Oregon HealthCare.gov

IMPORTANT: Check your HealthCare.gov account

HealthCare.gov may ask you for documents to verify your income, immigration status, identity, Special Enrollment status, or something else. It’s important that you submit your documents by the HealthCare.gov deadline so you don’t lose your health insurance or your tax credits.

Monthly premiums

As the policy holder, you may still receive invoices or bills from your carrier. If your enrollment is in good standing, the program pays your monthly premiums directly to your carrier. If your enrollment needs to be paused for any reason, the program will contact you directly to work out any discrepancies or alert you of premium non-payment before the payment is due for the upcoming month.

Using your COFA Program-sponsored health insurance

Once you have received your insurance card and your coverage has started, you can use it to help cover medical costs like going to the doctor, filling a prescription at the pharmacy, and getting emergency care. Prepare for your healthcare needs by checking if your preferred doctor, pharmacy, and hospital are in your carrier’s network.

Call your insurance company, search their website, or check the member handbook for providers in your network. Sometimes networks change, so it’s a good idea to double-check with your health plan.

Reimbursement for out-of-pocket costs

The program will reimburse you for allowed in-network out-of-pocket costs up to $750 (individual enrollment) or $1,500 (family enrollment).

To get reimbursed for your out-of-pocket costs, you will need to submit:

  1. COFA program reimbursement claim form
  2. Original receipt of payment from your doctor, pharmacy, or other provider
  3. A copy of your insurance company’s Explanation of Benefits

Please type or clearly print your information into the form, print and then mail or fax (along with a copy of your Explanation of Benefits and your official receipt) to the program:

COFA Premium Assistance Program
Oregon Health Insurance Marketplace
P.O. Box 14480
Salem, OR 97309
Fax: 503-947-7092

Once the program has processed your paperwork for payment, your reimbursement amount will be deposited in the U.S. Bank ReliaCard that was mailed to you. All your reimbursements for 2017 will be deposited in this card, please keep it in a safe place and treat it like cash.

Learn more about the COFA program ReliaCard:

I’ve submitted my claim. Where’s my reimbursement?

Life Changes

IMPORTANT: Report your life changes as soon as they happen. The changes may affect the amount of tax credits you qualify for or the plans available in your area.

What changes to report:

  • Changes to your expected income for the year
  • Changes in health coverage:
    • Someone in your household getting an offer of job-based insurance, even if they don’t enroll in it
    • Someone in your household getting coverage from a public program like the Oregon Health Plan Plus or Medicare
    • Someone in your household losing coverage, like job-based coverage or emergency Medicaid (CAWEM or CAWEM Plus)
  • Changes to your household or individual members:
    • Birth or adoption
    • Placing a child for adoption or foster care
    • Becoming pregnant
    • Marriage or divorce
    • A child on your plan turning 26
    • Death
    • Gaining or losing a dependent some other way
    • Moving to a permanent address in Oregon
    • Moving to a permanent address outside of Oregon
  • Corrections to name, date of birth, or Social Security number
  • Changes in status:
    • Change in disability status
    • Change of tax filing status
    • Change of citizenship or immigration status
    • Incarceration or release from incarceration

How to report your changes:

  1. Report your changes to HealthCare.gov
  2. Once completed, download and print your new HealthCare.gov eligibility notice
  3. Complete the COFA program Life Changes Report Form (hyperlink to attached), attach your new HealthCare.gov eligibility notice, and mail or fax it to:
    COFA Premium Assistance Program
    Oregon Health Insurance Marketplace
    P.O. Box 14480
    Salem, OR 97309
    Fax: 503-947-7092

Appeals

If there is an issue with a reimbursement claim you previously submitted, or if you would like to request an eligibility redetermination, fill out and submit the following form and any supporting materials by mail or fax to:

COFA Premium Assistance Program
Oregon Health Insurance Marketplace
P.O. Box 14480
Salem, OR 97309
Fax: 503-947-7092

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