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)
Reimbursement amounts may change from year to year.
If you are eligible for Healthcare Cost Assistance benefits, 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.
Important Things to Know
- We strongly recommend you apply for Medicare coverage during your Initial Enrollment Period. If you don’t, a penalty may be assessed by Social Security.
- If you’re receiving Healthcare Cost Assistance benefits for an approved Marketplace (healthcare.gov) plan, be sure to sign up for Medicare as soon as possible. And then complete the Carewell Medicare Paperwork to request Healthcare Cost Assistance benefits.
- If you’re over 65 (or turning 65 in the next 3 months) and not already receiving a monthly check from Social Security, you need to sign up to get Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You can sign up online at 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. 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.
- 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, and a penalty may be assessed by Social Security.
- For additional assistance, see the Senior Health Insurance Benefit Assistance (SHIBA) resources at shiba.oregon.gov.
- If you’ve been using the Benefit Convenience Card to pay premiums for a Marketplace plan, one major difference with Medicare is that you can no longer use the Benefit Convenience Card for Medicare premiums. Instead, you need to request reimbursement of your Medicare premiums. More information can be found in the Reimbursements tab below.
- If you’re currently receiving Healthcare Cost Assistance for an approved Marketplace plan and then sign up for Medicare, you won’t need to complete the Annual Paperwork during Open Enrollment or complete the annual Healthcare Cost Assistance Benefits Request Form anymore. The Carewell Medicare Paperwork replaces these forms.
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.
Enrollment
Steps to Enroll
In order to enroll in Carewell Medicare Healthcare Cost Assistance, you need to:
Fill out the required Carewell Medicare paperwork
You only have to fill out this paperwork when
- you first transition to Medicare coverage to see if you’re eligible for Healthcare Cost Assistance benefits, or
- you have changed Medicare plans.
If you would like assistance from Valley Insurance Professionals with your Medicare Supplement or Advantage plan, fill out this paperwork online. These forms give Valley Insurance Professionals legal permission to assist you with researching, enrolling in, and maintaining your Medicare Supplement, Advantage, or Part D plan.
On the Thank You page of the paperwork, be sure to submit a Medicare Premium Reimbursement Claim Form to Carewell SEIU 503 with evidence of your Part B premium and evidence of your Part D, Supplement, or Advantage plan premiums, if any.
Enrollment Confirmation
You know you are enrolled in 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 in the mail to pay for your out-of-pocket medical expenses.
If you have not received your reimbursement for Medicare premiums by the 15th of the month, please call Carewell SEIU 503 at 1-844-503-7348.
Please feel free to call to verify your eligibility for Healthcare Cost Assistance at 1-844-503-7348.
Reimbursements
Steps to get Reimbursed
In order to get reimbursed for Medicare premium and expenses, you need to:
Submit a Reimbursement Claim Form
Carewell SEIU 503 can reimburse your Medicare premiums and expenses up to 12 months back, if you were eligible for Healthcare Cost Assistance benefits at the time. If you haven’t received your reimbursement for Medicare premiums by the 15th of the month, please call Carewell SEIU 503 at 1-844-503-7348.
Fill out these reimbursement forms every year to get reimbursed.
For Medicare premium reimbursements use:
Submit a reimbursement claim form to Carewell SEIU 503 with evidence of your Part B premium and evidence of your Part D, Supplement, or Advantage plan premiums, if any.
For proof of Part B, use your annual Social Security letter or CMS Medicare Premium Bill. The most common proof for Part D, Advantage, or Supplement premiums is the invoice showing the premium amount for that plan.
For Medicare out-of-pocket expenses reimbursements use:
If you‘ve paid for any eligible out-of-pocket expenses with your own funds, you need to submit this 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.
Sign up for Direct Deposit
If you would like your reimbursements faster and safer, sign up for direct deposit. Fill out this secure Direct Deposit Form with a photo of a voided check.
Benefit Details
Use This Benefit
Using Your Card
Use your Benefit Convenience Card 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 below 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 received by 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;
- Covered medical expenses from a previous calendar year; for these expenses submit a reimbursement request by filling out the Ameriflex Reimbursement Claim Form online.
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;
- Stay current on your tax filing.
Renewal
To continue receiving Healthcare Cost Assistance for your Medicare coverage, please remember to:
- Complete a new Medicare Premium Reimbursement Claim Form for your Part B premium if your premium has changed — along with evidence of your new premium amount.
- Complete a new Medicare Premium Reimbursement Claim Form every year if you have a Part D, Supplement, and/or Advantage plan with evidence of your new premium amounts.
- Submit the Carewell Medicare paperwork again if you need assistance from Valley Insurance Professionals (VIP) to add or change coverage for a Supplement, Advantage, or Part D plan.
The Social Security Administration generally announces new Part B premiums in November. If you have an Advantage, Part D, or Supplement 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 does not mean you’re losing your health insurance coverage! But at the end of your grace period month, 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 are able to use the BCC for your out-of-pocket expenses. When you’re on Medicare, you should start receiving reimbursements for your premiums in the same amount as you did previously.
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 Carewell SEIU 503 at 1-844-503-7348 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 six-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 the day before your Medicare plan starts. The agents at Valley Insurance Professionals may be able to help you with that — call 1-844-503-7348 for assistance. Also, if you already have a Benefit Convenience Card, please hold on to it. You can continue to use it for covered Medicare copays, coinsurance, deductibles, and prescriptions as long as you remain eligible for Healthcare Cost Assistance. However, you cannot use your Benefit Convenience Card for your Medicare premiums.
How much money is on my Benefit Convenience Card?
The Benefit Convenience Card 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.
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.