Oregon Marketplace Health Insurance Plans
Qualified Plans on Cover Oregon
Beginning October 1, 2013, each state was required by law to have a new online marketplace where residents can buy health insurance. In these marketplaces, most states will offer five tiers of Obamacare Health Exchange Plans: platinum, gold, silver, bronze and catastrophic. Platinum plans will offer the highest level of coverage but tend to cost more in monthly premiums. Bronze plans will cover only a bare minimum of health care expenses but tend to have low premiums. If you are relatively healthy and want to pay less up front, consider a lower-tier plan such as bronze or silver.
You should also look at a Cover Oregon plan if you are lower-income, because the government will give financial help on a sliding scale to pay for premiums, and better benefits if you select a silver-tier plan. If you have not already done so, we can tell you if a Cover Oregon plan makes sense given your income on the State Overview tab, under the heading, "Do I Qualify For a Tax Break?"
Read ACA and Health Insurance: Which "Metal" Tier is Right for You? for more advice on choosing between metal tiers.
Atrio Health Plans. Established in 2004, Atrio is owned by local doctors and providers, according to the company. The company offers Bronze, Silver, Gold, and Innovative plans, called the Pioneer Plans. The Innovative plan model is designed to allow members to only pay for the benefits they purchase. Atrio Health plans are available to residents living in Douglas, Klamath, Marion and Polk counties.
BridgeSpan Health Company. BridgeSpan is affiliated with Regence BlueCross BlueShield of Oregon through its parent company, Cambia Health Solutions, according to the Oregon State Public Interest Research Group Foundation. BridgeSpan offers statewide health coverage in Oregon.
Health Net Health Plan of Oregon. The company is a subsidiary of Health Net Inc., a public, health services organization with over 5.4 million members nationwide. Health Net of Oregon offers residents a new network HMO product called CommunityCare, which gives them access to a network of local providers. Health Net offers health coverage in Clackamas, Multnomah and Washington counties.
Health Republic Insurance Co. With funding from the federal government, this nonprofit, member-governed, co-op is affiliated with Freelancers Union, a Brooklyn-based union established in 2003. Though Freelancers Union only offers health coverage to its freelancer members, the co-op sells health plans under the name Health Republic to anyone eligible to purchase insurance through the Oregon exchange. The Union received $167 million to establish the Oregon and New Jersey co-ops, according to The Post-Standard. In Oregon, Health Republic exchange plans are available statewide.
Kaiser Foundation Health Plan of the Northwest. Established in 1945, Kaiser is the largest nonprofit health insurance plan in the U.S. with over 8.7 million members. Its network includes over 13,500 doctors and 35 medical centers. Kaiser offers health coverage to residents living in Northwest Oregon (Portland and Salem), according to eHealth. Kaiser serves the following counties: Benton, Clackamas, Columbia, Hood River, Linn, Marion, Multnomah, Polk, Washington and Yamhill.
LifeWise Health Plan of Oregon. Established in 1986, the private, for-profit company has over 1.6 million members in Washington, Oregon and Alaska. Its statewide network includes over 9,000 doctors, hospitals and providers. LifeWise exchange plans are available statewide.
Moda Health Plan. Established in 1955 and formerly known as ODS Health, Moda has over 1 million members. Moda exchange plans are available statewide.
Oregon’s Health Co-Op. This new, nonprofit, member-governed, co-op serves the following eighteen counties: Benton, Clackamas, Clatsop, Columbia, Crook, Deschutes, Jackson, Jefferson, Josephine, Lane, Lincoln, Linn, Marion, Multnomah, Polk, Tillamook, Washington and Yamhill. The other eighteen counties outside of the network are covered by the First Choice Health provider network. Its network includes over 11,000 providers and the following hospitals are in-network in Portland: Adventist Health, Legacy Health, Oregon Health & Science University, Providence Health & Services and Tuality Healthcare. In addition, OHC includes 730 pharmacies in Oregon and over 68,000 nationwide. OHC also has two out-of-area networks: First Choice Health in the Pacific Northwest (Oregon, Washington, Alaska, Idaho and Montana) and the national First Health Network. Members may use ePocrates, a free, web and mobile search tool to look up drug formulary status.
PacificSource Health Plans. Established in 1933, this independent, nonprofit has over 46,300 doctors and hospitals in the Northwest. PacificSource exchange plans are available in every county, except Umatilla.
Providence Health Plans. Providence Health Plan is a part of Providence Health & Services, an integrated health delivery system with over 375,000 members. The insurer serves the following counties: Benton, Clackamas, Clatsop, Columbia, Crook, Deschutes, Douglas, Gilliam, Grant, Harney, Hood River, Jackson, Jefferson, Josephine, Klamath, Lane, Linn, Marion, Multnomah, Polk, Sherman, Tillamook, Wasco, Washington, Wheeler and Yamhill.
Trillium Community Health Plan (Oregon Health Plan). Trillium is a private, for-profit, coordinated care organization (CCO) offering health care options for low-income residents in Lane County, Oregon. Trillium has approximately 57,000 members.
Last updated by Heilbrunn, Evi | December 5, 2013