How to Choose an Individual Health Insurance in Oregon


Health insurance is one of the most significant investments which you can make over the year. It has never been easy to compare health benefits and find quotes and details about individual health insurance in Oregon. 

Even if you and your loved ones are in good health, the program you chose will affect your financial future significantly. If you are sick and don’t have the right health insurance, you may have to pay out – of-pocket expenses in hundreds, if not thousands of dollars.

Step 1: Consider Your Needs and Budget 

You need to ask yourself a few questions before you pick a health plan to help narrow down your search.

Who Needs Coverage?

Are you just looking for coverage on your own or do you still have dependents who need coverage? After the Affordable Care Act (ACA) came into force in 2010 young adults 26 and under are eligible for coverage on the insurance plan for your family. Also if your kids don’t stay with you, you can report them as dependent and they’re going to be protected by your plan.

Are You Required to Buy Health Insurance?

Until 2019 you were paid a fee called an Individual Shared Responsibility Payment if you could afford health insurance and did not want to purchase it. You are no longer immune to these penalties but not getting health insurance has its own costs.

What’s Your Budget?

Costs are a major concern when looking for health insurance. When you are compensated by your job, you do not need to pay a great deal on health benefits. When insured, you are likely to be paying other out – of-pocket expenses like a premium or copay.

A deductible is a fixed amount you are expected to pay before the insurance provider covers the claim. A copay is a fixed expense that you pay up front every time you visit either a hospital, your doctor, specialist or other service.

What Do You Currently Need in a Health Care Plan?

Some health care plans offer all-in – one packages that provide prescription coverage while others provide tailor-made plans that you can select based on your individual needs.

How much do you go to the doctor a year? Have any pre-existing conditions? Should you take the drugs many times? Want vision or the benefits of dental insurance? Most basic health insurance policies don’t provide comprehensive coverage for hearing, vision or dental. The answers to those questions will help you find the best path for health care.

Step 2: See if You Qualify for Government-Funded or Employer-Backed Health Care

Through doing a bit of online research you will easily find out whether you are eligible for a government-funded health plan.

Government-Funded Health Insurance

You may be eligible for a free or low-cost health plan, depending on other factors such as income, family size and age. Medicaid qualifications are based on the number and income of dependents and various other factors.

If you are 65 years of age or older you can apply for Medicare. In certain situations, if you’re under 65 and are impaired, you should apply. Even if open enrollment is over (Nov. 1 through Dec. 18), you will still be eligible to sign up based on relevant life events such as marriage or divorce, childbirth or loss of an employer-paid package.

Employer-Backed Health Insurance

Contact the human resources department of your organization for health benefits enquiries. If you apply, there could be more than one program your company may give. You can research the best option for you by reading the paperwork provided and visiting the plan’s website.

Some employers pay 100 percent of the health benefit benefits for workers, but most require a fixed amount deducted from your paycheck. Familiarize yourself with the fine print on a health insurance package for your employer and determine which one is better for you if there is more than one choice.

Step 3: Find a Plan Through Private Marketplace

You should look at the private insurance marketplace if your company doesn’t provide health care coverage.

Consider Plan Cost

The cost of planning varies depending on what’s included. Many private insurance firms give a number of types of policies and rates, and some similarities exist. When you have an ACA-compliant health plan, you will be saving money in the form of tax credits.

Basic Individual Health Insurance in Oregon offers lower premium rates but can bill for facilities such as medical testing, office visit copays and deductibles and a la carte features. Do your homework to see what’s covered and what’s not, before you sign up for any health insurance program.

Pick Your Plan Type

Many forms of health insurance policies are available but these are the most common types of policies:

    • Health Maintenance Organization (HMO)

HMO expects collaborating with different physicians. In order to see a professional they typically need a referral. Usually, unless it’s an emergency, you can not go out of network. HMO policies support services that facilitate good health and wellbeing. If you’re open to the concept of selecting a doctor within a defined network, an HMO program may be right for you.

    • Preferred Provider Organization (PPO)

If you have a PPO plan, you can pay less if you select a doctor or specialist from inside the network. PPOs allow you to see providers without a referral, but pay more. If you want to keep your current doctor, a PPO plan may be your best bet.

Getting The Coverage You Need

It may feel like a daunting job to select the right health insurance provider, but it doesn’t have to be. Equipped with knowledge and analysis online, you will be able to compare plans and suppliers and select the right one for you.

Leave a Comment

Your email address will not be published. Required fields are marked *

Call Now Button Scroll to Top