Health Insurance Companies in Oregon Guide

Oregon has a unique healthcare landscape, with a mix of private and public insurance options. There are five main health insurance companies operating in the state.

Moda Health is one of the largest health insurance companies in Oregon, serving over 500,000 members. It offers a range of plans, including individual and group plans, as well as Medicare and Medicaid plans.

PacificSource Health Plans is another major player in the Oregon health insurance market, with a strong presence in the state's rural areas. It offers a variety of plans, including individual and group plans, as well as plans for small businesses.

Oregonians can choose from a range of health insurance companies, each with its own strengths and weaknesses.

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If you're looking for health insurance in Oregon, there are many options available. You can check if OHSU is in network with your insurance plan, as some plans limit what they'll cover at OHSU.

There are hundreds of insurance plans that include OHSU, including original Medicare, also called traditional Medicare. Some examples of insurance plans that are accepted by OHSU include Aetna, AllCare, and Cigna.

Here are some of the insurance plans that are accepted by OHSU:

Oregon also offers other health insurance options, including Medicare coverage, Medicaid, and the Basic Health Program (OHP Bridge).

Dental plans can be a great option to consider when looking for insurance plans. Delta Dental of Oregon is a reputable provider that covers all of Oregon and offers access to providers nationwide.

You'll have access to two of the largest preferred provider dental networks in Oregon and across the country: the Delta Dental PPO Network and the Delta Dental Premier Network. These networks give you a wide selection of in-network dentists to choose from.

With the Delta Dental PPO Network, you'll have access to over 1,200 in-network dentists in Oregon and 114,000 nationwide. The Delta Dental Premier Network offers even more choice, with 153,000 participating dentists nationwide.

Intriguing read: Tufts Health Plan Ppo

Delta Dental of Oregon also offers the Willamette Dental Network, which provides seamless, personalized care at nearly 50 connected locations across Oregon, Washington, and Idaho.

If you're looking for a specific dentist, you can search for them in the following networks:

To enroll in a dental plan, you can do so during the Open Enrollment period, which runs from November 1, 2024 to January 15, 2025. However, if you experience a qualifying life event, you may be eligible for Special Enrollment at any time.

OHSU accepts hundreds of insurance plans, including original Medicare. Some plans limit what they'll cover at OHSU, so it's best to check with your insurer before getting care.

Aetna, AllCare, CareOregon, Cigna, and Eastern Oregon CCO are just a few of the many plans OHSU accepts. You can find a complete list of accepted plans on the OHSU website.

If you're looking for affordable health insurance in Oregon, the Oregon ACA Marketplace is a great resource. You can find individual and family health insurance plans, as well as Medicaid and Medicare options.

Oregon's reinsurance program helps keep unsubsidized premiums lower, and the state also requires all state-regulated health plans to cover female and male contraception without out-of-pocket costs.

Here are some of the insurance plans that OHSU accepts:

You can enroll in a Marketplace health plan in Oregon through various channels. You can visit OregonHealthCare.gov to learn more about health insurance plans and eligibility.

To enroll online, you'll be redirected to the federal Marketplace website, HealthCare.gov. Oregon's new state-run Marketplace platform is expected to debut in the fall of 2026.

You can also enroll by phone by dialing 1-800-318-2596 (TTY: 1-855-889-4325) to speak with a Marketplace representative. The call center is available 24 hours a day, seven days a week, but it's closed on holidays.

In-person enrollment assistance is available from trained Navigators and assisters. You can find local help in your area by visiting localhelp.HealthCare.gov or OregonHealthCare.gov/GetHelp.

Billing is a crucial part of the enrollment process. You'll need to understand the different types of billing methods, such as monthly or quarterly payments, to manage your finances effectively.

A common billing method is the monthly payment plan, which breaks down the total cost into manageable installments. This plan is often preferred by students who want to spread out the cost of tuition and fees over several months.

You'll also need to know how to read your bill, which typically includes a breakdown of charges, such as tuition, fees, and any applicable late payment fees. A sample bill might include a tuition charge of $1,000, a $100 late payment fee, and a $50 administrative fee.

Understanding the billing cycle is essential to avoid late payment penalties. The billing cycle usually starts on a specific date, such as the 1st of the month, and ends on a specific date, such as the 25th of the month.

Some institutions may offer a payment plan that allows you to make interest-free payments over a set period. This can be a great option for students who need to manage their finances carefully.

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You're protected from surprise billing by federal law, which is a huge relief. Federal law protects you from surprise billing for emergency care from an out-of-network provider or facility.

You're also protected if you receive care from an out-of-network provider at an in-network facility. This means you won't get hit with unexpected medical bills.

Here are the specific situations where you're protected:

In Oregon, open enrollment for ACA Marketplace/exchange individual and family health coverage runs from November 1 through January 15.

You can enroll in an exchange plan or change your coverage outside of the open enrollment period if you meet the criteria for a Special Enrollment Period (SEP).

A SEP typically requires a qualifying life event, such as losing your health insurance, getting married, or having a baby.

However, some SEPs aren't dependent on a specific qualifying life event, like if your income falls at or below 150% of the poverty level and you're eligible for premium tax credits.

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Native Americans can enroll or switch plans year-round.

You can enroll anytime if you fall into one of these special categories.

Here are the ways you can enroll in a Marketplace plan in Oregon:

If you lose Oregon Health Plan (Medicaid or CHIP) coverage between March 31, 2023, and November 30, 2024, there's an extended SEP available for enrollment.

Oregon also received federal approval to not disenroll people from Medicaid if their income wasn't more than 200% of the poverty level while the state waited to implement a Basic Health Program (OHP Bridge).

Oregon's ACA Marketplace is a one-stop shop for finding affordable health insurance coverage. You can find affordable health insurance coverage in Oregon through the Marketplace.

About eight out of 10 Oregon exchange enrollees qualified for premium subsidies in 2024, saving around $524 monthly. People who receive these subsidies pay an average monthly premium of $164 in 2024.

Related reading: Can Health Insurance Companies Deny Coverage

You may be eligible for cost-sharing reductions if your income is no more than 250% of the federal poverty level, and you enroll in a Silver-level plan through the Oregon Marketplace. CSRs help lower your out-of-pocket costs, making coverage more affordable.

Oregon implemented a reinsurance program starting in 2018, using a 1332 waiver that allows the state to capture federal savings generated by the program. This helps to minimize premiums for those who don’t qualify for premium subsidies.

Here are some key facts about affordable health insurance options in Oregon:

If you're not eligible for subsidies, Medicare, or Medicaid, short-term health insurance might be an affordable temporary solution. Short-term health insurance is available in Oregon with terms of up to three months.

If you're a resident of Oregon, you're in luck because there are many resources available to help you navigate the world of health insurance companies.

Moda Health is one of the largest health insurance companies in Oregon, offering a range of plans to suit different needs and budgets.

The Oregon Health Plan is a public health insurance program that provides coverage to low-income individuals and families.

Oregonians can also access the Oregon Health Insurance Marketplace, which allows them to compare and purchase health insurance plans from various companies.

Aetna and Providence Health Plan are two other major health insurance companies operating in Oregon, each with their own network of providers and coverage options.

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Insurance Providers in Oregon offer a range of health insurance plans to individuals and families.

Hokanson Insurance, a Portland-based company, has been providing health care insurance policies for over 30 years. It offers plans that cover mental health, dental visits, and prescription drugs, as well as life insurance and pet injury coverage.

Elliott, Powell, Baden & Baker Insurance is an independent agency that assists in finding health insurance plans for customers in Portland and its nearby areas. It represents a vast network of health insurance companies that provide coverage for various health concerns.

Health Plans in Oregon is an independent insurance agency serving Portland and surrounding communities. It offers individual and family health insurance as well as group plans for employee groups of any size.

Some notable insurance providers in Oregon include Aetna, AllCare, CareOregon, Cigna, and Moda, among others. These providers offer a range of health insurance plans, including original Medicare, also called traditional Medicare.

Here are some of the insurance providers listed:

Choosing the right healthcare provider is a crucial aspect of your insurance plan. You'll want to select an in-network PCP to establish a relationship and work together to achieve your health and wellness goals.

You can check if your providers are in the Affinity Network, which covers members residing in Oregon. This network features various health systems, including Adventist Health Portland, Asante Health System, and OHSU Hospital.

Some insurance plans, like Samaritan Health Plans, INC., offer Medicare and Oregon Medicaid contract plans, including HMO options. Their network includes various healthcare providers and pharmacies.

You can also check if OHSU is in-network with your insurance, as some plans may limit what they'll cover at OHSU.

Here's a list of some of the featured health systems in the Affinity Network:

Milt Marcy Insurance has been serving clients in the Portland metro area for over 35 years.

This independent agency offers a wide range of health insurance products that cover prescription drugs, mental health, and dental expenses.

One of the benefits of using Milt Marcy Insurance is that they also offer insurance policies for vehicles and homes.

Their insurance carriers include London Underwriters and Foremost Insurance Group.

OHSU has the same pricing for all patients, regardless of their insurance plan.

However, the actual cost can vary depending on your insurance coverage. If you have a plan, your insurance will likely cover a significant portion of the bill.

You can call 503-494-8505 to learn more about potential discounts if you don't have health insurance or if your plan doesn't cover enough.

For more insights, see: Tufts Health Plan