Division of Financial Regulation : Understand your health insurance : Health insurance : State of Oregon (2024)

You and your health insurance

Health care coverage, or health insurance, helps cover your medical bills when you seek medical care. The right health care coverage for you and your family can make a huge difference. Everyone needs medical care at some point. Health care coverage can protect you from unexpected expenses.

Buying health insurance for yourself and your family can be difficult. The Oregon Health Insurance Marketplace has developed an easy-to-use-tool to help you find the right plan.

Key health insurance rules

Under Federal and Oregon law:

  • People with pre-existing health conditions will not be denied coverage or charged more to be enrolled.
  • Insurance companies and employers that offer dependent coverage to children must cover adult children up to age 26, regardless of whether they are married or have coverage available through an employer.
  • While small employers do not have to offer insurance, large employers with 50 or more full-time equivalent employees must offer health coverage or pay a penalty.
  • You are protected from surprise medical bills when you receive either: covered out-of-network emergency services including air ambulance services (not applicable to ground ambulance services) or covered non-emergency services provided by an out-of-network provider at an in-network facility.

Help paying for health insurance

Most Oregonians buying insurance on their own qualify for financial help if they enroll through the Oregon Health Insurance Marketplace.

Depending on their income, they may qualify for tax credits to help pay their monthly premium and assistance with out-of-pocket costs such as deductibles and co-pays. More than 75 percent of Oregonians enrolled through the Marketplace received financial help in 2021, bringing health plan premiums down to as low as $1 per month..

Find out how much you can save on health coverage at https://ohim.checkbookhealth.org/.

How to enroll in health insurance

Most Oregonians get their health insurance through their employer, however Oregonians purchasing insurance on their own may only do so during the health insurance open enrollment period.

For 2022 coverage, open enrollment is Nov. 1, 2021 to Jan. 15, 2022.

People may also qualify for a special enrollment period, allowing them to enroll outside of open enrollment if they experience certain life events, such as getting married, having a baby, or involuntarily losing other coverage.

Oregon has a network of health coverage experts ready to help people enroll. You can find an expert in your area by going to OregonHealthCare.gov/GetHelp or by calling the Oregon Health Insurance Marketplace at 855-268-3767 (toll-free).

Oregon Health Plan

Individuals and families who are eligible for Oregon Health Plan (Medicaid) can apply at any time. Visit OregonHealthCare.gov for more information.

Employer coverage

Ask your human resources staff when your open enrollment occurs at work.

Division of Financial Regulation : Understand your health insurance : Health insurance : State of Oregon (2024)
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