Subsidies make it possible for thousands through OREGONHEALTHCARE.GOV
Many single Oregonians making about $19,000 a year can qualify for a basic plan costing them, after a federal subsidy, $1 a month. People qualifying for deep subsidies are among the nearly 104,000 Oregonians who are estimated to qualify for financial help with their coverage but who remain uninsured.
Among that group, about 25,000 people of varying incomes and family sizes are estimated to have access to basic plans for a net premium of between $1 and $150. To get subsidized coverage for 2020, people must sign up by Dec. 15.
The amount of a person’s premium subsidy—the price break they get on the monthly cost of coverage—varies based mostly on income and family size, with a few other qualifications. The $1 plans are available amid other choices, many with higher premiums and richer benefits, and all sold by private insurance companies and certified by the Oregon Health Insurance Marketplace, a part of state government.
Solid estimates of subsidies, net premiums and plan options are available at OregonHealthCare.gov/windowshop. In new video ads for open enrollment, Oregonians talk about their experiences with financial help for health insurance.
Karl B., an independent contractor, says in one video, “Having the subsidy, having the benefits, through OregonHealthCare.gov, that really alleviates a lot of the pressure on me.”
Deductibles on the lowest-cost plans are substantial, but some benefits are available before a person has to pay it.
“I always want my clients to know if a plan includes benefits they can access regardless of a high deductible, even when they haven’t met that deductible,” said Tina Kennedy, of Healthwise Insurance Planning in Portland. “Every plan through the Marketplace covers certain preventive care right away, at no extra cost to you, and on some large-deductible plans, you get office visits for a copay even when you haven’t dented the deductible.”
In Oregon, plans with the words “standard bronze” in their name all cover primary care office visits for a flat $45 copay, even when the plan’s $7,900 deductible has not been met. This plan type is among the options with a net cost of $1 per month for people making around $19,000 a year and meeting a few other qualifications.
A certified community partner or licensed insurance agent can, at no cost to you, help you apply for a subsidy and translate health-plan plan details into dollars and cents for you. They are listed in a directory at OregonHealthCare.gov/gethelp. Only a licensed insurance agent can recommend the best plan for you.
The Oregon Health Insurance Marketplace, a part of state government, helps people get health insurance when they do not have job-based coverage and do not qualify for the Oregon Health Plan or another program. The Marketplace is the state-level partner to HealthCare.gov, and a division of the Department of Consumer and Business Services (DCBS). For more information, go to OregonHealthCare.gov.