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Living with Diabetes
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Oregon
The following information details health insurance and assistance programs available to uninsured people in Oregon.
Oregon Insurance Division - (888) 877-4894
In Oregon, state law allows health insurance companies to turn people down for individual health insurance coverage based on the status of their health. In most cases, diabetes is considered an “uninsurable” condition. Even though you can be turned down for an individual policy in Oregon, you can never be turned down for health insurance that is offered through an employer.
If you are having a problem with your state-regulated health plan and you are unable to resolve it with the plan directly, file a complaint with the Insurance Division. They may be able to provide you with assistance in reaching a conclusion.
Oregon Medicaid (Oregon Health Plan) - (800) 359-9517
Medicaid is available to anyone who meets income and eligibility criteria. Even if your income meets the criteria, you must fall into one of the eligibility categories in order to qualify. Contact your state Medicaid program for more information.
Oregon Medical Insurance Pool (OMIP) - (800) 848-7281
Oregon Medical Insurance Pool is the Oregon state high-risk pool. This program allows individual health insurance policies to be sold to people who might otherwise be considered “uninsurable” because of a chronic illness. Premiums may be high, and a pre-existing condition period may apply. Contact OMIP for more information.
Oregon Children’s Health Insurance Program (CHIP) - State Children’s Health Insurance Program - (800) 359-9517
The Oregon Children’s Health Insurance Program is administered through the Orgeon Health Plan.
Oregon Family Health Insurance Assistance Program
FHIAP provides assistance with the health insurance premiums of individuals who have coverage through their employer and meet eligibility guidelines. Employers must be contributing some portion of the employee’s premium to qualify for this subsidy. There is currently a 1 1/2 to 2 year waiting list for the FHIAP program.
For those without job-based coverage, FHIAP allows individuals to gain coverage through seven FHIAP-certified insurers, including the Oregon Medical Insurance Pool, and helps to pay a portion of the monthly premium.
Pre-Existing Condition Insurance Plan (PCIP)
Through the Affordable Care Act, uninsured people with diabetes who have been continually uninsured for six months or more will be able to access insurance through a new program called the Pre-Existing Condition Insurance Plan (PCIP). PCIP, which is administered by either your state or the U.S. Department of Health and Human Services, will be available until the provisions banning discrimination based on pre-existing conditions are fully implemented in 2014.
PCIP will be available in every state, but the program may vary depending on the state. Currently, many states run programs, often called “high risk pools,” to offer insurance for those with pre-existing conditions. To build on what states are already doing, states can either run a new program with resources from the Affordable Care Act or rely on the U.S. Department of Health and Human Services to provide coverage. Please check out the State Plans page to learn more about how PCIP works in your state. http://www.pcip.gov/StatePlans.html
Local Community Health Clinics
If you or your loved one is unable to see a physician due to the cost of care, there may be a local community health clinic in your area. These clinics generally are free to patients or require a very small fee. Find a clinic in your area.
