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Oregon Health Insurance

Oregonians can enjoy new health insurance choices thanks to the Affordable Care Act, or ACA. According to a 2013 Kaiser Family Foundation profile of Oregon, Gov. John Kitzhaber in 2011 allowed the state to create its own health insurance marketplace. Oregon is also one of 27 states including Washington, D.C., that decided to expand Medicaid.

This means Oregon residents can visit OregonHealthCare.gov to register for an account during open enrollment, apply for coverage and learn more about their options. From there, applicants can learn if they qualify for the following:

Private Oregon medical insurance.
A subsidy to help pay for a private plan.
Medicaid.
The Children’s Health Insurance Program, also called CHIP.

People who would rather not apply online can get personal assistance through the community partner program.

Do you qualify for a subsidy in Oregon?

Because Oregon expanded Medicaid coverage, nearly 70 percent of formerly uninsured state residents will qualify for some type of assistance. This assistance might come from tax credits (subsidies) that can be used to help pay for private marketplace plans, Medicaid or CHIP. Typically, people who can get affordable health insurance elsewhere will not qualify for assistance.

If you don’t have access to other affordable medical insurance and your income is between 100 percent and 400 percent of the federal poverty level, you may qualify for tax credits that can be applied toward your insurance premium.

This is between $11,490 and $45,960 for an individual and between $23,550 and $94,200 for a family of four.

Generally, subsidy eligibility will be based on 2013 poverty level limits, and Medicare and CHIP qualification will be based on 2014 limits.

Oregon adults who make less than 138 percent of the poverty level – $16,105 for an individual – might qualify for Medicaid.

Oregon children from families with an income below 305 percent of the poverty level, or $72,750 for a family of four, may qualify for CHIP.

Some Oregonians may choose to sign up for private marketplace plans even if they do not qualify for subsidies. Qualified plans must provide certain mandated benefits, and insurers are not allowed to decline applicants based on pre-existing health issues.

Insurance companies with marketplace health plans in Oregon

These companies offer qualified health insurance plans on the Oregon marketplace.

Atrio Health Plans
BridgeSpan Health Co.
Health Net Health Plan of Oregon
Health Republic Insurance Co.
Kaiser Foundation Health Plan of the Northwest
LifeWise Health Plan of Oregon
Moda Health Plan
Oregon’s Health Co-Op
PacificSource Health Plans
Providence Health Plans
Trillium Community Health Plan

Oregon health and coverage statistics

Oregon population (2013): 3,930,065
Population 65 and older (2012): 14.9 percent
Life expectancy (2010): 79.5 years
Number of Medicaid beneficiaries (2012): 638,600
Number of Medicare beneficiaries (2012): 566,800
Estimated number of uninsured residents (2012): 564,300

Overall state health ranking: 13

Sources: Kaiser Family Foundation, U.S. Census Bureau, America’s Health Rankings 2014 report.