Oregon Health Plan
Oregon health plan is Oregon's Medicaid program. It was intended to make health care more available to the working poor, while rationing benefits. Basic eligibility requires that the applicant be a resident of Oregon, as a citizen or otherwise. The level of coverage is based on income, age, mental and physical condition. New enrollment in the program were closed from mid-2004 until early 2008, when a lottery-based system was introduced. Tens of thousands of Oregonians signed up, competing for 3,000 new spots in the plan.
The Oregon Health Plan was expanded to cover 80,000 uninsured children through legislation that passed in 2009. The program has enrolled 38,000 additional children through February, 2010.
Add your name to the Reservation List
Oregon Healthy Kids
This program was passed in 2009 to cover uninsured children in Oregon. Depending on family income, children may be eligible for free or low-cost health coverage for doctor visits, dental care, vision, medicines and more through the Healthy Kids program.
Eligibility
- Child must be under the age of 19 (19th birthday).
- Child must live in Oregon and be a legal resident.
- Your child must have been without health insurance for two months (though there are exceptions to this rule for special circumstances, like a parent’s job loss or a child’s serious medical need).
Coverage and Benefits
OHP and the healthy kids programs provide full medical, dental and vision coverage to the members. Members have their choice of multiple insurance companies, but PacificSource is the only carrier that provides coverage statewide. Below you will find the benefit summary.
PacificSource Benefit summary
Costs
For free or low-cost coverage, household income can’t be more than 300 percent of the federal poverty level, which is about $66,000 for a family of four. Income level depends on family size, so for smaller families, income is less. For larger families, income is more. For households with income greater than 300 percent of federal poverty level, there is an option for affordable option coming soon.
Children in families earning 200% of the Federal Poverty Level ($44,100 for a family of four) or less will receive Healthy Kids coverage at no cost. Here is chart illustrating all the premiums available and the costs of the plan
Oregon Healthy Kids premiums
Children in families between 200 and 300% of the Federal Poverty Level will receive a sliding scale subsidy for the cost of their premium. Rates will vary depending on which plan the family selects.
Monthly rates for families between 201 and 250% FPL* will pay:
Family Size |
Statewide Carrier Rate
(PacificSource) |
Regional Carriers |
Range of Rates |
Average Rate |
1-child |
$25 |
$18 - $28 |
$22 |
2-4 children |
$43 |
$31 - $49 |
$38 |
5 or more children |
$62 |
$45 - $70 |
$54 |
*44,101 - $55,128 for a family of four
Monthly rates for families between 251 and 300% FPL* will pay:
Family Size |
Statewide Carrier Rate
(PacificSource) |
Regional Carriers |
Range of Rates |
Average Rate |
1-child |
$38 |
$27 - $42 |
$33 |
2-4 children |
$66 |
$47 - $73 |
$57 |
5 or more children |
$95 |
$67 - $105 |
$81 |
Application
Download application
Keep in mind the requirements for proof of eligibility. Typically, proof of residency, current month income and porjected next month's income. You will be required to verify next months income at time of approval.
Feel free to contact us with any questions.
|