When is my Initial Enrollment Period?
Your Initial Enrollment Period (IEP) is 7 months long: the 3 months before the month you turn 65, your birthday month, and the 3 months after. When your coverage starts depends on when you sign up:
- In the 3 months before your birthday month: coverage starts the first day of your birthday month.
- In your birthday month or the 3 months after: coverage starts the first day of the month after you sign up.
If you miss your IEP and don't have health coverage from current work, you may have to wait for the General Enrollment Period (January 1 to March 31) and pay a Part B late penalty of 10% for each full 12 months you could have had Part B, for as long as you have Part B. See Medicare enrollment in Oregon.
What should I do month by month?
- 6 months before: gather your information. List your doctors, prescriptions and pharmacy. Ask your employer, union, PEBB, OEBB or PERS how your coverage works once you're eligible for Medicare. If you contribute to a health savings account, plan to stop 6 months before you sign up.
- 3 months before: sign up. Your IEP opens. Sign up for Part A and Part B with Social Security, unless you're enrolled automatically or are delaying Part B because you have health coverage from current work.
- 2 to 1 months before: choose your coverage. Decide between Original Medicare with a Medigap policy and a Part D plan, or a Medicare Advantage plan sold in your county. Apply so your new coverage starts the same day as Medicare. If you're a PERS retiree, compare PHIP's Medicare plans now.
- Your birthday month: coverage starts. If you signed up early, Medicare starts the first of the month. Your 6-month Medigap open enrollment period starts when your Part B starts. PEBB or OEBB retiree medical coverage has already ended, on the last day of the month before you became eligible.
- 3 months after: your IEP ends. This is the last month to sign up without waiting. Your first chance to join a Part D or Medicare Advantage plan also ends, unless you have other creditable drug coverage.
- Up to 90 days after Medicare eligibility: PERS deadline. PERS rules let retirees join the PERS Health Insurance Program within 90 days of first becoming eligible for Medicare, if they have Part A and Part B.
- 6 months after Part B starts: Medigap window closes. After this, Oregon's birthday rule lets you switch Medigap policies each year, but only if you already have one.
What if I already get Social Security?
If you get Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65, you're enrolled in Part A and Part B automatically, and your Medicare card arrives about 3 months before your coverage starts. Most people pay no premium for Part A. Part B has a premium ($202.90 a month for most people in 2026), usually taken out of your Social Security payment. If you have job-based coverage from current work and want to delay Part B, follow the instructions that come with the card.
How do I sign up in Oregon?
Social Security handles Medicare sign-up for Oregonians. You can:
- Apply online at ssa.gov/medicare.
- Call Social Security at 1-800-772-1213 (TTY 1-800-325-0778).
- Visit a Social Security office. Find the nearest one with Social Security's office locator.
What if I'm still working at 65?
If you or your spouse are still working and have health coverage from that job, the employer's size decides who pays first. With 20 or more employees, the job-based plan pays first and you can usually delay Part B without a penalty; you get 8 months to sign up after the job or the coverage ends. With fewer than 20, Medicare usually pays first. Active PEBB and OEBB coverage through a current state, university or school district job is coverage from current work. COBRA and retiree coverage are not. See working past 65 in Oregon and the Part B special enrollment period.
When should I buy Medigap?
Your best time is your 6-month Medigap open enrollment period, which starts the first month you have Part B. During it, a company selling Medigap in Oregon can't turn you down, charge you more or make you wait because of your health, and must offer you every policy it sells (OAR 836-052-0138). After it ends, a company can usually ask health questions.
Oregon adds a yearly birthday rule: if you already have a Medigap policy, you can switch to one with the same or lesser benefits, from the same or another company, without health questions, from 30 days before to 30 days after your birthday each year (OAR 836-052-0143). It doesn't help someone in Medicare Advantage move to Medigap. See Medigap in Oregon.
PEBB, OEBB and PERS retirees
| Coverage | What happens at Medicare eligibility |
|---|---|
| PEBB retiree coverage (state employees) | Ends the last day of the month before the month you become eligible for Medicare (OAR 101-050-0010). Example from the rule: born May 15, Medicare-eligible May 1, PEBB retiree coverage ends April 30. |
| OEBB retiree coverage (school districts, education service districts, community colleges) | Medical and vision end the last day of the month before your Medicare effective date, unless you're eligible because of end-stage renal disease. Report Medicare to OEBB within 31 days. Dental may continue if your employer allows it (OAR 111-050-0015). |
| PERS Health Insurance Program (PHIP) | Medicare plans for PERS retirees, including a Part D plan. You can enroll within 90 days of first becoming eligible for Medicare if you have Part A and Part B (OAR 459-035-0070). |
| RHIA premium subsidy | For Tier One and Tier Two retirees with 8 or more years of qualifying service who are enrolled in Part A and Part B and in a PERS-sponsored Medicare plan (OAR 459-035-0030). |
A spouse or dependent who isn't yet eligible for Medicare may be able to keep PEBB or OEBB coverage; ask your plan. See PEBB and Medicare, OEBB and Medicare and PEBB, OEBB and PERS vs. individual Medicare plans.
IHS and tribal clinics
If you get care from the Indian Health Service, one of Oregon's nine federally recognized tribes or an urban Indian health program, signing up for Medicare doesn't replace that care. It covers care outside those clinics, and IHS and tribal clinics can bill Medicare for care they give you. Purchased/Referred Care is the payer of last resort, so it expects Medicare to pay first when you have it (42 CFR 136.61). Drug coverage through IHS, a tribe or an urban Indian program counts as creditable coverage for Part D (42 CFR 423.56), so you can wait on a drug plan without a penalty. IHS isn't health coverage from a current job, though, so it doesn't let you delay Part B without a penalty. See tribal health and Medicare and IHS and tribal clinics vs. Medicare.
OHP and help paying for Medicare
- If you have OHP now: the Oregon Health Authority says Medicare becomes your primary coverage and you keep your OHP until your next renewal. Send OHP your Medicare number. Most OHP members with Medicare have "OHP with Limited Drug": Medicare Part D covers your drugs, and your CCO doesn't change when you get Medicare. Questions go to OHP Client Services, 1-800-273-0557 (TTY 711). See the Oregon Health Plan and Medicare.
- Medicare Savings Programs: the Oregon Department of Human Services (ODHS) runs QMB, SMB (federally called SLMB), SMF (QI) and QDWI, which can pay your Part B premium and, with QMB, Medicare deductibles and coinsurance. Oregon has no asset limit for these programs. Apply at one.oregon.gov or call 1-800-699-9075 (TTY 711). See Medicare Savings Programs in Oregon.
- Extra Help with Part D costs comes automatically with a Medicare Savings Program or OHP; others apply through Social Security. See Extra Help in Oregon.
Veterans and military retirees
VA health care and Medicare generally don't pay for the same service: the VA pays for care at VA facilities, such as the Portland and Roseburg VA systems, and Medicare pays for Medicare-covered care elsewhere. Many veterans keep Part B so they can also see providers outside the VA. If you have TRICARE, you generally need Part A and Part B to keep TRICARE For Life. See veterans and Medicare in Oregon.
Your turning-65 checklist
- Mark your IEP dates. Put the first and last months on your calendar.
- Sign up for Part A and Part B. Apply with Social Security, or confirm you're enrolled automatically.
- Check your other coverage. Call your employer, PEBB, OEBB, PERS Health (1-800-768-7377), the VA or TRICARE, and your tribal clinic if you use one.
- Choose your coverage. Original Medicare with Medigap and Part D, or Medicare Advantage. Check how many plans your county has on our counties page.
- Check for help paying. See if you qualify for a Medicare Savings Program or Extra Help.
- Keep your papers together. Your Medicare card, letters and creditable coverage notices.
When you're ready to look at coverage, see plans for your ZIP code, or you can request a call from a licensed insurance agent to go over plans from the companies they work with, at no cost to you. See also what is Medicare and when to sign up if you're turning 65 in Oregon.
Sources
- Medicare.gov — When does Medicare coverage start?
- Social Security — Sign up for Medicare
- Medicare.gov — Avoid late enrollment penalties
- Or. Admin. Code § 836-052-0138, Medigap open enrollment (via Cornell LII)
- Or. Admin. Code § 836-052-0143, annual opportunity to select another Medicare supplement policy (birthday rule) (via Cornell LII)
- Or. Admin. Code § 101-050-0010, PEBB retiree coverage termination (via Cornell LII)
- Or. Admin. Code § 111-050-0015, OEBB early retiree coverage and Medicare (via Cornell LII)
- Or. Admin. Code § 459-035-0070, PERS Health Insurance Program enrollment (via Cornell LII)
- Or. Admin. Code § 459-035-0030, RHIA eligibility (via oregon.public.law)
- Oregon Health Authority — OHP and Medicare
- Oregon Health Authority — Continuous eligibility (turning 65 or getting Medicare)
- Oregon Department of Human Services — Medicare Savings Programs
- 42 CFR 136.61, IHS payer of last resort (via Cornell LII)
- eCFR — 42 CFR 423.56, creditable prescription drug coverage
- TRICARE — TRICARE For Life
Frequently asked questions
Will I be enrolled in Medicare automatically in Oregon?
Yes, if you already get Social Security or Railroad Retirement Board benefits at least 4 months before you turn 65. Your card arrives about 3 months before coverage starts, with Part A and Part B. If you don't get benefits yet, you sign up yourself through Social Security online, by phone at 1-800-772-1213 or at a local office.
When should I buy a Medigap policy in Oregon?
During your 6-month Medigap open enrollment period, which starts the first month you have Part B. Any company selling Medigap in Oregon must then sell you any policy it offers regardless of your health (OAR 836-052-0138). After that, Oregon's birthday rule lets current Medigap policyholders switch to a policy with the same or lesser benefits each year without health questions.
What happens to my PEBB or OEBB retiree coverage at 65?
It ends. Oregon's rules end PEBB and OEBB retiree medical coverage the last day of the month before the month you become eligible for Medicare. OEBB asks you to report Medicare within 31 days. Plan your Medicare coverage so it starts the day after your PEBB or OEBB coverage ends.
I'm a PERS retiree. Can I join the PERS Health Insurance Program at 65?
PERS rules let a retiree enroll in PHIP within 90 days of first becoming eligible for Medicare, if the retiree is enrolled in Medicare Part A and Part B. The RHIA premium subsidy also requires Parts A and B. Call PERS Health at 1-800-768-7377 before your Medicare starts.
I have OHP. What happens when I turn 65?
The Oregon Health Authority says Medicare becomes your main coverage, and you keep your OHP until your next renewal. Send OHP your Medicare number. Most OHP members with Medicare get OHP with Limited Drug, so your drugs move to a Medicare Part D plan, and you may also qualify for a Medicare Savings Program.
Medicare in your Oregon county
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