Monday, November 22, 2010

Insurance Resources

If you lost income or employment, you may now qualify for OHP, go here:

Oregon Health Plan
Low-income Oregonians may be eligible for one of these three Oregon Health Plan (Medicaid) programs administered by DHS.

The OHP Plus Program is for people who are aged, blind, disabled, under age 19, pregnant or receiving Temporary Assistance for Needy Families (TANF) benefits. OHP Plus includes the no-cost public assistance option of the Healthy Kids Program, the Children’s Health Insurance Program (CHIP).  CHIP is for children and adolescents younger than 19 living in households with incomes below 200 percent of the federal poverty level.

The OHP Standard program provides free or low-cost health care coverage to Oregon residents who have limited income, are ages 19 and older, and do not qualify for traditional Medicaid. DHS will soon have a limited number of openings for Oregon residents who need health care coverage. Add your name to the OHP Standard reservation list to become a potential applicant.

Households may be eligible for other assistance through the Office of Private Health Partnerships (OPHP), such as the Family Health Insurance Assistance Program (FHIAP) or the private insurance option of the Healthy Kids Program, KidsConnect (see below).

How to apply
To apply for medical assistance under Medicaid (OHP Plus) or any of the Healthy Kids program options:
Use the OHP application packet; or
Fill out and submit the online OHP application.



If you or your spouse is working, but insurance through your work is too expensive for your dependents, here are two options:

FIHAP: Family Health Insurance Assistance Program
http://fhiap.oregon.gov/  Request an Application
FHIAP pays from 50 percent to 95 percent of the premium for Oregonians who are uninsured and meet income and other guidelines. Individuals and families use FHIAP subsidies to pay for insurance at work or to buy individual health plans if insurance is not available through an employer. With FHIAP, Oregonians often cover their entire families for just a few dollars a month instead of hundreds of dollars!

Healthy Kids
http://www.oregonhealthykids.gov/  Apply Online or call 1-877-314-5678

Families making between 200 and 300 percent of the federal poverty level, roughly $44,000 to $66,000 a year for a family of four, pay a sliding fee for insurance through Healthy KidsConnect. Monthly premiums range from $22 to $83 for families in this category, depending on their income and how many children are covered. Families making more than 300 percent of the federal poverty level can buy coverage for the full cost of $214 a month per child.

Healthy KidsConnect Insurance Carriers:
Clear One (a PacificSource company) COIHS 877-330-8688
PacificSource 888-684-5220
These are the insurance plans covered if you apply through DHS and qualify for Healthy Kids

Access to Coverage for Children: Millions of young adults under 26 are now eligible to stay on their parents' plan, and children under 19 can no longer be denied coverage due to a pre-existing condition (the same will apply to adults beginning in 2014).

Pre-Existing Condition Insurance Plan (PCIP): For individuals who have been without health insurance coverage for six months due to a pre-existing condition, each State has a PCIP which allows these uninsured individuals to purchase affordable health coverage.

Pre-Existing Condition Insurance Plan: Oregon and Washington

Ban on Lifetime Limits and Recissions: Health plans are now prohibited from imposing a lifetime dollar limit on covered benefits.  Health plans cannot revoke coverage based solely on a mistake on an application, a method some insurers have used to disenroll sick, high-cost enrollees.

Choice of Your Doctor: Patients in many health plans can choose the primary care doctor they want from their plans provider network.  They may also see an OB-GYN without a referral.  In addition, most health plans may not require prior approval for emergency services or charge more for emergency services obtained out of network.

Free Preventative Services:  All new health plans must cover all recommended preventative services without cost sharing.  Patients in these plans have access, at no cost, to preventative services such as blood pressure, diabetes and cholesterol tests, cancer screenings, and vacinnations.

Jane Rekas

LCSW, CHt

Jane Rekas is a Licsensed Clinical Social Worker at Turtle Dove Counseling and Hood River DBT, Certified Hypnotist at Hood River Hypnosis, Reiki Master at Rekas Reiki, Astrologer at Astrological Counsel, and Seasonal Color Analyst at Expressing Your Truth.

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