Coverage for Individuals and Families
OregonHealthCare.gov is here to help you find the best health care coverage for you and your family.
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. You can visit the doctor when you need to. In short, it can improve you and your family’s life. Learn more about the benefits of having health insurance.
Most people must have health care coverage. Learn more about health coverage requirements and possible penalties for not being covered.
Types of coverage available
Most Oregonians can enroll in either private health insurance through HealthCare.gov or free or low-cost coverage through the Oregon Health Plan (Medicaid). All Oregonians can apply for coverage, and no one can be denied coverage because of a pre-existing health condition.
Oregon Health Plan
Free or low-cost coverage is available to people who meet requirements for income, residency, and other factors. Oregonians may also qualify based on age and disability status. Adults and children who qualify will be enrolled in the Oregon Health Plan (OHP), Oregon’s Medicaid program. Coverage through the Oregon Health Plan includes doctor visits, hospital care, mental health services, dental, some vision care and more.
Private health insurance
Many of the top insurance companies in Oregon offer health insurance plans through HealthCare.gov, the federal health insurance website, where you can browse, compare, and purchase a plan. All plans available include comprehensive health benefits and have been certified by the Oregon Insurance Division. Many people who qualify for private health insurance will also qualify for a tax credits to help pay for coverage. Learn more about financial assistance.
If you have questions about plan benefits, the Oregon Health Insurance Marketplace offers free help from our network of certified health insurance agents and community partners. You can search for an agent or community partner in your area by using our online directory. You can also contact the insurance company to ask questions about plans and benefits.
2016 Medical carriers:
To purchase a dental plan through HealthCare.gov, you must also purchase a medical plan. You may purchase a dental and medical plan separately; or a medical plan that includes dental coverage. You can find medical plans that include dental coverage when you compare plans. Dental and medical plans purchased separately are also priced separately. When you purchase a medical plan that includes dental coverage, the premium cost is bundled together.
2016 Dental carriers:
Medicare is the health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities and those who have permanent kidney failure. The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care. You have choices for how you get Medicare coverage. Learn more about Medicare coverage by visiting oregonshiba.org or call 800-722-4134 for answers to your Medicare questions by certified counselors.
When to apply
Oregon Health Plan – Anytime
Those eligible for Oregon Health Plan can apply at any time. If you applied through Oregonhealthcare.gov and enrolled in Oregon Health Plan coverage in 2015, the Oregon Health Authority will send a letter letting you know when it is time to renew. For more information on renewals, visit Renew OHP.
Private health insurance – During open enrollment
Private health insurance uses an open enrollment period. Open enrollment is the one time during the year when you can apply for health insurance, change plans, change insurance companies, or choose to stay with the plan you have. Open enrollment occurs every year in the fall.
You can enroll at other times if you experience a life change. Examples include:
- Loss of coverage
- Getting married
- Having or adopting a child
- Newly gaining citizenship, moving
- A change in income that makes you eligible for financial help
You can learn more about qualifying events at HealthCare.gov.
How to apply
For most people, it is best to apply through HealthCare.gov. People who qualify for the Oregon Health Plan can choose to apply through an online form. Note: This option is best for people with special circumstances. To see which might be best for you, go to Apply or Renew Now.
To complete the application, you need this information for everyone who wants coverage:
- Social Security number (for those who have one)
- Income and deduction information
- Immigration documentation (if applicable)
- Information about health insurance available to you through an employer
If you need help applying, you can get free in-person help from one of our community partners or from a certified insurance agent.
Using your coverage
For more information about using your coverage follow this link.
Special benefits for members of tribes
Private health plans available through HealthCare.gov and public plans available through the Oregon Health Plan include special benefits for American Indians and Alaska Natives who are enrolled in a federally recognized tribe. Learn more about special benefits for members of tribes.
Need more information?
Health care coverage flow chart
Apply or renew now
Using your coverage
Tribal member benefits