Jane Dotson
Medicare is a federal health insurance program for people aged 65 and over. Those under 65 may be eligible for Medicare if they have a disability, End-Stage Renal Disease (ESRD), or Lou Gehrig's Disease (ALS). To apply for Medicare, individuals can sign up for Part A (Hospital Insurance) and Part B (Medical Insurance). If you live in the United States, you will automatically receive Part A, and you need to sign up for Part B. However, if you live in Puerto Rico or outside the US, you will need to sign up for both Part A and Part B. Signing up for Medicare can be done online, by phone, or by contacting your local Social Security Office.
| Characteristics | Values |
|---|---|
| Who is eligible for Medicare? | People 65 or older. People under 65 with a disability, End-Stage Renal Disease (ESRD), or ALS (Lou Gehrig's Disease) may also be eligible. |
| How to apply | If you begin receiving Social Security retirement benefits between age 62 and up to 4 months before turning 65, you will be automatically enrolled. If you apply for Social Security 3 months before turning 65 or later, you can sign up when you apply for Social Security. You can enroll online for Parts A and B, or Part A only. |
| Enrollment period | The Initial Enrollment Period begins 3 months before you turn 65 and ends 3 months after the month you turn 65. You may have to pay a penalty if you miss this period. |
| Medicare Savings Programs | There are income and asset limits that determine eligibility. |
| Medicare Advantage and drug plans | You can review and sign up for these on Medicare.gov. |
| Medicare plans | Compare plans in your area to find out what they cost and what services they provide. |
| Medicare card | You can get help replacing your card on the official website. |
| Medicare fraud | Do not give out your personal information or your Medicare card to people you don't know. |
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What You'll Learn
Medicare Part A and Part B
Medicare is a federal healthcare program for people aged 65 or older, with some individuals qualifying earlier due to disability or specific medical conditions. In Oregon, residents have access to Original Medicare, which is provided by the federal government and is made up of two parts: Medicare Part A (hospital insurance) and Medicare Part B (medical insurance).
Medicare Part A
Medicare Part A covers hospital and inpatient medical care. Part A is typically premium-free, although you will still pay a share for the services received. Most people do not pay the Part A premium because they have paid taxes for at least 10 years. However, Part A has a deductible and coinsurance that must be paid.
Medicare Part B
Medicare Part B covers preventive care and outpatient services. Unlike Part A, everyone pays a premium for Part B. This premium is based on your income level.
Enrollment and Costs
Medicare has specific enrollment periods when you can sign up, change, or drop your plan. If you are already receiving retirement or disability benefits from Social Security before turning 65, you may need to actively sign up for Medicare. However, if you are waiting until you are 65 or older to receive these benefits, the process may differ. Additionally, those with End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS) may qualify for Medicare earlier.
While some parts of Medicare might be premium-free, there are still costs associated with the services. The amount you pay will depend on factors such as your income level and how long you have paid into the Medicare system through taxes.
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Applying for Medicare online
Medicare is a federal health insurance program for people aged 65 and over. If you are under 65, you may still be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or Lou Gehrig's Disease (ALS).
If you are 65 or older, you can enroll online for Parts A and B, or Part A only. You can delay Part B if you already have coverage through an employer group health plan. The application is for retirement benefits and Medicare, or Medicare only. If you already have Part A and did not previously sign up for Part B, you can sign up for Part B only.
If you have Lou Gehrig's Disease (ALS), you will receive Medicare Parts A and B when you enroll in Social Security disability benefits. If you have ESRD, you can call 800-772-1213 to apply for Medicare.
To join a Medicare health plan or drug plan, you generally must have Medicare Part A (Hospital Insurance) and Part B (Medical Insurance), live in the service area of the plan you want to join, be a U.S. citizen or lawfully present in the U.S., and have your Medicare Number and your Part A and/or Part B coverage start dates.
You can compare plans in your area on Medicare.gov/plan-compare, where you can select "Enroll" for the plan you want to join. You can also contact the plan to join by calling them or visiting their website. You can also request a paper form to fill out and mail back to the plan.
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Medicare eligibility
Medicare is generally for individuals 65 years or older. However, there are certain conditions that may make you eligible for Medicare earlier. These include:
- Having a certified disability
- End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant)
- ALS, also known as Lou Gehrig's disease
If you are already receiving retirement or disability benefits from Social Security (or the Railroad Retirement Board) before turning 65, you may automatically get enrolled in Medicare without having to sign up. On the other hand, if you are not yet receiving these benefits, you will need to actively sign up for Medicare.
To qualify for premium-free Part A coverage under Medicare, you must meet one of the following criteria:
- Qualify for or receive retirement or disability benefits from Social Security or the Railroad Retirement Board
- Are eligible for or are already receiving Medicare benefits before turning 65
- Are 65 or older, and you or a qualifying person (such as your current or former spouse) paid Medicare taxes while working for a certain period, typically at least 10 years
If you do not meet the requirements for premium-free Part A, there is an option to purchase this coverage. Additionally, it is important to note that you will need to pay a premium for Part B coverage every month, regardless of whether you utilise any of the Part B-covered services.
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Medicare Supplement plans
Medicare is a national health insurance program for people aged 65 or older, as well as people of all ages with disabilities, and people with specific diseases. In Oregon, Medicare Supplement Insurance, also referred to as Medigap and Medsupp, is available from multiple companies. These plans are designed to supplement the benefits offered by original Medicare coverage.
The annual deductible for all Medicare Part B beneficiaries in Oregon was $257 in 2025. For Part A, which covers inpatient hospital, skilled nursing facility, and some home health care, Medicare pays all covered costs except the Medicare Part A deductible during the first 60 days of a hospital stay. For hospital stays beyond 60 days and up to 150 days, there is a designated copay per day.
To get started with Medicare in Oregon, you can visit the official Medicare website or contact 1-800-MEDICARE to learn more about the specific plans and rates available in your area. It is important to carefully review the plan details and choose the one that best suits your needs and eligibility.
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Cancelling Medicare coverage
Cancelling your Medicare coverage depends on your location and the type of plan you have.
Kaiser Permanente
If you have a Kaiser Permanente plan, you can submit a Kaiser Permanente Individual & Family plan Disenrollment Request form, or contact Member Services at 1-800-464-4000 (TTY 711), 8 a.m. to 8 p.m., 7 days a week, for more information.
CMS Form 1763
If you are ready to cancel your coverage, you can submit CMS Form 1763 to your local Social Security office.
Exchange Plan
If you have an Exchange plan, contact the Exchange unit you purchased your plan through for guidance.
Group Retiree Benefits
If you are eligible for Group Retiree benefits, you typically won't cancel your existing coverage. Reach out to your benefits administrator to advise them of your intent to enroll. Avoid getting billed twice.
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Frequently asked questions
You can apply for Medicare online at Social Security. You will need to create a secure my Social Security account to sign up for Medicare or apply for benefits.
If you are 65 or older, you can enroll in Medicare Parts A and B, or Part A only. If you are under 65, you may be eligible for Medicare if you have a disability, End-Stage Renal Disease (ESRD), or Lou Gehrig's Disease (ALS).
The Initial Enrollment Period begins 3 months before you turn 65 and ends 3 months after the month you turn 65, for a total of 7 months. If you miss this period, you may have to pay a penalty.
Medicare Part A is hospital insurance, which covers hospitalization, home or skilled nursing, and hospice. Part B is medical insurance.
Medicare Supplement plans are available in Oregon for persons eligible for Medicare because of disability. You can apply for a Medicare Supplement plan once you are 65 or older and enrolled in Medicare Part B.
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