State officials are offering free insurance enrollment assistance to the 1 million Oregonians who are eligible for Medicare or purchase health insurance on the federal marketplace.
Open enrollment in Medicare, available to people 65 and older or receiving Social Security disability benefits, begins October 15 and runs through December 7. Meanwhile, open registration to purchase individual plans will run from November 1st to January 15th. About 145,500 Oregonians are self-insured, but more than 930,000 are enrolled in Medicare.
During Open Medicare Enrollment, people can enroll for the first time, change plans, including prescription drug plans (Medicare Part D), and switch between Medicare Advantage and Original Medicare. Health insurance is complex and there are many options. The Department of Human Services has five employees who work with about 160 volunteers across the state to help people sift through documents and avoid fraud.
Throughout this year, most Medicare prescription plans have had a “doughnut hole,” or prescription drug coverage gap, but the Inflation Control Act signed into law in 2022 closed the Medicare policy gap starting in 2025. Also next year, Medicare plans will end their caps. The out-of-pocket cost for the prescription is $2,000. DHS experts will also discuss coverage for weight loss drugs, expanded coverage for family caregivers, and increased access to mental health services.
This year, the state revamped its window shopping tools for individual plans to make it easier to explore insurance options and control costs, according to a news release from the Oregon Health Authority. This tool compares plans, previews out-of-pocket costs, and determines if your plan covers specific providers, facilities, and prescription drugs. And it’s not just limited to individual plans, but to Oregon Health Plan, Medicaid, Medicaid, Medicare, and new OHP bridge plans for low-income people who spend just a little more than what’s allowed in the federal marketplace for individual plans. Those who subscribe can also help.
The health authority has 1,700 pro bono professionals who help people apply for Medicaid and the Marketplace in English and other languages.
The market offers federal tax subsidies, which more than 80% of enrollees benefit from, health department spokeswoman Amy Coven said. The federal government offers an average tax credit of about $525 per month, which lowers monthly premiums to about $165 on average.
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