Who pays your Medicare premiums
| Program | Part B premium | Part A premium (if you owe one) | Part D premium |
|---|---|---|---|
| QMB | Paid | Paid | Lowered by Extra Help |
| SLMB (Oregon's SMB) | Paid | No | Lowered by Extra Help |
| QI (Oregon's SMF) | Paid | No | Lowered by Extra Help |
| QDWI | No | Paid | Not automatic |
| Full OHP with Medicare | Often paid; ask ODHS | Ask ODHS | Lowered by Extra Help |
The standard Part B premium is $202.90 a month in 2026. When the state pays it, it stops coming out of your Social Security check. The Oregon Health Authority (OHA) says OHP "can help pay for things like Medicare premiums, deductibles, and coinsurance."
The Medicare Savings Programs
The clearest way to get your Part B premium paid is a Medicare Savings Program. ODHS sets the income limits as a percent of the federal poverty level: up to 100% for QMB, up to 120% for SLMB, and 120% to 135% for QI. Oregon has no asset limit for these programs, and you must have Part A. See Oregon's income limits.
QMB also covers Part A and Part B deductibles and coinsurance. Providers may not bill a QMB member for Medicare cost sharing.
What OHP doesn't pay
OHA says OHP doesn't pay Medicare Part D premiums, deductibles or copays. Instead, everyone with full OHP or a Medicare Savings Program gets Extra Help automatically, which lowers or covers the Part D premium depending on the plan and caps drug copays. Which drugs a plan covers depends on its formulary.
How to get the state to pay
- Apply through ONE. Go to one.oregon.gov or call 1-800-699-9075 (TTY 711). One application covers OHP and the Medicare Savings Programs.
- Wait for your notice. ODHS says it tells you within 45 days.
- Check your Social Security payment. Once the state's payment starts, the Part B premium is no longer deducted. If you have questions, call Social Security at 1-800-772-1213.
To review your Medicare plan once your premiums are covered, you can request a call from a licensed insurance agent.
Related questions
Can I have Medicare and OHP?
How the two work together.
What happens to my OHP at 65?
What changes when Medicare starts.
How do I apply for a Medicare Savings Program?
Step by step.
Sources
- Oregon Department of Human Services — Medicare Savings Programs
- Oregon Health Authority — OHP and Medicare
- CMS — Qualified Medicare Beneficiary program
- Medicare.gov — Help with drug costs (Extra Help)
More questions in this guide
- Can I have Medicare and the Oregon Health Plan?
- Do I keep my CCO when I get Medicare in Oregon?
- How do I qualify for Medicaid long-term care in Oregon?
- What's the difference between Medicare and Medicaid in Oregon?
- What happens to my OHP when I turn 65?
- What is a dual special needs plan (D-SNP) in Oregon?
- What is Oregon Project Independence and who qualifies?
Part of the guide: Oregon Health Plan and Medicare: combined coverage · All questions
Frequently asked questions
How do I know if the state is paying my Part B premium?
Check your Social Security benefit statement or your Medicare premium bill. If the premium is no longer deducted or billed, the state is paying it. ODHS can confirm which program you're in.
Does OHP pay my Part A premium?
Most people pay no Part A premium. If you do owe one, QMB pays it, and QDWI pays only the Part A premium.
Does OHP pay my Medicare Advantage or Part D premium?
OHA says OHP doesn't pay Part D premiums, deductibles or copays. Extra Help, which you get automatically with OHP or a Medicare Savings Program, lowers or covers your Part D premium depending on the plan.
Medicare in your Oregon county
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