Shopping for health insurance in the state of Oregon might seem like a daunting task. Thankfully, there are many options open to Oregonians who are uninsured or underinsured. Whether you're healthy or not, this page will provide you with valuable information for obtaining health coverage. Read on to learn about the difference between group and individual coverage. If you're healthy enough to obtain coverage on the individual market or if you have a small business and qualify for small group, HealthPlanOne can help. If not, review the information on this page about Oregon Health Plan (Medicaid), SCHIP, Family Planning, prescription assistance, Oregon MothersCare, Babies First!, Oregon Breast and Cervical Cancer Program (BCCP), and the high risk pool. All of these government programs can help those who are medically uninsurable or who cannot afford private insurance to obtain basic health coverage.
What Every Oregonian Should Know About Health Insurance
The type of health insurance familiar to most consumers is group coverage offered by an employer. With group health insurance through your employer, the policy is partially paid for by the company on behalf of their employees. The company will contribute a large percentage toward the monthly premium and you (the employee) will be responsible for paying the difference, about 16-27%. With group plans you have little choice in the specific benefits of the plan (these are determined by negotiations between the company and the insurance carrier) but you also cannot be denied coverage under the group plan no matter what prescriptions you may take or preexisting conditions you may have. By insuring a large group of employees together under one plan of the company's choosing, individual employees are not medically underwritten, rather the entire group is underwritten as a whole to determine the premium level everyone will pay. Therefore, the amount you pay in premiums as well as the quality of the coverage you receive are dependent not on how healthy you are or what benefits you would like to have, but how healthy your group is as a whole and what benefits the company has chosen for you.
Unfortunately, companies frequently have a waiting period before new employees can qualify to receive health insurance benefits. If this is the case with your new job, consider getting a short-term policy from the point where your previous coverage ends to the time when your new company's insurance kicks in. Such options are available through HealthPlanOne. Simply visit our Short-Term information page for your free quotes.
It is important not to have a lapse in coverage of more than 63 days. If you do, your new insurance carrier may refuse to cover treatment for pre-existing conditions you may have such as asthma or acne for up to a year after your policy goes into effect. For this reason, having continuous health insurance coverage is particularly important.
What If I'm Between Jobs?
As previously mentioned, it is important not to have a break in coverage of more than 63 days. As a result, if you've recently lost your job, look into extending the coverage you had with your employer through COBRA. With the COBRA program through the federal government, you can extend your plan for up to 18 months after losing your job. You will however have to pick up the entire premium cost which your employer had previously been paying. For this reason, it is frequently more economical for people who've lost their jobs, to invest in an individual/family insurance policy through HealthPlanOne.
With individual coverage, you choose the health insurance carrier and benefits you want with the help of HealthPlanOne. We will quote plans for you and your family from all the different carriers available in Oregon so that you can choose from a wide price range and spectrum of options to tailor a plan that fits your needs. Even if you are not between jobs, a plan on the individual market through HealthPlanOne could still be the best option for your family. Many companies do not offer benefits to their employees, and often those companies that do offer benefits do so at an exorbitant cost for low quality plans. It is important to note that with individual coverage in Oregon each person who applies is medically underwritten and may be approved, denied, or rated-up by the carrier depending on their health history in recent months.
If you're healthy and are unhappy with the health insurance offered by your employer, are between jobs, or are not offered benefits by your company, enter your zip code into the HealthPlanOne quoting engine at the top of this page to view the most competitively priced plans in your area with benefits tailored to your needs. Quotes are absolutely free, and you're under no obligation to buy. Our licensed insurance specialists are also available via LiveChat (see the button to the right) or toll-free at (877) 567-5267 to answer any questions.
Small Group Plans
If you are self-employed, you can apply for a small group plan. You must have 2 or more eligible employees who each work at least 17.5 hours per week. Small group plans are not medically underwritten by carriers in Oregon. This means that no one in the group can be denied coverage, and the carrier cannot increase the rates based on the health history of employees enrolling. HealthPlanOne can help you by quoting plans for small groups. Simply call us toll-free (877) 567-5267.
If you're not healthy, there are still many programs available to you. See below for details on the options which best fit your medical and financial situation.
Oregon Health Plan - Medicaid
Oregon's Medicaid program is known as the Oregon Health Plan. The program is a federal-state cooperative meant to provide basic health coverage to low-income groups in the state. For eligibility requirements, click here:http://www.oregon.gov/DHS/healthplan/app_benefits/main.shtml For a complete list of covered services, click here:http://www.hrsa.gov/reimbursement/states/Oregon-Medicaid-Covered-Services.htm
Oregon also has the Children's Health Insurance Program. This federally-mandated SCHIP program is meant to provide quality health coverage under the Medicaid umbrella of programs to children in the state who are ineligible for Medicaid but whose parents cannot afford private health insurance. If your family does not qualify for Medicaid, apply for the Oregon Health Plan anyway as your children may still qualify for OHP coverage via SCHIP eligibility. Visit the following OHP webpage for more details: http://www.oregon.gov/DHS/healthplan/app_benefits/schip.shtml
Click here to view information on Oregon Medicare plans
This website http://www.oregon.gov/DHS/healthplan/rxsites.shtml provides information on all prescription assistance programs offered through the state. For example, the Oregon Prescription Drug program (OPDP) is a cost-saving program for all Oregonians. OPDP has free enrollment and can help you save up to 60% off your prescriptions. There is no required paperwork, age limit, or income limit. For more information, click here http://www.opdp.org/ Visit the above link for information on prescription assistance programs for seniors and other groups.
Oregon MothersCare and Family Planning
Because 1 in 5 Oregonian women do not receive proper prenatal care, the state has created the Oregon MothersCare program to make these important services more available. Services include:
- Pregnancy testing
- Help applying for Oregon Health Plan (Medicaid)
- Help making their first prenatal care appointment with a doctor, nurse practitioner or midwife
- Help making a dental appointment
- Information about WIC
- Information about Maternity Case Management services
Babies First! is the state's public health nurse home visiting program for children at risk for poor health and development. The program's purpose is to identify children at risk for poor health outcomes and to improve those outcomes through prevention and early detection. To make a referral to Babies First! contact your local Oregon county health department, whose information you can find using this tool: http://www.oregon.gov/DHS/ph/lhd/lhd.shtmlBabies First! nurses visit children's homes and provide the following services:
- Developmental screening
- Hearing, vision, and dental screening
- Immunization assessment
- SIDS support services
- Assessment of learning opportunities and safety in the home, and much more
To learn more about the program, visit their website at http://www.oregon.gov/DHS/ph/ch/bf1/index.shtml
Oregon Breast and Cervical Cancer Program
The Oregon Breast and Cervical Cancer Program (BCCP) was designed to give low-income, uninsured women access to screening programs for early detection of breast and cervical cancers. The program is funded by several non-profit and government organizations. The program's website is http://www.oregon.gov/DHS/ph/bcc/index.shtml, and full eligibility requirements (including income ceilings) can be viewed by downloading this pdfhttp://www.oregon.gov/DHS/ph/bcc/docs/BCCPeligibility.pdf This pdf also contains information on what specific screenings are available to women of various age groups. To enroll, call the BCCP at (971) 673-0581.
Oregon Medical Insurance Pool
The Oregon Medical Insurance Pool is the state's high risk health insurance pool. OMIP is meant to cover adults and children who have been rendered medically uninsurable on the private market by a preexisting condition. OMIP provides a way for these and other Oregonians to continue insurance coverage after they have exhausted COBRA and so is considered the insurer of last resort for residents. To review the extensive eligibility requirements for coverage under OMIP, click here:http://www.omip.state.or.us/DCBS/OMIP/apply_omip.shtml#Are_you_eligible_for_OMIP_coverage_ For more information, including specific plan benefits, visit the pool's homepage at http://www.omip.state.or.us/