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Health coverage in Oregon

If you live in Oregon and you are not offered coverage from an employer, it is important to consider your health coverage options. Below are summaries of each health plan option; more information is available through the links below.

Not sure what coverage you qualify for?Preview plans and savings through the window shopping tool.

Oregon Health Plan (OHP)

OHP is Oregon's Medicaid program. It provides free coverage for people in Oregon who meet eligibility criteria. Coverage includes doctor visits, hospital care, mental health services, dental, and some vision care.

Learn about Oregon Health Plan coverage

Private health insurance through HealthCare.gov

Individual health plans, also called private health coverage, are available through the Marketplace. People in every county of Oregon can purchase a plan through the Marketplace. All plans sold through the Marketplace include a comprehensive set of essential health benefits and are regulated by the State of Oregon. Although you can buy private health plans directly through an insurance company, financial assistance is available only through the Marketplace.

Learn about Marketplace coverage

Special savings for members of tribes

Health plans available through the Marketplace include special savings for American Indians who are enrolled in a federally recognized tribe, band, or pueblo, and Alaska Native Claims Settlement Act shareholders.

Enrolled tribal members and Alaska Natives who buy coverage through the Marketplace can enroll in a zero cost-sharing plan if their income is at or below the limit for their family size. This means they do not have to pay for deductibles, co-pays, co-insurance, or prescriptions. They also can enroll in coverage any time of year and can change plans up to once a month.

Learn about savings for tribal members

Medicare

Medicare is available to people who are 65 and older through the Social Security Administration. Some people who are younger than 65 also qualify for Medicare due to disability, end-stage renal disease (ESRD), or amyotrophic lateral sclerosis (ALS). Medicare does not cover everything, and there is cost sharing involved. It is important to consider additional coverage when you are enrolled in Medicare.

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

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

Health 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.

Learn about coverage for small businesses

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