Accessing Affordable Healthcare in Oregon
Getting affordable health care is essential for everyone. However, finding the right program can be confusing. In Oregon, there are several options to help individuals and families get the health care they need at a cost they can manage.
This article explains the programs available in Oregon and provides links to websites for more information.
Affordable health insurance options
Oregon Health Plan (OHP)
The Oregon Health Plan is Oregon's Medicaid program. It offers free or low-cost health insurance for low-income individuals and families, including children, pregnant women, immigrants, seniors, and people with disabilities.
OHP covers doctor visits, hospital stays, mental health care, prescription drugs, dental care, and long-term care.
Learn more about OHP and apply on the Oregon Health Authority website. If you are a senior or have disabilities, contact your local Aging and People with Disabilities office for help applying.
Health Insurance Marketplace
If you don’t qualify for the Oregon Health Plan, you can find affordable health insurance through the federal Health Insurance Marketplace. The Marketplace lets you compare different health plans to find one that meets your needs.
Depending on your income, you might be eligible for financial help to lower your insurance costs. Some people can get financial assistance that covers almost all the premiums and copays of a private health insurance plan.
You can find more information and apply at HealthCare.gov.
Medicare for seniors and people with disabilities
Medicare is a federal health insurance program for people 65 and older or those with long-term disabilities. While Medicare is not free, you can get help with Medicare costs through programs like Medicare Savings Programs or Medicare Advantage. Some people qualify for Medicare and Oregon Health Plan at the same time.
Here are some places you can visit to learn more about Medicare:
- Shiba.Oregon.gov: Information and assistance for Seniors in Oregon about Medicare health insurance benefits.
- Medicare.gov: The official government website for Medicare. You can learn about Medicare and apply for benefits through this site.
Employer-provided health insurance
Many people in Oregon get health insurance through their jobs. Employers with 50 or more employees must provide health insurance for their workers. These plans must cover pre-existing conditions and essential health benefits, such as preventive care and mental health services.
Employer-provided insurance usually means you share the costs. Employers often pay part of the health insurance premiums, which helps lower employee costs.
If you're using insurance from your employer, read your Summary Plan Description (SPD) to understand your rights and benefits. Employers must provide this information.
For more details, visit the U.S. Department of Labor's "Health Plans and Benefits" page.
Affordable health centers
Free and low-cost clinics
Oregon has many free and low-cost health clinics that offer essential services to individuals and families without insurance or underinsured. Many clinics use a sliding fee scale, which means the cost is based on your income.
These clinics provide primary care, preventive services, dental care, and mental health support.
Find a free or low-cost clinic using the National Association of Free & Charitable Clinics website.
Federally Qualified Health Centers (FQHCs)
FQHCs are community health centers that get federal funding to offer affordable health care. They are available to everyone, including uninsured people.
FQHCs provide medical, dental, and mental health care services. They often have sliding fee scales to make care affordable for everyone.
You can find an FQHC near you on the Oregon Primary Care Association website.
Prescription drug assistance
The ArrayRx program (formerly the Oregon Prescription Drug Program) offers discounts on prescription medications for Oregon residents. This program is free to join and open to everyone, regardless of income or insurance status. It can help lower the cost of many commonly prescribed medications.
You can learn more about the ArrayRx program on the Oregon Health Authority website.
Help for the uninsured
Emergency care
Oregon hospitals must provide emergency care, even if you cannot pay. If you need urgent medical help, you can go to your local emergency room, and you won't be turned away for not having insurance.
Charity care or financial assistance
Many hospitals also have financial assistance or charity care programs to lower or wipe out medical bills for low-income patients. You can ask the hospital's billing department about their charity care policies. To learn more about Charity Care, visit DollarFor.org.
Frequently Asked Questions
Eligibility is based on income, household size, and other factors like age or pregnancy. You can check your eligibility for the Oregon Health Plan using the government's checkbookhealth.org website.
Yes! You can apply for the Oregon Health Plan or health insurance through the Marketplace if you're unemployed. If you don't qualify for the Oregon Health Plan, you might still get financial help to cover your insurance costs.
You can still apply for the Oregon Health Plan even if your employer provides health insurance. You might qualify if your employer's insurance is too expensive or doesn't cover enough services. Your eligibility depends on your household income and some other factors.
If you can't afford health insurance payments, you can look for insurance plans on the Health Insurance Marketplace. You can see if you qualify for tax credits or other help to lower your costs there. You can also check if you are eligible for the Oregon Health Plan, which provides free health insurance for low-income people.
Yes, in Oregon, there are options for undocumented immigrants. The Healthier Oregon program (previously called "Cover All People") allows anyone, regardless of their immigration status, to get full Oregon Health Plan benefits if they meet income requirements. This includes medical, dental, mental health care, prescriptions, and more.
You can learn more about Healthier Oregon on the Oregon Health Authority website.
Emergency care is also available for everyone regardless of immigration status.
Many hospitals provide financial assistance or "charity care" for people who need it. You can also talk to them about payment plans or apply for help through state programs. Visit the non-profit website, DollarFor.org, to learn more about charity care.
To find a free or low-cost clinic, you can use the National Association of Free & Charitable Care website, which has a directory of clinics offering affordable care based on income.
Seniors can qualify for Medicare, Medicare Advantage Plans, or programs to help lower costs, like Medicaid and Medicare Savings Programs. Visit the Senior Health Insurance Benefits Assistance (SHIBA) website to learn more.
Seniors may also qualify for the Oregon Health Plan, which provides free insurance coverage to low-income Oregonians. For help applying, contact your local Aging and People with Disabilities office.