Oregon Health Insurance: Key Facts
- Medicaid Status Expanded (2014) - Oregon Health Plan
- Exchange Type Federal (Healthcare.gov)
- Open Enrollment November 1, 2024 - January 15, 2025
- Medicaid Income Limit 138% FPL (~$20,783/year single)
Oregon has a strong commitment to healthcare access, with both expanded Medicaid through the Oregon Health Plan (OHP) and marketplace options through Healthcare.gov. The state has been a pioneer in healthcare innovation, with coordinated care organizations designed to improve outcomes while controlling costs.
Oregon Health Plan (Medicaid)
The Oregon Health Plan (OHP) is Oregon's Medicaid program, providing comprehensive health coverage to low-income Oregonians. The program expanded in 2014 to cover all adults with incomes up to 138% of the federal poverty level.
Who Qualifies for the Oregon Health Plan?
- Adults 19-64: Household income up to 138% of the Federal Poverty Level (approximately $20,783/year for an individual)
- Children: Up to 305% FPL through OHP Plus
- Pregnant Women: Up to 190% FPL
- Seniors 65+: Various programs with different income and asset limits
- People with Disabilities: Multiple programs based on income and disability status
What Does the Oregon Health Plan Cover?
- Doctor and specialist visits
- Hospital care (inpatient and outpatient)
- Prescription medications
- Mental health and addiction treatment
- Preventive care and wellness visits
- Lab work and diagnostic testing
- Dental care (comprehensive)
- Vision care
- Non-emergency medical transportation
- Home health and long-term care services
Health Insurance Marketplace in Oregon
Oregon uses the federal marketplace at Healthcare.gov for individual and family health insurance. After operating its own troubled exchange (Cover Oregon) in the early ACA years, the state transitioned to the federal platform for a more reliable enrollment experience.
How to Enroll Through Healthcare.gov
- Create an account at Healthcare.gov
- Complete your application with household and income details
- Find out if you qualify for OHP, tax credits, or cost-sharing reductions
- Compare plans from available insurers
- Select a plan and complete enrollment
- Pay your first month's premium to activate coverage
Insurance Companies in Oregon
Oregon residents can choose from several insurers on the marketplace:
- Kaiser Permanente
- Moda Health
- Providence Health Plan
- PacificSource Health Plans
- BridgeSpan Health
Average Health Insurance Costs in Oregon
Oregon's health insurance costs are moderate compared to other western states. The Portland metro area tends to have more affordable options due to insurer competition.
| Metal Tier | Average Monthly Premium | Typical Deductible |
|---|---|---|
| Bronze | $340 - $440 | $7,000 - $8,500 |
| Silver | $490 - $570 | $4,500 - $6,000 |
| Gold | $590 - $690 | $1,500 - $2,500 |
Important Enrollment Dates
- Open Enrollment: November 1, 2024 - January 15, 2025 (for 2025 coverage)
- December 15 Deadline: Enroll by this date for January 1 coverage
- January 15 Deadline: Final deadline for February 1 coverage
- Oregon Health Plan: Apply year-round; no enrollment deadline
Frequently Asked Questions
Does Oregon have Medicaid expansion?
Yes, Oregon expanded Medicaid through the Oregon Health Plan (OHP) in 2014. Oregon was actually an early adopter of expanded coverage and now provides comprehensive benefits to adults with incomes up to 138% of the federal poverty level.
Where do Oregon residents enroll in marketplace health insurance?
Oregon uses the federal marketplace at Healthcare.gov for health insurance enrollment. Residents can compare plans from multiple insurers, apply for subsidies, and complete enrollment through the federal platform.
When is Oregon's health insurance open enrollment period?
Oregon's Open Enrollment for 2025 coverage runs from November 1, 2024 through January 15, 2025 on Healthcare.gov. Oregon Health Plan applications are accepted year-round with no enrollment deadline.
How much does health insurance cost in Oregon?
The average monthly premium for a benchmark Silver plan in Oregon is approximately $490-$570 before subsidies. Most Oregonians qualify for premium tax credits, and many pay under $100 per month after subsidies are applied.
Need Help Finding Coverage in Oregon?
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