What You Need to Know About Medicare in Oregon
Medicare can feel complicated, but it doesn’t have to be. With the right information, you can understand how it works, who qualifies, and how it can support your health. This guide breaks it down step-by-step. It will also explain how Neighborhood Health Center (NHC) can help you get the most from your coverage.Â

What is Medicare?Â
Medicare is a national health insurance program run by the U.S. government. It helps pay for medical care when you reach a certain age or have certain health conditions.Â
Think of Medicare as a safety net that ensures millions of Americans have access to affordable healthcare as they age or face health challenges.Â
Who Qualifies for Medicare?Â
- Age 65+: U.S. residents who meet the age requirementsÂ
- Under 65 with disabilities: If you receive Social Security Disability Insurance for 24 monthsÂ
- Any age with certain conditions: People with ALS or End-Stage Renal Disease (kidney failure)Â
The Four Parts of MedicareÂ
Part | What It's Called | What It Covers | Cost |
Part A | Hospital Insurance | Inpatient hospital care, skilled nursing, hospice, some home healthcare | Usually free if you worked and paid Medicare taxes for 10+ years |
Part B | Medical Insurance | Doctor visits, outpatient care, preventive services, medical supplies | Monthly premium (around $174 in 2024) |
Part C | Medicare Advantage | Everything in A & B, often includes dental, vision, hearing, prescriptions | Varies by plan |
Part D | Prescription Drug Coverage | Help paying for medications | Varies by plan |
Original Medicare vs. Medicare AdvantageÂ
You can choose between Original Medicare and Medicare Advantage (Part C).Â
Original Medicare (Parts A + B)Â
Positives:Â
- See any provider who accepts MedicareÂ
- Go to any hospital that takes MedicareÂ
- No referrals needed for specialistsÂ
Things to consider:Â
- You pay 20% for many servicesÂ
- Need to add Part D for prescriptionsÂ
- May want extra insurance for gapsÂ
Medicare Advantage (Part C)Â
Positives:Â
- Usually bundles A, B, and D in one planÂ
- May include extra benefits like dental or visionÂ
- Often has an out-of-pocket maximumÂ
Things to consider:Â
- Must use providers in the plan's networkÂ
- May need referrals for specialistsÂ
- Benefits can change each yearÂ
At NHC, we partner with Medicare agents who work with our Membership & Engagement Services team to help you determine the right program for you that also helps you keep your primary care provider. Contact our Membership & Engagement Services team and get your questions answered.Â

How to Enroll in MedicareÂ
Automatic EnrollmentÂ
If you're getting Social Security at 65, you'll automatically get Medicare Part A and Part B. Your card comes in the mail three months before your birthday.Â
Manual Enrollment Needed If You:Â
- Aren't receiving Social Security benefits at 65Â
- Are still working with employer insuranceÂ
- Have certain government employmentÂ
- Live outside the U.S. when you turn 65Â
Your Enrollment WindowÂ
If you need to sign up yourself, you have 7 months:Â
- 3 months before your 65th birthdayÂ
- The month you turn 65Â
- 3 months after your 65th birthdayÂ
- During this window, you choose Original Medicare or Medicare Advantage.Â
Where to Sign UpÂ
- Visit Medicare.gov onlineÂ
- Call 1-800-MEDICARE (1-800-633-4227)Â
- Visit your local Social Security officeÂ
Open Enrollment in 2025: October 15 - December 7Â
Every year, you can change your Medicare plan during Open Enrollment. Your coverage continues automatically, but you can:Â
- Switch between Original Medicare and Medicare AdvantageÂ
- Change Medicare Advantage plansÂ
- Add/drop/change Part D plansÂ
- Add/drop Medigap policiesÂ
Use the same enrollment methods above to make changes.Â
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NOTE: What Medicare Doesn't CoverÂ
Standard Medicare covers many healthcare services, but not everything. Here are a few things that aren’t covered:*Â
- Long-term nursing home careÂ
- Most dental care (cleanings, fillings, dentures)Â
- Eye exams for glassesÂ
- Hearing aidsÂ
- Cosmetic proceduresÂ
- Healthcare outside the U.S.Â
*Some Medicare Advantage plans may include these services.Â
Good news: Some services Medicare doesn't cover might be available at reduced cost through NHC's sliding fee discount program.Â
How NHC Supports Medicare PatientsÂ
At NHC, we want you to feel confident about your coverage and care. Here’s how we support Medicare patients:Â
- We accept most Medicare and Medicare Advantage plansÂ
- If you qualify, sliding fee discounts are available for services Medicare doesn’t coverÂ
- Whole-person care: NHC provides medical, dental, behavioral health care, as well as pharmacy servicesÂ
- Bilingual support: English and Spanish-speaking teams to help you navigate your benefits and careÂ

Common Questions about MedicareÂ
Is Medicare free?Â
Part A is usually free (if you or your spouse worked 10+ years and paid Medicare taxes). Parts B, C, and D have monthly costs. Â
Do I still need other insurance if I have Medicare?Â
You may want extra coverage to help with costs. Many people get additional coverage like:Â
- Medigap policies for extra protection. Medigap is Medicare Supplement Insurance that can help pay for things not covered by your planÂ
- Employer insurance if still workingÂ
- Medicaid if you have a low incomeÂ
Can I use Medicare at a community health center like NHC?Â
Yes! As a Federally Qualified Health Center (FQHC), NHC is specially designed to serve Medicare patients. Â
What if I'm still working at 65?Â
You may be able to delay Part B if you have employer coverage. Our Outreach & Enrollment Coordinators can help review your options.Â

Tips for Getting the Most from MedicareÂ
Use Your Preventive ServicesÂ
Medicare covers these at no cost:Â
- Annual wellness visitsÂ
- Cancer screeningsÂ
- Flu shotsÂ
- Many other preventive servicesÂ
Keep Good RecordsÂ
Save your Medicare card, bills, and benefit statements.Â
Review Your Coverage Each YearÂ
Your needs change, and plan benefits can change too. Look at options during Open Enrollment each fall.Â
Ask QuestionsÂ
Don't hesitate to ask about your coverage. NHC staff are here to help you understand your benefits.Â
When to Get HelpÂ
Get help with Medicare if you:Â
- Don't understand your coverageÂ
- Have trouble paying for healthcareÂ
- Want to compare plan optionsÂ
- Have enrollment questionsÂ
- Need help using your benefitsÂ
Ready to Use Your Medicare Benefits?Â
Call us to:Â
- Schedule appointmentsÂ
- Ask coverage questionsÂ
- Learn about sliding fee discountsÂ
- Get help understanding benefitsÂ
Remember: You're Not AloneÂ
Medicare is here to help you stay healthy, but it can be tricky to understand. At NHC, we’re committed to making it easier. Whether you’re enrolling for the first time or exploring new options, our team can guide you every step of the way.Â
Ready to learn more? Call NHC today to schedule an appointment or speak with our enrollment team.Â