Cheap Health Insurance in Oregon (OR)

Medical insurance provides payment or reimbursement for healthcare related expenses. The specific services covered can be different for each policy. For example, preventive care visits may be covered in one policy and not in another.

In Oregon, medical insurance is regulated by the Insurance Division of the Division of Business and Consumer Services. The agency’s website at http://www.cbs.state.or.us/ins/index.htmlprovides detailed information for Oregon consumers, including a Consumer Guide to Health Insurance, a place to report and researh complaints, and Medicare information.

The majority of Oregonians with private insurance are covered by employer based group health plans. Ninety-two percent of all companies offer health benefits to full-time employees and 73 percent offer health benefits to part-time employees. Employers work with insurance companies to determine the benefits and rates desired. If eligible under employer policies, employees can enroll without a screening or physical exam. Insurers cannot deny group coverage to people with pre-existing conditions. Employers often pay the majority of the premium cost, but employees may pay a small monthly amount toweards their own coverage. The cost to cover family members is usually paid for by the employee.

Oregon resident who need to purchase individual health insurance must complete a standard health statement that requests medical information from the past five years. Insurers may deny coverage based on responses to this statement, but if the company offers coverage, premium rates cannot be based on an individual’s health experience. All individual health insurance policies must include certain mandated health benefits, but some benefits mandated for group policies, such as mental health parity, do not apply to individual insurance. However, insurance companies cannot require a waiting period for any mandated benefit for individuals. A list of mandated benefits can be found at http://www.cbs.state.or.us/external/ins/sehi/mandated_health_provisions.pdf.

The Oregon Medical Insurance Pool (OMIP) is available for those who are denied individual coverage due to medical conditions. Premium rates cannot exceed 125 percent of individual market rates.

In Oregon, eight companies have 91 percent of the health care business, and none has more the 34 percent of the market share. This contrasts many states in which one or two companies dominate the market. The largest insurers in Oregon include Kaiser Foundation Health Plan of the Northwest, Regence BlueCross BlueShield of Oregon, Providence Health Plan, Inc., Health Net Health Plan of Oregon, Lifewise Health Plan of Oregon, Inc., Pacific Source Health Plans, ODS Health Plan, Inc., and PacifiCare of Oregon.