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Health insurance plans

Private individual and small group insurance plans available through Explore Health.

Plan tiers

Explore Health plans are grouped into metal tiers:

  • Bronze
  • Silver
  • Gold

All plans cover essential health benefits, but each tier balances monthly premium costs and out-of-pocket costs differently.

In general:

  • Bronze plans usually have lower monthly premiums and higher out-of-pocket costs.
  • Silver plans offer moderate premiums and costs and may qualify for extra savings.
  • Gold plans usually have higher monthly premiums and lower out-of-pocket costs.

Compare plans

When comparing plans, consider:

  • Monthly premiums
  • Deductibles and copays
  • Prescription coverage
  • Provider networks
  • Covered services

You can explore available plans and insurance companies through ExploreHealthOR.gov.​

The Oregon Health Plan (OHP) is a public medical program that provides free or low-cost coverage for people who qualify. There are different types of OHP: OHP (Medicaid/CHIP) and OHP Bridge (Basic Health Program).

Coordinated Care Organizations (CCOs)

Most OHP members receive care through a local health plan called a Coordinated Care Organization (CCO).

CCOs help coordinate physical health, dental health, and behavioral health services.

All CCOs provide the same core OHP benefits, though some extra services and pharmacy options may vary.

Choosing or changing your CCO

You can:

  • Choose a CCO when you apply for OHP
  • Change your CCO in some situations
  • Check your current CCO through your ONE online account
  • Contact OHP Client Services for help

Learn more about CCOs on OHP's website.

Medicare is federal health coverage for people age 65 and older and some younger people with disabilities or certain medical conditions.

Medicare parts

Part A — Hospital coverage

Helps cover:

  • Hospital stays
  • Skilled nursing facility care
  • Hospice care
  • Some home health care

Part B — Medical coverage

Helps cover:

  • Doctor visits
  • Outpatient care
  • Preventive services
  • Durable medical equipment
  • Some home health care

Part D — Prescription drug coverage

  • Helps cover prescription medications and certain vaccines through private insurance plans approved by Medicare.

Medigap (Medicare Supplement Insurance)

  • Optional private insurance that helps pay some out-of-pocket costs in Original Medicare.

Medicare coverage options

Original Medicare

  • Includes Part A and Part B.
  • People with Original Medicare can:
    • Use any provider that accepts Medicare
    • Add a separate Part D drug plan
    • Purchase Medigap coverage for additional cost protection

Medicare Advantage (Part C)

  • Medicare Advantage plans are offered by private insurance companies approved by Medicare.
  • These plans usually include:
    • Hospital coverage
    • Medical coverage
    • Prescription drug coverage
  • Many plans also include extra benefits such as:
    • Dental
    • Vision
    • Hearing
  • Medicare Advantage plans may require members to use provider networks and get approval for some services.

Need Medicare help?

Oregon's Senior Health Insurance Benefits Assistance (SHIBA) program offers free Medicare counseling and education.​

Veterans may qualify for health care and services through the U.S. Department of Veterans Affairs (VA).

VA health care may include:

  • Preventive care
  • Primary care
  • Specialty care
  • Mental health services
  • Prescriptions
  • Hospital care

Eligibility depends on factors such as military service history, discharge status, disability status, and income.

Using VA coverage with other insurance

Veterans may have VA health care along with:

  • Explore Health coverage
  • Oregon Health Plan (OHP)
  • Medicare
  • Employer-sponsored insurance

Having more than one type of coverage may improve access to providers and services.

Important things to know

VA health care is different from Explore Health insurance.

Veterans enrolled in VA health care generally meet requirements for qualifying health coverage.

Family members usually need their own separate health coverage.

Some veterans may still qualify for Explore Health financial help depending on their situation.

Need help understanding your options?

Veterans can:

  • Contact the VA directly
  • Work with a local enrollment assister or community partner
  • Compare coverage options through HealthCare.gov
  • Get help understanding how VA coverage works with Medicare or OHP

Free help is available.​