Find Low Cost Health Insurance in Oregon

You can purchase private health insurance through the Marketplace in Oregon. These plans are regulated by the state and are required to have a set of essential benefits. Also referred to as individual health insurance, these private plans can be purchased outside of the Marketplace but then you won’t receive any subsidies or cost-sharing reductions, so it’s better to purchase on the exchange.

Private health insurance is grouped into metal tiers, including bronze, silver, and gold. These tiers don’t tell you if one plan is better than the other; rather, they tell you roughly how much coverage you get versus out-of-pocket costs you’ll have to pay.

Let’s quickly review each tier:

• Bronze: You’ll pay the lowest premiums in this tier, but the highest out-of-pocket costs. You’ll get 60-65% of costs covered, and pay the rest. Bronze plans are best for those that rarely need medical care, which is why it makes sense to pay lower premiums for most of the year. 
• Silver: These plans come with moderate premiums and moderate out-of-pocket costs. You’ll get 70% of your costs covered with these plans. The good thing about Silver plans is that they’re the only tier available for cost-sharing subsidies, which means they can often end up being the most affordable plan with more coverage.
• Gold: These plans come with the highest premiums, but lowest out-of-pocket costs. 80% of your medical costs will be covered. Gold plans are best for those who have recurring healthcare needs. 
• Catastrophic: These plans aren’t available to everyone. You need to be in good health and under the age of 30, or you have a financial hardship to qualify. Catastrophic plans cover the bare minimum, so they’re often not the best coverage for most people. 

Note, you can only change your plan or enroll in a new plan during open enrollment. This runs from November 1st to January 15th each year. If you want your new coverage to start by January 1st, be sure to choose a plan and enroll by December 15th, or else your coverage will start February 15th.

You don’t always have to wait until open enrollment though. If you’ve recently had a qualifying life event, like a marriage, birth, divorce, job loss, etc., then you may be able to switch your plan early.

Medicare/Medicaid

If you qualify for government programs like Medicare and Medicaid, then you’ll pay the least in coverage. These programs are designed to get you affordable health insurance in Oregon. Let’s explore the difference between programs:

• Medicare: This is health insurance for anyone over the age of 65, or those who qualify because of health conditions like ALS or End-Stage Renal Disease. You automatically become eligible for Medicare at the age of 65 and are fined for not enrolling on time, unless you have adequate health insurance still from another source, like your employer. Medicare is broken into four parts:
  
  • Part A: Hospital coverage
  • Part B: Doctor’s visits, outpatient coverage, medical equipment
  • Part C: Medicare Advantage, Medicare-approved plans from a private insurer that bundles Parts A, B, D and often vision, dental and more. 
  • Part D: Prescription drug coverage

You can choose which parts of Medicare to enroll in and you can also double up with additional coverage even though you’re enrolled in Medicare. Keep in mind, Medicare is just for individuals and not for families.

Pro tip: Medicare and retirement often go hand in hand. But there’s more to retirement than just sorting out your health insurance. Grab our free guide to retirement planning to make sure you’ve got everything covered, whether retirement is coming up or even as you’re settling into work-free days.

• Medicaid: In Oregon, Medicaid is referred to as Oregon Health Plan (OHP). This low cost health insurance in Oregon is designed to get free coverage to those who would struggle to pay for it otherwise. To qualify for OHP, you must meet certain income and residency requirements, or you can qualify based on your age and disability status. You can apply for OHP at any time of the year.