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General Information & Eligibility

Who we are: FamilyCare offers a variety of health plans throughout our service area of Multnomah, Clackamas, Morrow, Umatilla, Washington, and Clatsop counties. We pride ourselves in offering personalized care and coordinated care services to treat your individual healthcare needs. We are Oregon healthcare, born and raised with local people ready to serve you.

Making Medicare Simple for you

When you turn 65, you have some decisions to make about your Medicare coverage. As time goes on, you may find that your needs change. Before you make any decisions, it is important to know exactly how Medicare works and what your choices are.

View our Making Medicare Simple handbook.

Medicare is the government’s federal health insurance program for people who are age 65 or older or under the age of 65 with certain disabilities, like permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease). Medicare medical coverage is made up of four parts: Parts A, B, C and D. Parts A and B make up “Original Medicare.”

PART A — Hospital Services

  • Hospital
  • Skilled Nursing
  • Home Health
  • Hospice

Medicare Part A helps pay for inpatient hospital care, selected skilled nursing facilities, hospice care, and some home health care. Medicare Part A is premium-free for most people.

PART B — Professional Services

  • Physicians
  • Outpatient Hospital Services
  • Durable Medical Equipment

Medicare Part B covers doctors office visits, both primary care and specialists. Premiums are paid through payroll deduction. You are eligible to sign up at age 65. Most beneficiaries do pay a monthly premium to be covered under Medicare Part B – the part that helps pay for doctors, outpatient hospital care, and certain other health care that Part A doesn't cover, such as physical and     occupational therapy.

PART C — Medicare Advantage

  • Services covered by Part A and Part B

You must be in Medicare Part A and Medicare Part B to be eligible for Medicare Part C. Medicare Part C is from private insurers. This will replace Medicare A and Medicare B and will add more benefits than typical Medicare Part A and Part B. It can be an HMO (a Health Maintenance Organization), PFFS (Private Fee For Service), or a PPO (Preferred Provider Organization). There are many options for the services you can receive through Medicare Part C.  You will have the option to select what is right for you. The following Medicare site offers an excellent book to help you choose and plan your package. (www.medicare.gov).

PART D — Prescription Drug Coverage

  • Provides insurance coverage for prescription medications

Medicare Part D is the prescription drug plan that is handled through private insurance sectors. This was added in 2006 to give Medicare patients a plan to cover prescription medications. You will select it either separately or as part of your Medicare Part C plan. Depending on where you live, you may have different options for services covered by Medicare. When you enroll in Medicare, you may want to consider adding a Medicare Prescription Drug Plan, or a Medicare Advantage Plan (HMO or PPO) that covers Medicare Part A, Medicare Part B, and often Medicare Part D coverage.

To learn more about Medicare, visit www.medicare.gov.

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10/29/2013
H3818_WEB_00352v2 CMS Approved