ensure it’s still going to meet your or their needs.


HealthNet Inc. is ending its “Jade” special-needs plan for enrollees with chronic health conditions, leaving 4,000 patients with diabetes, heart failure and cardiovascular diseases tasked with finding other coverage. 


Some plans are controlling costs by reducing the number of providers in their coverage networks. Some of the state’s largest plans are asking members to pay higher copays and drug deductibles. And the cost of any prescription drug is always subject to change year to year, experts say. 


“As usual, people should really evaluate their options and see if their current plan remains their best option for them,” said Gretchen Jacobson, associate Medicare policy director with the Kaiser Family Foundation, a nonpartisan research firm. “All plans can change and many do change during open enrollment. Look at the provider networks, drug coverage, cost-sharing premiums and extra benefits they offer.”


Open enrollment, Oct. 15 to Dec. 7, is the period when current Medicare Advantage members can change plans without penalty. The same goes for enrollees in stand-alone Part D prescription drug plans. Here are a few things to watch for as you shop this year:

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