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Oregon Medicare Requirements

Medicare is a federally administered health care program for elderly and disabled Americans. Medicare is available both as original Medicare and through Medicare Advantage, both of which are available in Oregon. Most plans nationwide have the same eligibility requirements, but a few details are different for Oregon.

  1. Work and Citizenship Requirements

    • To be eligible for Medicare, you must be a legal citizen who has worked for at least 40 working quarters (10 full years). If you have worked less than 40 working quarters but your spouse has worked the full amount, you are still eligible.

    Age Requirements

    • If you are not disabled, then you must be at least 65 years old. You become eligible for benefits beginning in the month of your 65th birthday.

    Disability Requirements

    • If you are eligible because of disability, you must be 24 months into receiving Social Security disability benefits before Medicare begins.

    Enrollment Requirements

    • Those who are qualified for Medicare can only enroll during certain periods. First, they can enroll during their initial enrollment period, which is the seven months surrounding their eligibility month (three months before, the month itself, and the three months following). When you sign up during your birth month or during the three months prior, your coverage begins on the first date of your birth month. When you sign up in the months following, your coverage begins on the first date of the month following your enrollment.

      You can also enroll during the annual coordinated election period from Nov. 15 through Dec. 31 and during the general enrollment period from Jan. 1 to March 31 each year. You may also qualify for a special enrollment period if you fit eligibility criteria.

    Low-income Program Requirements.

    • The low-income programs available to Oregon citizens are Medicare Savings Programs (MSP). There are three Medicare Savings Programs, including Qualified Medicare Beneficiary (QMB), Specified Low-income Medicare Beneficiary (SLMB) and Qualifying Individual Program (QI).

      These programs require an income and asset test. Income levels are measured against 100 percent (QMB), 120 percent (SLMB) and 135 percent (QI) of the federal poverty level. Individuals can't have assets that add up to more than $4,000, and couples can have no more than $6,000. The beneficiary's house, car, burial expenses, life insurance and household items are not counted as assets.

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