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Medicare in Oregon
By the numbers
The Medicare program provides health coverage for eligible individuals who qualify by age, disability, or having end-stage renal disease or amyotrophic lateral sclerosis. You must be a U.S. citizen or have legally and permanently resided in the country for five continuous years. Below is an overview of Medicare enrollment in Oregon as of 2015*:
Oregon beneficiaries enrolled in Medicare Part A and/or Part B: 414, 968
Oregon beneficiaries enrolled in a Medicare Advantage plan: 330, 468
Total number of Oregon beneficiaries enrolled in Medicare: 745, 436
Oregon beneficiaries enrolled in Medicare Part D: 538, 975
Oregon beneficiaries enrolled in a Medicare Advantage plan that includes prescription drug benefits: 295, 092
Oregon beneficiaries enrolled in a stand-alone Medicare Prescription Drug Plan: 243, 883
Whether you're newly eligible for Medicare or currently a Medicare beneficiary in Oregon, you may be wondering about how Medicare works and your different coverage options.
You'll have two options when it comes to how you receive your Medicare Part A and Part B coverage: Original Medicare (Part A and Part B) and a Medicare Advantage (Medicare Part C) plan. Original Medicare is the federal program that provides hospital and medical coverage to eligible beneficiaries. If you have Original Medicare and want prescription drug coverage (Medicare Part D), you can get it through a stand-alone Medicare Prescription Drug Plan that works alongside your Medicare Part A and Part B coverage.
Medicare Advantage plans are another way to get your Medicare Part A and Part B benefits. These plans cover at least the same level of benefits as Original Medicare, Part A and Part B, but may also cover extra benefits, such as hearing benefits, wellness programs, and prescription drugs. If you want prescription drug coverage, you can get it through a Medicare Advantage plan that includes this benefit, also known as a Medicare Advantage Prescription Drug plan.
Medicare Advantage plans and Medicare Prescription Drug Plans are available through private insurance companies that are contracted by Medicare to sell Medicare insurance plans (such as a Medicare HMO or a Medicare Prescription Drug Plan). Depending on the terms of the contract between the Medicare plan and Medicare, not every plan is available statewide or in all service areas. Each year, the Medicare plan must renew its contract with Medicare, so plan availability in a specific service area may be subject to change.
Medicare resources in Oregon
Oregon Medicare Savings Programs:Beneficiaries with limited income can apply for Medicare Savings Programs in Oregon that offer financial assistance for those who meet income eligibility requirements. These programs may help with Medicare costs like premiums, copayments, coinsurance, and deductibles. For more information and to enroll, contact the Oregon Department of Human Services.
Oregon State Health Insurance Counseling and Assistance Program (SHIP): The Senior Health Insurance Benefits Assistance (SHIBA) program in Oregon has a toll-free number you can call to get one-on-one health coverage counseling from a trained SHIBA volunteer in your area.
*Source: Statistical data from the Centers for Medicare & Medicaid Services, "On its 50th anniversary, more than 55 million Americans covered by Medicare" as of July 28, 2015.