Medicare

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Very few government programs will help pay your long-term care expenses. Those that do have strict eligibility requirements and limits on what is covered.

You should not count on Medicare to pay for your Long-term services and supports needs. Medicare pays little or nothing for help with Activities of daily living for long periods of time. Medigap insurance (supplemental insurance for Medicare) is not intended to meet long-term services and supports needs; it covers very few long-term services and supports.

What is Medicare?

Medicare is health insurance for the following:

• People 65 or older
• People under 65 with certain disabilities
• People of any age with end-stage renal disease
  (permanent kidney failure requiring dialysis or a kidney transplant)

Resources to help navigate Medicare

Senior Health Insurance Benefits Assistance (SHIBA)

Do you need help comparing Medicare medical and drug plan coverage? Senior Health Insurance Benefits Assistance (SHIBA) program counselors give one-on-one help with:

• Selecting a Medicare prescription drug plan
• Comparing Medicare Advantage plans and Medicare supplement plans
• Applying for Medicare savings programs, including Extra Help with Medicare prescription drug coverage.

Call SHIBA toll-free at Tel: 1-800-722-4134 or visit the program’s website to Find a local SHIBA volunteer.

Senior Medicare Patrol (SMP)

The Senior Medicare Patrol (SMP) empowers and assists Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse through outreach, counseling, and education.

SMP staff and highly trained volunteers conduct outreach to Medicare beneficiaries in their communities. Their primary goals are to teach Medicare beneficiaries to:

• Protect their personal information
• Identify and report errors on their health care bills
• Identify deceptive health care practices such as:
• Illegal marketing
• Providing unnecessary or inappropriate services
• Charging for services that were not provided

Volunteers teach others to protect themselves against potential fraud. They teach beneficiaries to protect their Medicare number; how to review Medicare Summary Notices (MSNs) and Explanations of Benefits (EOBs) for potential errors; and how to report suspicious activity.

You can reach the Oregon SMP by calling the ADRC of Oregon (1-855-673-2372), calling the Oregon SHIBA program (800-722-4134), or emailing oregon.smp@odhsoha.oregon.gov