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Oregon Health Insurance Information

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Updated June 29, 2012

Oregon Insurance Division

The Oregon Insurance Division is responsible for regulating all types of insurance sold in the state of Oregon, including health insurance policies.

If you are looking for health insurance coverage, the Insurance Division's website has a list of insurance companies licensed to sell individual policies in Oregon.

If you are having trouble resolving a claims dispute with your insurer, you can file a complaint with the Insurance Division. Find out more about the consumer complaint process, then download a complaint form off the website when you are ready.

Oregon Insurance Division
Street Address: 350 Winter St NE Room 440, Salem, OR 97301-3883
Mailing Address: P.O. Box 14480, Salem, OR 97309-0405
Phone: 503-947-7980
Email: dcbs.insmail@state.or.us

U.S. Department of Labor

If you get your insurance through your job, your plan is also regulated by the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). The EBSA makes and enforces the rules that your employer must follow when offering health insurance coverage to employees. For example, your employer cannot single out an individual employee to exclude her from the plan because she (or one of her dependents) has a costly illness. Also, if there are 20 or more employees at your job, you should be offered COBRA continuation coverage when you leave your job. The EBSA works to make sure that all of this happens and your rights are protected.

If you have concerns about your employer's practices in administering your job-based health coverage, contact your regional EBSA office.

U.S. Department of Labor Employee Benefits Security Administration
Seattle District Office
1111 Third Avenue, Suite 860
Seattle, WA 98101-3212
Duane Peterson - Supervisor
Phone: 206-553-4244 Fax: 206-553-0913

Buying Individual Policies in Oregon

As a general rule, insurers in Oregon are allowed to reject your application for coverage based on your health status. However, you may qualify for coverage as a "HIPAA-eligible" individual if you:
  • had at least 18 months of continuous creditable coverage, the last day of which was under a group plan
    AND
  • you have exhausted all COBRA continuation coverage available to you

People who are HIPAA-eligible are guaranteed the right to buy an individual policy from a private insurer. You can also buy insurance through the Oregon Medical Insurance Pool (described below). If you are not sure whether you are a HIPAA-eligible individual, your insurance agent or the Oregon Insurance Division can help you find out.

Oregon Medical Insurance Pool (OMIP)

The Oregon Medical Insurance Pool offers coverage to individuals who are unable to purchase an individual health insurance policy because they have pre-existing health conditions. It also covers "HIPAA-eligible" individuals.

Oregon Medical Insurance Pool
C/O Regence BlueCross BlueShield of Oregon MS 5K
P.O. Box 1271
Portland, OR 97207-1271
Phone: 503-225-6620 or 800-848-7280

Oregon Health Plan - The State Children's Health Insurance Program

The Oregon Health Plan is Oregon's State Children's Health Insurance Program. It provides health insurance coverage for children whose family income meets certain income guidelines. The Oregon Helps website can tell you whether you and your family might be eligible.

Oregon Health Plan
Division of Medical Assistance Programs
Administrative Office
500 Summer Street NE
Salem, OR 97301-1079
Phone: 503-945-5772 or 800-527-5772

Oregon Senior Health Insurance Benefits Assistance Program (SHIBA)

SHIBA provides free one-on-one counseling for Medicare beneficiaries with questions about any aspect of Medicare, including the Medicare Part D prescription drug benefit, or Medigap coverage.

SHIBA
Phone: 800-722-4134

Oregon Medicaid

Medicaid is a government program designed to help the poor and indigent obtain health care services. Pregnant women and children under age 19 who meet certain income requirements may be eligible for Medicaid coverage, along with aged, blind, and disabled individuals. The Oregon Helps website can tell you whether you and your family might be eligible.

Oregon Health Plan
Division of Medical Assistance Programs
Administrative Office
500 Summer Street NE
Salem, OR 97301-1079
Phone: 503-945-5772 or 800-527-5772

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