You and your health insurance
Health care coverage, or health insurance, helps cover your medical bills when you seek medical care. The right health care coverage for you and your family can make a huge difference. Everyone needs medical care at some point. Health care coverage can protect you from unexpected expenses. Learn more about the benefits of having health insurance.
Most people must have health care coverage. Learn more about health coverage requirements and possible penalties for not being covered.
Buying health insurance for yourself and your family can be difficult. We have developed an easy-to-use-tool to help you find the right plan.
Key health insurance rules
Under the Affordable Care Act and Oregon law:
- Everyone can get health insurance, even if they have pre-existing health conditions.
- Most individuals, including young people, must have health insurance or pay a tax penalty. In 2016, the penalty could potentially be as much as $2,085 for a family of four, with two parents and two children younger than 18, earning $50,000 a year.
- Insurance companies and employers that offer dependent coverage to children must cover adult children up to age 26, regardless of whether they are married or have coverage available through an employer.
- While small employers do not have to offer insurance, large employers with 50 or more full-time equivalent employees must offer health coverage or pay a penalty. The requirement extends to employers with 50 or more employees in 2016.
Help paying for health insurance
Most Oregonians buying insurance on their own qualify for financial help if they enroll through HealthCare.gov.
Depending on their income, they may qualify for tax credits to help pay their monthly premium and assistance with out-of-pocket costs such as deductibles and co-pays. For example, a family of four with an income of up to $97,000 (in 2016) now may qualify for federal help with private health insurance premiums.
Of the approximately 147,000 Oregonians who enrolled through HealthCare.gov for 2016, more than 104,000 paid an average of just $142 a month for their health insurance after receiving financial help.
How to enroll in health insurance
Most Oregonians get their health insurance through their employer, however Oregonians purchasing insurance on their own may only do so during the health insurance open enrollment period.
For 2017 coverage, the Open Enrollment Period is Nov. 1, 2016, to Jan. 31, 2017.
People may also qualify for Special Enrollment Periods allowing them to enroll outside of Open Enrollment if they have certain life events, like getting married, having a baby, or losing other coverage.
Oregon has a network of insurance agents and community organizations ready to help people enroll. You can find an agent or community partner in your area by going to www.oregonhealthcare.gov/get-help.html or calling the Oregon Health Insurance Marketplace at 1-855-268-3767 (toll-free).
Oregon Health Plan and Healthy Kids
Individuals and families who are eligible for Oregon Health Plan (Medicaid) and Oregon Health Kids can apply at any time. Visit OregonHealthCare.gov for more information.
Ask your human resources staff when your open enrollment occurs at work.