Healthcare Cost Assistance for
Medicare
Helping you afford the care you need.
Benefit Summary
For eligible homecare and personal support workers who have Medicare, Healthcare Cost Assistance benefits help with the costs of:
- Monthly premiums for Medicare Part B (up to $185/month in 2025)
- Monthly premiums for Medicare Part D, Supplement, or Advantage plans (up to $50/month in 2025)
- Out-of-pocket expenses, such as deductibles, copayments, coinsurance, and prescriptions for services covered by Medicare (up to $7,165 in 2025)
Healthcare Cost Assistance benefits amounts may change from year to year.
If you’re eligible for Healthcare Cost Assistance benefits for Medicare:
- Premiums are reimbursed by submitting a request for Healthcare Cost Assistance for Medicare. Once your request has been processed and approved, you receive monthly reimbursements for your premiums.
- You receive a Benefit Convenience Card (a Mastercard credit card) to pay for your covered out-of-pocket medical expenses. The card comes from Ameriflex (the Benefits Convenience Card Administrator). For more information about the Benefit Convenience Card and how to use it, click here.
If you’re eligible for Healthcare Cost Assistance for Medicare for the current year and eligible for the previous year (up to 12 months back), you can submit the required documents for both years at the same time.
- For example, if you find out in March of 2025 that you were eligible for HCA for Medicare back to September of 2024, then submit documentation for both years.
Important Things to Know
Request Healthcare Cost Assistance for Medicare
Every year, you request Healthcare Cost Assistance for Medicare by submitting these required documents:
- For Part B: your Social Security letter or Medicare Premium Bill
- For a Part D, Supplement, and/or Advantage plan: your premium bill
See samples of Medicare premium bills here.
You can do this in 1 of 2 ways:
1. Submit a Medicare Healthcare Cost Assistance Benefits Request Form. This form is used to submit your required documents to request reimbursements for a portion of Medicare premiums and receive funds for out-of-pocket medical expenses.
2. Securely log in to MyCarewell503.org (available in English):
- Click on “View or Update health Info” or “policy” under Medical Insurance Info on the Dashboard page
- Click on “add health insurance” or “add another policy”
- If you have an existing policy, you need to “Terminate this policy” the date before your Medicare begins or the last day of the current month and click on “Save” prior to clicking on “Add Another Policy”
- From the “Policy Type” drop-down menu, choose what you need to update:
- “Medicare B”; or
- “Medicare Part D, Advantage, or Supplement plan”
- Enter the date and premium amount
Transition from Marketplace to Medicare
- If you’re receiving Healthcare Cost Assistance benefits for a Carewell-approved Marketplace (HealthCare.gov) plan, be sure to sign up for Medicare A and B through Social Security as soon as possible. You can then request HCA for Medicare once you’re enrolled.
- If you currently have a Benefit Convenience Card (BCC) because you’re receiving HCA benefits for a Marketplace plan:
-
- One major difference with Medicare is that you can’t use the BCC for Medicare premiums. Instead, you need to request Healthcare Cost Assistance benefits for Medicare to reimburse a portion of your Medicare premiums.
- You use this same card for eligible Medicare out-of-pocket expenses too (covered Medicare copays, coinsurance, deductibles, and prescriptions as long as you remain eligible for Healthcare Cost Assistance). You don’t receive a new card when you move from a Marketplace plan to Medicare.
- As a reminder, Carewell SEIU 503 Healthcare Cost Assistance is not employer-sponsored or group health insurance coverage. If you incorrectly report to the Social Security Administration that you have group coverage when you enroll, your Medicare enrollment could be delayed. If this happens, a financial penalty may be assessed by Social Security.
Basic Medicare Information
- You have a limited amount of time to sign up for Medicare called the Initial Enrollment Period — 3 months prior to your birthday, your birth month, and 3 months after your birth month. If you don’t sign up during the Initial Enrollment Period, a financial penalty may be assessed by Social Security.
- You can sign up for Medicare A and B online at www.ssa.gov/benefits/medicare/or call the Social Security Administration at 1-800-772-1213.
- During your Initial Enrollment Period, and during the Medicare Annual Enrollment Period (every year from October 15 to December 7), you may enroll in a Part D, Supplement, or Advantage plan of your choice. You can also make changes to your existing plan during this time. Our partners at Valley Insurance Professionals can help you enroll in additional Medicare coverage. Call them at 503-480-0499, extension 7 to explore your options.
- If you are under 65 and eligible for Social Security due to disability, you may also be eligible for Medicare. The Social Security Administration should notify you of your eligibility status along with your next steps.
- For additional assistance, see the Senior Health Insurance Benefit Assistance (SHIBA) resources at shiba.oregon.gov.
- As a reminder, Carewell SEIU 503 Healthcare Cost Assistance is not employer-sponsored or group health insurance coverage. If you incorrectly report to the Social Security Administration that you have group coverage when you enroll, your Medicare enrollment could be delayed. If this happens, a financial penalty may be assessed by Social Security.
You can also join our online events through Zoom to help you learn more and get answers to your Medicare and Carewell benefits questions!
Learn & Connect: Medicare and Healthcare Cost Assistance 101 – The first Friday of every month. (These events are offered in English at this time.)
During these live webinars, the Carewell Benefits team and our insurance partners, Valley Insurance Professionals, review the basics of Medicare, including how and when to enroll. We also explain how eligible Medicare participants can use the Healthcare Cost Assistance benefit for help with monthly premiums and some covered out-of-pocket expenses.
Click here for more information.
Check Your Eligibility
This information is for Medicare recipients: Adults age 65 and older as well as adults under 65 with disabilities. The Social Security Administration determines your eligibility for Medicare benefits.
To see if you qualify for Healthcare Cost Assistance, please complete this eligibility questionnaire.
Request Healthcare Cost Assistance for Medicare
Submit the required documentation
Every year, you request Healthcare Cost Assistance for Medicare by submitting these required documents:
- For Part B: your Social Security letter or Medicare Premium Bill
- For a Part D, Supplement, and/or Advantage plan: your premium bill
See samples of Medicare premium bills here.
You can do this in 1 of 2 ways:
1. Submit a Medicare Healthcare Cost Assistance Benefits Request Form. This form is used to submit your required documents to request reimbursements for a portion of Medicare premiums and receive funds for out-of-pocket medical expenses.
2. Securely log in to MyCarewell503.org (available in English):
- Click on “View or Update health Info” or “policy” under Medical Insurance Info on the Dashboard page
- Click on “add health insurance” or “add another policy”
- If you have an existing policy, you need to “Terminate this policy” the date before your Medicare begins or the last day of the current month and click on “Save” prior to clicking on “Add Another Policy”
- From the “Policy Type” drop-down menu, choose what you need to update:
- “Medicare B”; or
- “Medicare Part D, Advantage, or Supplement plan”
- Enter the date and premium amount
Healthcare Cost Assistance Benefits Confirmation
You know you’ve been approved for Healthcare Cost Assistance for your Medicare coverage when:
- You get a check in the mail or a direct deposit into your bank account for your premiums from Carewell SEIU 503.
- You receive a Benefit Convenience Card (BCC) in the mail to pay for your out-of-pocket medical expenses.
If you currently have a BCC because you’re receiving HCA benefits for a Marketplace plan, you use this same card for eligible Medicare out-of-pocket expenses too. You don’t receive a new card when you move from a Marketplace plan to Medicare.
You should receive your reimbursement for Medicare premiums by the 15th of the month.
If you’d like assistance from our partner insurance agents at Valley Insurance Professionals (VIP) with your Medicare Supplement or Advantage plan, fill out the VIP Medicare Paperwork. These forms give Valley Insurance Professionals legal permission to help you with researching, enrolling in, and maintaining your Medicare Supplement, Advantage, or Part D plan.
Call Carewell SEIU 503 at 1-844-503-7348:
- If your Medicare premium reimbursement isn’t received by the 15th of the month.
- To schedule an appointment with VIP.
- To verify your eligibility for Healthcare Cost Assistance.
Out-of-Pocket Reimbursements
Steps to get Reimbursed
In order to get reimbursed for eligible expenses paid out of your own funds rather than your Benefit Convenience Card, you need to:
Medicare Out-of-Pocket Expenses Reimbursements
If you’ve paid for any eligible out-of-pocket expenses with your own funds rather than your Benefit Convenience Card, you need to submit the Ameriflex Reimbursement Claim Form.
Include receipts showing your out-of-pocket medical expenses for services covered by Medicare and your Explanation of Benefits (EOB), up to 12 months back. If you’re eligible for HCA for Medicare for the current year and eligible for the previous year (up to 12 months back), you can submit the required documents for both years at the same time.
For example, if you find out in March of 2025 that you were eligible for HCA for Medicare back to September of 2024, then submit documentation for both years.
For Medicare out-of-pocket expenses reimbursements use:
Sign up for Direct Deposit
If you would like your reimbursements faster and safer, sign up for direct deposit through MyCarewell503. You must include a copy of a voided check, bank letter, or bank statement.
Benefit Details
Use This Benefit
Using Your Card
Use your Benefit Convenience Card (BCC) for out-of-pocket expenses covered by your Medicare Part B, Part D, Supplement, and Advantage plans, such as deductibles, copayments, coinsurance, and prescriptions. You may be asked to show proof of your expenses, so keep your Explanation of Benefits and all receipts.
You cannot use the Benefit Convenience Card for:
- Medicare premiums (see above for information on the reimbursement process for Medicare premiums);
- Dental care, vision care, and hearing services;
- Out-of-pocket expenses for dental, vision, and/or hearing services;
- Medical expenses for your spouse or dependents;
- ATM withdrawals or to get cash back when making a purchase;
- Expenses for products or services that your health insurance plan doesn’t cover;
- Premium expenses to anyone other than your current medical carrier;
- Expenses incurred while you were not eligible for Healthcare Cost Assistance benefits
Make an appointment
Please check with your healthcare provider before making an appointment to make sure your provider is covered by Medicare and services are covered under your Medicare coverage.
Keep Your Benefit
To ensure you continue receiving Healthcare Cost Assistance benefits, please remember to:
- Turn in your timesheets and/or payroll vouchers at the end of each pay period;
- Avoid recording 0 hours of eligible working hours — also known as bargaining unit hours — for 2 months in a row. Going 2 months with 0 hours of work could result in you losing your eligibility for Carewell SEIU 503 benefits, including Healthcare Cost Assistance;
- Keep your personal information up to date with Carewell SEIU 503 and your employer (state, county, or brokerage);
- Pay your premiums to your insurance carrier on time, or your carrier may terminate your plan;
- Check for and respond to mail from Carewell SEIU 503, your insurance carrier, Ameriflex, and the Social Security Administration.
Renewal
Every year, you request Healthcare Cost Assistance for Medicare by submitting these required documents:
- For Part B: your Social Security letter or Medicare Premium Bill
- For a Part D, Supplement, and/or Advantage plan: your premium bill
See samples of Medicare premium bills here.
You can do this in 1 of 2 ways:
- Submit a Medicare Healthcare Cost Assistance Benefits Request Form. This form is used to submit your required documents to request reimbursements for a portion of Medicare premiums and receive funds for out-of-pocket medical expenses.
- Securely log in to MyCarewell503.org (currently available in English):
- Click on “View or Update health Info” or “policy” under Medical Insurance Info on the Dashboard page
- Click on “add health insurance” or “add another policy”
- If you have an existing policy, you need to “Terminate this policy the date before your Medicare begins or the last day of the current month and click on “Save” prior to clicking on “Add Another Policy”
- From the “Policy Type” drop-down menu, choose what you need to update:
- “Medicare B”; or
- “Medicare Part D, Advantage, or Supplement plan”
- Enter the date and premium amount
The Social Security Administration generally announces new Part B premiums in November. If you have a Part D, Supplement, or Advantage plan, you should receive your new bill in December. Please complete the steps above as soon as you know your new premiums.
Losing Eligibility
Losing Carewell SEIU 503 benefits doesn’t mean you’re losing your Medicare health insurance coverage! But at the end of your 1-month waiting period, your Benefit Convenience Card (BCC) is turned off and you won’t receive the monthly reimbursements for Part B and/or Part D, Supplement, or Advantage plans.
Don’t throw away your BCC! If you become eligible for Healthcare Cost Assistance benefits again, you’ll be able to use your card again.
What To Do When Regaining Trust Eligibility for Benefits After Losing Them
Once you regain eligibility for benefits, you start receiving premium reimbursements and you can use the Benefit Convenience Card (BCC) for your out-of-pocket expenses.
If you kept your BCC, you should still be able to use it, unless the expiration date on the front has passed.
If you don’t have a valid BCC, call Ameriflex at 1-888-868-3539 to order a new card.
If you are 65 or older and not eligible to enroll in Medicare, you may be eligible to enroll in a medical insurance plan on the Marketplace. For questions regarding your eligibility, contact us at 1-844-503-7348.
Contact Information
Valley Insurance Professionals
1-503-480-0499 (extension 7)
Reasons to contact Valley Insurance Professionals:
- If you are transitioning to Medicare coverage: your initial enrollment period starts three months before your 65th birthday, or your disability Part B effective date, and extends for three months afterwards — call anytime in this 6-month period to discuss your Medicare plan options!
- If you want to enroll in a Part D, Supplement, or Advantage plan, you can generally sign up for those plans either during your initial enrollment period or between October 15 and December 7.
Social Security Office
Contact the Social Security Office to enroll in Medicare Part A and B coverage. Contact the Social Security Office as soon as your initial enrollment period begins, three months before your 65th birthday.
Apply online: www.ssa.gov/benefits/medicare
Apply by phone: 1-800-772-1213 from 7 am to 7 pm, Monday – Friday. If you are deaf or hard of hearing, you can call at TTY 1-800-325-0778.
Ameriflex
1-888-868-3539
When calling, please identify yourself as a homecare or personal support worker receiving Carewell SEIU 503 benefits, and also have your Benefit Convenience Card with you.
Click here to learn more about the Ameriflex mobile app
Reasons to contact Ameriflex:
- To check the balance on your Benefit Convenience Card, review your payment history, order a replacement card, etc.
- If your Benefit Convenience Card was declined and you were unable to make a payment
SHIBA (the Senior Health Insurance Benefit Assistance program)
1-800-722-4134 (toll-free)
SHIBA’s webpage on the Oregon.gov site
Contact SHIBA for guidance on:
- How to enroll in Medicare
- How to meet deadlines and avoid penalties
- Rights and protections
- Coverage and exclusions
- Rules to obtain benefits
- Costs associated with Medicare
Note: SHIBA counselors are most likely unaware of Carewell SEIU 503 benefits and are not qualified to answer questions about them.
Frequently Asked Questions
Read common questions about Healthcare Cost Assistance for Medicare coverage. See the FAQs page for more information.
You can also find more resources about Medicare on our Resources page.
Information for people transitioning to Medicare
If you’re currently enrolled in a Marketplace plan, you’ll need to take steps to end your Marketplace plan (at HealthCare.gov) the day before your Medicare plan starts.
You can cancel your Marketplace plan by:
- Calling the Marketplace at 1-800-318-2596 and requesting the cancellation of your Marketplace plan or online at HealthCare.gov; or
- Getting assistance from the agents at Valley Insurance Professionals — call 1-844-503-7348 to schedule an appointment.
If you currently have a Benefit Convenience Card (BCC) because you’re receiving HCA benefits for a Marketplace plan:
- One major difference with Medicare is that you can’t use the BCC for Medicare premiums. Instead, you need to request Healthcare Cost Assistance benefits for Medicare which reimburses a portion of your Medicare premiums.
- You use this same card for eligible Medicare out-of-pocket expenses too (covered Medicare copays, coinsurance, deductibles, and prescriptions as long as you remain eligible for Healthcare Cost Assistance). You don’t receive a new card when you move from a Marketplace plan to Medicare.
How much money is on my Benefit Convenience Card?
The Benefit Convenience Card (BCC) is preloaded with the annual amount for paying medical and prescription copays, deductibles, and coinsurance expenses for covered services and prescriptions. In 2025, that amount is $7,165, but this may change from year to year.
If you have questions about your BCC, call Ameriflex at 1-888-868-3539.
Does my leftover balance roll over into the next year's amount?
No. The maximum amount you can be reimbursed for covered expenses incurred in each calendar year is the set amount for that calendar year. Any portion that isn’t used for a calendar year cannot be rolled over for payment of expenses incurred in a future calendar year.