Introduction: The health insurance situation in Oregon is average, in comparison to the overall health insurance situation of the entire United States. The Center for Disease Control conducted a survey on the Oregon health insurance status. The survey report revealed that almost 15% of the total Oregon population did not get Oregon medical insurance for each year, between 2001 and 2003.
To let the Oregon residents be informed about their state's health insurance market, we have provided a useful article. Oregon medical insurance regulations and information on Oregon state medical insurance alternative options are discussed in the article.
Some Important Regulations for Oregon Medical Insurance
To control the health insurance industry and monitor the activities of different Oregon medical insurance companies, Oregon department of insurance has provided some regulations that are discussed below:
- Oregon medical insurance companies can not refuse or restrict any Oregon resident from getting employer's medical insurance coverage, if the individual is qualified for Oregon health insurance through an employer.
- However, as per state insurance law, an Oregon individual looking for individual Oregon medical insurance can be refused or restricted by the insurers, depending on his or her health, age and other deciding factors.
- Oregon medical insurance companies can inflict waiting periods for pre-existing medical conditions.
- As per insurance laws, a pre-existing medical condition may be defined as an illness for which an individual has been treated, received medical advice or otherwise diagnosed within 6 months, before applying for new Oregon medical insurance policy.
- Oregon medical insurance companies can implement a waiting period for any pre-existing medical condition for no more than 24 months.
- However, some of the Oregon insurers impose a waiting period for 90 days prior to starting of coverage.
- During the term of a pre-existing waiting period, an individual is not entitled to get any coverage for that particular health condition.
- Continual coverage from previous policy may be transferred to new Oregon medical insurance policy.
- Oregon state health insurance law considers pregnancy as a pre-existing health condition for which the insurance companies can impose exclusion period.
- All newborns and adopted children should get coverage under their parent's Oregon medical insurance policy that offers dependant coverage for the initial 31 days from the day of birth or adoption.
- Oregon residents, who are between health insurance plans or jobs, can purchase temporary Oregon medical insurance plans offered by several Oregon insurers. They can also purchase portability plans through Oregon Medical Insurance Pool or OMIP (discussed below).
Oregon Medical Insurance Alternative Options
Oregon Department of Insurance offers some medical insurance alternative programs to let the Oregon residents, who are unable to afford the cost of Oregon medical insurance or otherwise considered as “uninsurable”, get coverage. The programs are as follows:
- Oregon Health Plan: The program helps Oregon residents getting health coverage and the benefits of health insurance.
- Oregon Medicaid: Oregon residents, who meet all the qualifying as well as income criteria, are able to avail this program.
- Oregon Medical Insurance Pool or OMIP: This is the high risk pool for the state of Oregon. The program lets the uninsurable or high risk Oregon individuals purchase medical insurance through the state. Pre-existing medial condition may be applied.
- Family Health Insurance Assistance Program or FHIAP: Employed Oregon residents, who meet all the qualifying criteria, can avail the program. It helps them to pay their medial insurance premiums.
- Oregon Children's Health Insurance Program or CHIP: This program is available to the children below and up to the age of 19. Nevertheless, children from families, which are ineligible for Oregon Medicaid or unable to afford the cost of Oregon medical insurance, are only eligible for the program.
Oregon Insurance Division
PO Box 14480
Salem, OR 97309-0405