Oregon Health Insurance Quotes

Health Net of Oregon

Kaiser Permanente

LifeWise Health plan of Oregon

Pacificare of Oregon

PacificSource Health Plans

Regence Blue Cross Blue Shield of Oregon

In the past six years, the health care premiums in Oregon rose 5.9 times faster than families' earnings.  The average annual premiums for individual coverage have risen 77.5% while the premiums for family coverage have risen 74.9%.  Increases in annual premiums have left residents in Oregon paying $9, 906 for family coverage and $3, 706 for single coverage.  The number of uninsured people in Oregon has reached 471, 241 or 21% of the population.  Because of numbers like these, it is necessary to do enough research and comparing to find the health insurance plan that best fits your personal needs.

 

In Oregon, your individual health insurance premium cannot be determined by your health status which is called modified community rating.  Most Oregon health insurance policies are guaranteed renewable which means health insurance companies cannot cancel your plan if you become ill.  Premiums in Oregon can be determined however, by factors such as age.

 

Oregon has a high risk pool called the Oregon Medical Insurance Pool. You may be eligible for this pool due to your HIPAA rights or if you are a resident of Oregon, you have been denied coverage due to a medical reason, or you were involuntarily dropped from you health insurance.  This program was established by the Oregon Legislature to cover adults and children who are unable to obtain medical insurance becuase of health conditions.  Coverage under this high risk pool includes doctor visits, hospital, surgery, prescription drugs, ambulance and medical equipment.

To read more about OMIP visit www.omip.state.or.us

 

In Oregon, rates are based on a community rate. For groups of 2-25, rates are based on age, family members, and location of employer. There must not be more than a .43 variance in rates between the highest and lowest ages. For groups of 26-50, rates are based on age, family members, location of employer, and gender, but there are no age band requirements.  Under Oregon law, newborns and adopted children are automatically covered under parents' fully insured health plan for the first 31 days, if the plan provides dependent coverage.  Costs also depend on plan choice and the Modified Community Rate. 

 

Medical underwriting is allowed within small business health insurance.  There is a 6 month look back and 12 month exclusionary period limit for preexisting conditions for those without prior healthcare.

 

In Oregon, there are som factors that determine whether or not groups are eligible for small business health insurance coverage.  These include:

     - Company size 2-50 employees

     - Two employees must work 17.5 hours per week for coverage

     - Owner can count as an employee

     - Proprietor-name on license must draw wages

     - Credit for pre-existing conditions apply for individuals with no more than a 63 day break in coverage.

For more information visit www.coverageforall.org

 

Oregon offers COBRA, the Consolidate Omnibus Budget Reconciliation Act of 1985. Many companies with 20 or more employees that offer health insurance are required to offer employees and their dependents continuation coverage for benefits that were lost due, for example, to job loss, reduction in hours worked, death, or divorce. 

Medicaid is a state/federal program that pays for medical and long-term care services for low-income pregnant women, children, certain people on Medicare, disabled individuals and nursing home residents. These individuals must meet certain income and other requirements.

Children

Children (ages 1-5)-133% of the Federal Poverty Level
Children (Ages 6-19)-100% of the Federal Poverty Level

 

Pregnant Women and Infants

Pregnant Women-185% of the Federal Poverty Level
Infants (ages 0-1)-133% of the Federal Poverty Level

 

Parents

Non-Working Parents-100% of the Federal Poverty Level
Working Parents-100% of the Federal Poverty Level

 

Other populations

Medically Needy Individual- 58% of the Federal Poverty Level

Medically Needy Couple- 54% of the Federal Poverty Level

Supplemental Security Income Recipients- 74% of the Federal

Poverty Level

 

 

Hospital outpatient, rural health clinic, federally qualified health centers, laboratory and x-ray, nursing home, physician services, dental, early periodic screening diagnosis and treatment, family planning, clinic services, prescription drugs, case management, medical transportation, nurse midwife, extended services for pregnant women, and ambulatory prenatal care.

 

Co-payments vary. There are no co-payments if you are under 18, pregnant, living in a nursing home, or receiving family planning services.

 

You may learn more about Oregon Medicaid at http://www.oregon.gov/DHS/healthplan/index.shtml. 

Oregon offers the SCHIP program to children up to the age of 19, who are residents of Oregon, have no other health coverage including Medicaid, and whose family incomes are up to 170% of the Federal Poverty Level. Please visit the SCHIP website for more detailed information at   http://www.oregon.gov/DHS/healthplan/app_benefits/schip.shtml. 

 

Oregon offers families a program called The Family Health Insurance Assistance Program.  The Family Health Insurance Assistance Program, or FHIAP, helps thousands of Oregon families pay the monthly premium for high-quality, private health insurance plans.  FHIAP pays from 50% to 95% of the premium for Oregon residents who are uninsured and meet income  and other guidelines.  Individuals and families use FHIAP subsidies to pay for insurance at work or to buy individual health plans if insurance is not available through an employer.  (www.oregon.gov)