The people of Oregon have new choices in purchasing health insurance due to the passage of the Affordable Care Act (ACA), also known as ObamaCare. Oregon implemented its own state-run marketplace, CoverOregon. Oregonians can visit CoverOregon online to apply for and purchase coverage. Although the website has had technical difficulties, citizens of the state can finish their applications by phone or receive free, in-person assistance.
Oregon also chose to expand Medicaid guidelines to cover additional lower-income adults, allowing Oregon residents who have might never have had access to health insurance new coverage opportunities. Applications made through the marketplace are automatically reviewed for Medicaid and Children’s Health Insurance Program (CHIP) coverage.
Purchasing Health Insurance in Oregon
At the time of this writing, CoverOregon had been experiencing technical issues that did not allow citizens of the state to finish their applications online. However, there are several ways to apply. Oregonians can browse plans, finish their application in-person, or call 1-855-268-3767 to apply over the phone. Regardless of how it is completed, all applications are reviewed for any possible financial assistance, as well as eligibility for Medicaid or CHIP.
Oregonians who make between 100% – 400% of the federal poverty level will qualify for some form of help with insurance premiums. In addition, those who make between 100% – 250% of the federal poverty level will qualify for assistance with cost-sharing, such as deductibles or copayments. In 2013, the federal poverty level was $23,550 for a family of four. CMS just released the figures for 2014 ($23,850), but eligibility for cost sharing and premium assistance for coverage in 2014 will continue to be based on 2013 numbers.
Oregonians who already have affordable job-based coverage, Medicare, or other qualified coverage may purchase insurance through the Marketplace, but they will not receive financial assistance. They are already considered covered under the ACA.
Uninsured Oregonians will need to obtain health insurance coverage by March 31, 2014 to avoid paying a tax penalty. In 2014, the penalty is the higher of 1% of your income or $95 per adult ($47.50 for a child under 18). This penalty increases each year until 2016, and will rise to $695 or 2.5% of income, whichever is greater. It is important to note that paying the penalty does not mean you have health insurance. Oregon residents who cannot obtain coverage for some reason can apply for an exemption to avoid paying the tax penalty.
Due to the technical difficulties with the state marketplace, many insurers are giving new customers additional time to pay their premiums. Details, based on insurance company, can be found in the CoverOregon Consumer Bulletin.
Medicaid and CHIP in Oregon
Lower-income Oregonians may find that they qualify for Medicaid coverage, even if they’ve been turned down in the past. To apply for Medicaid, citizens may either fill out a Marketplace application or contact the state office directly. With the expansion of Medicaid guidelines, thousands of Oregonians are discovering that they have new access to health coverage that meets their needs.
For those with a moderate income who do not qualify for Medicaid, coverage for their children may still be available through CHIP. The program, called Oregon Healthy Kids, provides coverage for uninsured children in families whose incomes are too high to qualify for Medicaid. The children receive routine check-ups, immunizations, vision and dental care, emergency services, and more. The program gives Oregon’s children a chance to start out on a healthy path early in life. To learn more about Oregon Healthy Kids, visit the program’s site on the state webpage.
Oregonians have new options when it comes to health insurance since the passage of the ACA. Understanding all of the options available and making the right choice for every family will help Oregon move toward a happier, healthier future.