The Oregon Dept. of Human Services offers free help with open enrollment in Medicare

Medicare open enrollment for the 2025 plan year begins Tuesday and remains open through December 7. Medicare beneficiaries who want to compare or change their existing Medicare plan can get free help from the Oregon Department of Human Services.

During the Medicare Open Enrollment period, Medicare enrollees can make changes to their health insurance or prescription drug plan, select a Medicare Advantage plan, or opt for Original Medicare. The ODHS Office of Aging and People with Disabilities’ Senior Health Insurance Benefits Assistance (SHIBA) program is available to help Oregonians understand their Medicare options and benefits, provide enrollment guidance, and assist people to help identify and avoid Medicare fraud. Additionally, there are some important changes coming to Medicare in 2025 that APD’s SHIBA program advisors can help people understand, including:

• The new manufacturer rebate program that closes the coverage gap also known as the “doughnut hole”;
• The lower maximum amount for payment of covered drugs. The maximum amount for 2025 is $2,000;
• Coverage for weight loss medications when doctors prescribe them to people who meet certain requirements;
• Expanded coverage for family care services through the Guiding an Improved Dementia Experience (GUIDE) model; And
• Improve access to mental health services by allowing more providers to bill for Medicare services.

“Our APD SHIBA team is committed to helping people prepare for open enrollment and understand changes,” said Jane-ellen Weidanz, who oversees SHIBA as APD’s deputy director of policy.

Oregon residents who need help navigating Medicare open enrollment are encouraged to call SHIBA at 800-722-4134 (toll free) or learn more by visiting the SHIBA website at SHIBA.Oregon.gov. The Oregon Guide to Medicare Insurance Plans 2025 will be available on the SHIBA website in the coming days and will be translated into multiple languages.

SHIBA certified counselors can also help people report scams to Medicare and educate people on how to avoid Medicare scams or scams. According to the Senior Medicare Patrol, some of the most common scams include promising free durable medical equipment such as knee braces and catheters or offering free genetic testing. The scammer’s ultimate goal is to obtain the beneficiary’s Medicare number in order to commit Medicare billing fraud. “SHIBA counselors are committed to ensuring Oregonians have the information they need to avoid falling victim to fraud and to report fraud or suspected Medicare fraud,” said APD Director Dr. Nakeshia Knight Coyle.

Help from SHIBA is available by phone, virtual and in-person appointments. Because high call volumes during open enrollment may result in longer than usual wait times, Oregon residents are also encouraged to access free resources on the SHIBA website, such as: Such as Medicare FAQs, an agent search tool, and a list of free virtual and in-person Medicare presentations and videos to help people understand their Medicare options. Individuals needing Medicare assistance in a language other than English, including sign language, may call 833-685-0841 or email [email protected]; After you submit a request, a translator will contact you in the applicant’s preferred language to assist them in communicating with SHIBA.

Through the Oregon Department of Human Services

The mission of the Oregon Department of Human Services is to help Oregonians in their own communities achieve wellness and independence through opportunities that protect them, empower them, respect their choices and maintain their dignity.

About the Senior Health Insurance Benefits Assistance Program

The Senior Health Insurance Benefits Assistance (SHIBA) program is part of the ODHS Office of Aging and People with Disabilities. It is a nationwide network of certified counselors who volunteer in their communities to help all Oregonians make informed Medicare decisions. SHIBA provides free, objective, confidential, and local personal health insurance advice and support to people with Medicare coverage and their families.