Medicare Benefits in Oregon

Medicare is a federal health insurance program designed for elderly and disabled individuals who need help affording medical coverage. It offers comprehensive medical and hospital coverage and an optional prescription drug program. While the federal government controls the benefits and application process, Oregon has programs to assist people with choosing the right program and applying for benefits.

Coverage Options

• Medicare benefits in Oregon fall into four categories: A, B, C and D. Medicare Part A is the hospital insurance, which covers hospital stays and skilled nursing facility stays. Most people do not pay for this coverage. Part B is the medical insurance coverage, and some individuals pay a portion of their premiums for this coverage. Part C refers to Medicare Advantage Plans, which lumps all Medicare benefits together and requires the holder to use doctors and hospitals in the plan's network. Part D is the prescription drug coverage option.

Who Qualifies

• Medicare is designed to provide health insurance to people age 65 and older, whether or not they are retired. It also covers individuals with end-stage renal disease and other disabilities that are coved under the Social Security program. Qualified individuals who need additional coverage can get Medicare coverage in Oregon if they are already covered under a private health insurance plan through their employer.

How to Apply

• Individuals who already receive Social Security or Railroad cash benefits will automatically be enrolled in Medicare when they reach age 65. Those who do not must apply through the Social Security Administration. Oregon.gov recommends applying approximately four months before your birthday. To apply, visit Medicare.gov and fill out the online form, or make an appointment at your local Social Security (ssa.gov) office. You must apply within 3 months of turning 65. If you chose to delay Part B coverage because you have private health insurance, make sure you enroll during the open enrollment period when the time comes or you will pay more for your coverage. The open enrollment period is eight months after your private health insurance or employment ends, whichever comes first.

Where to Get Help

• Oregon has the Senior Health Insurance Benefits Assistance program, which is a statewide network of volunteers who are trained to help those interested in Medicare or currently receiving benefits. The program provides free one-on-one counseling for all individuals who need assistance with applying for or receiving Medicare. To get this help, contact a SHIBA (oregon.gov) counselor. General questions can also be directed to the Social Security Administration (ssa.gov). Those enrolled in Medicare should call the Social Security Administration if their card is stolen or lost.