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Learn about coverage

Types of coverage for individuals and families

The Oregon Health Plan, private plans sold on HealthCare.gov, and Medicare are coverage options for people who either do not get health insurance through a job or who qualify additional coverage. There are special options for COFA islanders, members of tribes, and small businesses.

Oregon Health Plan

This 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. Coverage through the Oregon Health Plan includes doctor visits, hospital care, mental health services, dental, and some vision care.

Apply  |  Learn about the Oregon Health Plan

Private health insurance through HealthCare.gov

Private health insurance plans, and financial help with your coverage, are available through HealthCare.gov. Private health insurance plans in every Oregon county are offered on HealthCare.gov. All the plans include comprehensive health benefits, and the Oregon Health Insurance Marketplace makes sure the plans meet state and federal requirements. In 2016, most Oregonians who enrolled in these plans got help paying for their coverage, receiving an average of $346 per month.

Apply  |  Learn about HealthCare.gov coverage

COFA Premium Assistance Program

The Compact of Free Association (COFA) Premium Assistance Program provides free health insurance for low-income citizens of the Republic of Marshall Islands, the Federated State of Micronesia, and the Republic of Palau who live in Oregon under the compact.

Learn about the COFA Premium Assistance Program

Special options for members of tribes

Private health plans available through HealthCare.gov include special benefits for American Indians and Alaska Natives who are enrolled in a federally recognized tribe.

Enrolled tribal members who buy private health insurance through HealthCare.gov can enroll in a zero cost-sharing plan if their income is at or below the limit for their family size ($70,650 for a family of four). This means they do not have to pay for deductibles, co-pays, co-insurance, or prescriptions. They also can enroll in a private health plan any time of year and can change plans up to once a month.

Apply  |  Learn about tribal coverage

Medicare

Medicare is the federal health insurance program for people age 65 and older. Certain people younger than age 65 can qualify for Medicare, including those who receive Social Security Disability Income and those who have permanent kidney failure. Because Medicare is health insurance, you share the costs of your care.

The Oregon Senior Health Insurance Benefits Assistance program (SHIBA) can tell you more about Medicare options.

Call SHIBA at 1-800-722-4134 (toll-free) or go to the SHIBA website

Coverage for small businesses

Any small business in Oregon with one to 50 employees can directly purchase a certified plan from one of the participating insurers. Small businesses with fewer than 25 full-time employees could be eligible for the Small Business Health Care Tax Credit. The Oregon Health Insurance Marketplace plays a role in some of the key steps toward your business qualifying for the credit.

Coverage for small businesses

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