Oregon Dept. of Human Services offers free help for Medicare Open Enrollment

Medicare Open Enrollment for the 2025 plan year begins Tuesday and remains open through Dec. 7. Medicare beneficiaries seeking to compare or change their existing Medicare plan can receive free help from the Oregon Department of Human Services. 

During the Medicare Open Enrollment period, people with Medicare can make changes to their health plan or prescription drug plan, pick a Medicare Advantage plan or choose 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 help people detect and avoid Medicare scams. Additionally, there are some key changes coming to Medicare in 2025 that APD’s SHIBA program counselors can assist people in understanding including:

• The new Manufacturer Discount Program which addresses the coverage gap, also known as the “donut hole;” 
• The lower maximum to pay for covered drugs. The maximum amount for 2025 will be $2,000; 
• Coverage for weight loss drugs when doctors prescribe them for people who meet certain conditions; 
• Expanded coverage for family caregiver services through the Guiding an Improved Dementia Experience (GUIDE) model; and
• Increased access to mental health services by allowing more providers to bill Medicare for services.

“Our APD SHIBA team is devoted to helping people prepare for open enrollment and understand changes,” said Jane-ellen Weidanz, who oversees SHIBA as APD Deputy Director of Policy. 

Oregonians 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 2025 Oregon Guide to Medicare Insurance Plans will be available on the SHIBA website in the coming days and will be translated to multiple languages. 

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

Help from SHIBA is available over the phone and through virtual and in-person appointments. Because high call volume during Open Enrollment may result in longer than usual wait times, Oregonians are also encouraged to access free resources on the SHIBA website such as Medicare frequently asked questions, an agent locator tool, a list of free virtual and in-person Medicare presentations and videos to help people understand their Medicare options. People who need Medicare help in a language other than English, including sign language, can call 833-685-0841 or send an email to odhs.languageaccess@odhsoha.oregon.gov; after placing a request, a translator will reach out in the requestor’s preferred language to provide assistance in communicating with SHIBA.

About the Oregon Department of Human Services

The mission of the Oregon Department of Human Services is to help Oregonians in their own communities achieve wellbeing and independence through opportunities that protect, empower, respect choice and preserve 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 statewide network of certified counselors volunteering in their community to help all Oregonians make educated Medicare decisions. SHIBA offers free, objective, confidential and local one-on-one health insurance counseling and assistance to people with Medicare and their families.