The annual open enrollment period for health coverage is currently open. It is the only time when anyone who is not offered coverage from a job or a public program like the Oregon Health Plan or Medicare can enroll in health coverage through the Oregon Health Insurance Marketplace, often with financial help. All Oregonians who do not currently have health coverage available are encouraged to apply.
Eligibility rules have changed this year, making health coverage more affordable for thousands of Oregonians. Previously, people offered health coverage through a spouse or parent’s employer could not access financial help if the least expensive plan offered to only the employee was considered affordable. The Affordable Employer Coverage Tool will help determine eligibility based on these new rules.
Nearly 80 percent of Oregonians who applied for financial help qualified in 2022. The average amount of financial help received was $483 per month.
Oregonians have choices when it comes to choosing their health plan. All Oregonians have at least four insurance companies and 26 plans to choose from.
Free local help is available throughout the state. Locate licensed insurance agents and trained community groups at OregonHealthCare.gov/GetHelp.
There is also OregonHealthCare.gov, which offers a quick and easy-to-use window-shopping tool where users can preview what plans and savings are available to them. The tool also allows users to see which plans cover their prescription drugs and are networked with their preferred doctors or hospitals. A new tool available on the website can help you figure out if job-based coverage is considered affordable.
For those who have the option of job-based coverage, this time of year can be used to review how they are using health services and decide if they should stay with that plan or switch to another. It’s also a good time to assess one’s overall care costs to ensure that the plan chosen will work best for the coming year’s budget. Jeff Underwood, UnitedHealthcare, offers seven tips for those who are assessing job-based coverage.
Consider all your options.
Take time to understand and compare the benefits, services and costs of each plan so you can figure out which will work best for you. UnitedHealthcare offers an insurance lingo video, bit.ly/UHCInsuranceLingo, which explains common health insurance words like premiums, deductibles, copays, coinsurance and out-of-pocket maximums.
Check your prescription benefits.
Knowing how to get the most out of your prescription benefits may help you manage costs. Check into discounts and lower-cost alternatives, including generics, which may be available. You may also be able to fill your prescriptions at a participating network pharmacy or with home delivery by mail—two more money-saving options.
Check for mental health coverage.
In addition to in-person mental health care, you may have access to a large virtual network of therapists and psychiatrists. Some health insurers also offer advocacy services to help you find the right type of behavioral health care.
Don’t forget about specialty benefits.
Additional benefits, such as dental, vision, hearing or critical illness insurance, are often available and may contribute to overall well-being.
Look into wellness programs.
Many health plans offer incentives that reward you for taking healthier actions, such as completing a health survey, exercising or avoiding nicotine.
Anticipate next year’s health expenses.
If you’re expecting a significant health event in the next year, such as surgery or the birth of a child, compare the differences in plan designs for that specific situation, including any out-of-pocket costs.
Consider a plan with virtual care services.
If you’re busy or just prefer connecting with a doctor from the convenience of your home, consider choosing a plan that includes 24/7 virtual care. You may have access to virtual wellness visits, urgent care and chronic condition management.
Sign up through the Oregon Health Insurance Marketplace through Thursday, December 15. Deadlines for making changes to job-based coverage vary so make sure to check with your employer. Either way, don’t miss this opportunity to make sure your 2023 coverage meets your needs.