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Peg Honyak
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GET FINANCIAL HELP TO PAY FOR COVERAGE

When you enroll through Cover Oregon, you may qualify for financial help to pay for your coverage. If you earn less then the maximum yearly income shown below, you might qualify for financial help.

Family SizeMaximum Yearly Income
1$45,960
2$62,040
3$78,120
4$94,200
5$110,280
6$126,360
  • Financial help comes in the form of a tax credit to help pay for premiums. If you qualify, you can choose to receive it monthly or annually.
  • You could also qualify for help paying "out-ofpocket" costs, such as co-pays and deductibles.
  • To find out how much financial help you could receive, click on the calculator below.
Key
Dates
October 2013 » Begin shopping for health coverage through Cover Oregon.
January 2014 » Coverage begins for plans purchased through Cover Oregon.

I am an individual

Starting October 1, 2013 we will be able to assist you in applying for coverage through Cover Oregon (Oregon's insurance "exchange"). You will have the opportunity to choose the insurance company[1] and benefit plan that best fits the needs of you and your family.

If you purchase a private insurance plan through Cover Oregon, you may qualify for tax credits to help cut the cost of your insurance.

These credits reduce the amount you pay for the insurance each month, or reduce the tax you owe to the Internal Revenue Service (IRS) at the end of the year. If you do not owe any taxes, you can get a bigger IRS refund.

 

  1. Do I qualify for tax credits?

    • If your employer does not offer health insurance;
    • If you do not receive a Medicare benefit; and
    • If your family does not make more than the yearly income (view chart above).

    Note: tax credits are only available to individuals who purchase their health insurance through Cover Oregon (the exchange).

  2. How much assistance will I receive?

    The amount of the tax credit you receive depends on your family income and your family size. Click the calculator to go to Cover Oregon to estimate how much you may qualify for.

  3. How do I take the tax credit?

    Take the tax credit now:

    • Choose to take the maximum tax credit each month (or take a part of it) to pay lower premiums each month in 2014
    • You will receive a statement from Cover Oregon showing how much tax credit you received in 2014
    • File your 2014 taxes, including information about the tax credit you have already taken

    Take the tax credit later:

    • Choose the minimum monthly tax credit ($0) - and pay the full premium each month in 2014
    • You will receive a statement from Cover Oregon showing how much tax credit you received in 2014 ($0)
    • File your 2014 taxes and subtract your tax credit from the tax you owe (or get a bigger refund if you owe nothing)

    Do a combination of the two (take some of the allowable tax credit) and settle up when you file your 2014 taxes!

    Other Ways to Get Financial Help

  4. Cost-Sharing Assistance

    If you buy a plan through Cover Oregon, you may also qualify for help paying for your portion of the cost of health care services. For example, you have a $100 medical bill, your plan might pay $80 and you would be responsible for the remaining $20. If you qualify for cost sharing you may get help paying your $20. Simply put, if you qualify for cost-sharing assistance, your plan will have lower deductibles, copayments and coinsurance.

    • Who Qualifies for this Assistance? You might qualify if you are an individual earning up to $29,275 a year or a family of six earning up to $78,975. You might qualify for both tax credits to help you afford your premiums (bullet numbers 1, 2 & 3) and cost sharing to pay your portion of the medical expenses.
  5. Oregon Health Plan and Healthy Kids

    The Oregon Health Plan and Healthy Kids are Oregon's Medicaid programs. They are opening to more adults and children from households that earned too much to qualify for Medicaid in the past. You may be eligible for this no-cost coverage even if you have never qualified for a public program before.

    • Who Is Eligible: Individuals earning up to $15,856 a year or all members of a family of six earning up to $43,594 might qualify. Families who earn more - up to $94,770 for a family of six - might be able to enroll their children in the Healthy Kids program, available through the Oregon Health Plan.
    • Coordinated Care: The Oregon Health Plan offers coverage that includes preventive care, primary care doctors, checkups, mental health treatment, some dental and vision benefits, and management of chronic conditions.
    • Easy To Apply: Use the online calculator at www.CoverOregon.com to see if you might qualify. You can also call toll-free to (855)268-3767 to talk to a trained specialist. You can sign up online at www.CoverOregon.com this fall.

[1] Insurance Carriers Participating in the Individual component of Cover Oregon:

  • Atrio Health Plans
  • Bridgespan (Regence BlueCross BlueShield of Oregon)
  • HealthNet
  • Health Republic
  • Kaiser Permanente
  • LifeWise
  • Moda Health (formerly ODS Companies)
  • Oregon Health Co-Op
  • PacificSource Health Plans
  • Providence Health Plans
  • Trillium
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