Help Paying Medicare Costs in Oregon
Are you on Medicare? Are you struggling to afford your monthly insurance payments, deductibles, or prescription drugs?
If you live in Oregon, you may qualify for programs that help with Medicare costs. This article explains your options and how to get help.
What is Medicare?
Medicare is health insurance for people who are 65 or older. Some people can get Medicare earlier if they have a disability, End-Stage Renal Disease, or ALS.
There are two main Medicare programs:
- Original Medicare, which is run by the federal government.
- Medicare Advantage Plans, which are Medicare-approved plans from private insurance companies.
Learn more about Medicare in this comprehensive guide for Oregonians.
What does Medicare cover?
What Medicare covers depends on your plan. Medicare often pays for:
- Doctor visits.
- Care to help you stay healthy.
- Medical equipment.
- Lab tests and X-rays.
- Short hospital stays.
- Short stays in a skilled nursing facility.
What costs aren't covered by Medicare?
It depends on your plan. Many people still pay some costs themselves, such as:
- Monthly insurance payments.
- Doctor copays.
- Deductibles.
- Prescription drug costs.
If you're struggling to afford these costs, there are programs in Oregon that can help.
Programs that help with Medicare costs
If you have Medicare, you may qualify for programs that help pay for monthly insurance payments, prescriptions, copays, deductibles, or other costs.
There are three main types of programs that may help:
- Medicare Savings Programs. These programs help people with lower incomes pay some Medicare costs. Depending on the program, they may help with monthly insurance payments, deductibles, coinsurance, and copays.
- Medicare Advantage Plans and other Medicare health plans. These are plans from private companies that work with Medicare. Some may lower your costs or add benefits.
- Prescription drug programs. These programs help pay for medicine. Some are only for people with lower incomes. Oregon also has a prescription drug discount program that is free for all Oregon residents.
Get help understanding your options
If you need help with Medicare and you live in Oregon, you can get free help through the Senior Health Insurance Benefits Assistance (SHIBA) program. SHIBA offers:
- Free events and presentations about Medicare.
- A free guide to Medicare insurance for Oregonians.
- Free benefits counselors who can help with Medicare questions.
Visit the SHIBA website for more help.
Frequently Asked Questions About Medicare
Medicare is split into “parts.” This can be confusing.
- Part A is hospital insurance. It helps pay for inpatient hospital care, skilled nursing facility care, hospice care, and some home health care. Many people do not pay a monthly payment for Part A if they worked and paid Medicare taxes for enough years.
- Part B is medical insurance. It helps pay for things like doctor visits, medical equipment, and some preventive care. Most people pay a monthly payment for Part B.
- Part C is also called Medicare Advantage. These are Medicare-approved plans from private companies. They are another way to get your Part A and Part B benefits. Many Medicare Advantage Plans also include drug coverage.
- Part D helps pay for prescription drugs. You can get Part D through a separate drug plan or through a Medicare Advantage Plan that includes drug coverage.
Not sure which Medicare plan to choose? Medicare can be confusing. The Medicare website has tools to help you compare plans and costs. If you live in Oregon, you can also get free help from a Senior Health Insurance Benefits Assistance (SHIBA) counselor.
Both are government health programs, but they help different groups of people.
- Medicare is for people who are 65 or older. Some people can get Medicare earlier if they have a disability, End-Stage Renal Disease, or ALS. Medicare is not only for people with low incomes.
- Medicaid is for people with low incomes who meet other rules. In Oregon, Medicaid is called the Oregon Health Plan, or OHP. People of many ages can qualify.
Some people have both Medicare and Medicaid. This can help lower health care costs.
Medicare costs depend on your coverage, income, and health care needs.
Some people pay little or nothing each month. Other people pay more. You may also have to pay deductibles, copays, or coinsurance.
Original Medicare does not cover most dental care. This means it usually does not pay for cleanings, fillings, dentures, or tooth removal.
Some Medicare Advantage Plans may include dental benefits. It depends on the plan.
You may also be able to buy separate dental insurance.
For help understanding your options, contact Senior Health Insurance Benefits Assistance (SHIBA) for free Medicare help.
Medicare usually does not pay for long-term care. Long-term care means ongoing help with daily needs, like bathing, dressing, meals, or using the bathroom. You may get this care at home, in the community, in an assisted living facility, or in a nursing home.
Medicaid may help pay for long-term care. To qualify, you must meet Medicaid’s income, asset, and care-need rules.
If you want to qualify for Medicaid, talk to an elder law attorney before you spend, sell, or give away money or property. Medicaid rules are complicated. Mistakes can delay Medicaid coverage for long-term care. To find an elder law attorney, search online for “elder law attorney Oregon,” or contact the Oregon State Bar Lawyer Referral Service.