Many individuals and families in Oregon may qualify for financial help to lower the cost of health coverage. Factors such as household income determine what health coverage you qualify for and how much financial savings you can get. Below are three types of financial help available to Oregonians:
Oregon Health Plan
The Oregon Health Plan (OHP) is Oregon’s Medicaid program. It provides health care coverage for low-income Oregonians from all walks of life. This includes working families, children, pregnant women, single adults, and seniors. To qualify for OHP, individuals and families must meet income and residency requirements. Oregonians may also qualify based on age and disability status. OHP includes benefits such as regular checkups, prescription drugs, mental health care, addiction treatment, and dental care.
Tax credits and lower out-of-pocket costs
People who qualify for a premium tax credit can lower the cost of private health insurance when they buy a health plan through HealthCare.gov. A premium tax credit can be applied toward the cost of monthly premiums to lower the amount owed each month, or it can be claimed when filing taxes.
Some people who qualify for a tax credit will also qualify for lower out-of-pocket costs (also called “cost-sharing reductions”). With a cost-sharing reduction, they will pay lower deductibles, co-pays, and co-insurance when they enroll in a Silver plan through HealthCare.gov.
When you apply through HealthCare.gov, you need to provide income and tax information for everyone you include on your application. After your application is processed, you will find out if you and others on your application are eligible for financial savings.
Income limits for financial savings
Use the table below to find out what you might qualify for based on your family size and yearly income. Find your family size in the first column, then follow the row to the dollar amounts in the other columns. If your estimated household income for 2016 is less than one of the amounts shown, you will likely qualify for that type of financial help.
Here is how this works for a family of four:
Example 1: With a yearly household income of up to $33,534, a family of four will likely qualify for the Oregon Health Plan. People who qualify for the Oregon Health Plan do not qualify for financial help to pay for private health insurance.
Example 2: With a yearly household income range of $33,534 to $74,115, the children in a family of four will likely qualify for no-cost coverage through the Oregon Health Plan. The adults will likely qualify for tax credits (and lower out-of-pocket costs) to lower the cost of private health insurance.
Example 3: With a yearly household income range of $33,534 to $97,200, a family of four will likely qualify for tax credits to lower the cost of monthly premiums for private health insurance. The family may also qualify for lower out-of-pocket costs on deductibles, co-pays, co-insurance, and prescriptions.
Note: These are only estimates. To find out what you qualify for, you must apply and enroll through HealthCare.gov.