PORTLAND, Ore. (AP) — The second open enrollment period for buying health insurance under the federal Affordable Care Act starts on Saturday. For the first time, Oregonians will be using the federal insurance exchange portal to shop for coverage, instead of the state's own failed Cover Oregon website.
Oregon's health insurance marketplace will be in a unique position: because of the switch to the federal portal, all Oregonians who previously enrolled in private health insurance will have to re-enroll via HealthCare.Gov to keep their coverage. That's in addition to uninsured Oregonians who will apply for the first time.
Oregon residents who already are covered cannot automatically roll over to the same or similar plan as the one they had last year — as people in other states who relied on the federal exchange last year can elect to do.
Altogether some 300,000 Oregonians could be enrolling in via HealthCare.Gov starting this weekend — 105,000 who enrolled through the state exchange last year and about 202,000 who remain uninsured according to a recent study.
That means there likely will be a lot more scrutiny of the various plans offered by 15 insurance carriers in Oregon, officials said.
Those who want coverage come January must enroll by Dec. 15.
Oregonians who already have insurance can switch carriers or plans, or stay with the same plan, throughout open enrollment, which runs Nov. 15 to Feb. 15. Under the federal health care overhaul, insurance companies can no longer deny coverage to people with pre-existing conditions.
Oregon abandoned its troubled exchange in April. Residents' individual data isn't being transferred to HealthCare.gov for reasons of privacy and security, state officials said.
Two other states, Nevada and Massachusetts, also will mandate already-insured people to re-enroll after similar problems.
In Oregon, hundreds of thousands of people shopping for health plans spells more competition for insurance carriers — and possibly, better deals for customers.
The state already has one of the most competitive health insurance markets in the country, Oregon Insurance Commissioner Laura Cali has said. And new health insurance rates, announced this summer by state regulators, show a much tighter ranger of premiums.
Moda, the company that captured nearly two-thirds of the market share for private health insurance because of its low prices in 2014, will see a 10.6 percent rate hike on average in 2015, according to the Oregon Insurance Division. That means Moda will now be in the middle of the pack in terms of premium prices, so the more than 70,000 Moda enrollees might want to shop around.
Some other carriers will see rate decreases in 2015. Plans from Providence Health and Trillium Community Health will both drop by about 14 percent on average, for example.
Here are a few tips on shopping for health insurance in Oregon:
.Do your research: When comparing plans, don't just look at the premiums, but also at deductibles and co-pays, and at what is covered by the plan.
.What's in the plan: Different plans have different hospitals, doctors, and specialists in their networks and those networks can change year to year. To make sure a doctor is included in a plan's network, call the insurance company and the doctor's office. Also, make sure the plan you want covers the prescription medications you need.
.Keeping the same plan: Your insurance company wrote to tell you your current plan will be offered in 2015 and you want to keep it? You still must re-enroll via HealthCare.Gov to continue your coverage.
.Do I qualify for a tax break? Americans making less than 400 percent of the federal poverty level are eligible for a subsidy, also called advanced premium tax credits. Those who don't believe they qualify for a subsidy can buy coverage outside the exchange, directly through carriers.
.Get help: find an insurance agent or a community partner to help you enroll or re-enroll. There are over 650 agents trained on how to use the insurance exchange and working with them is free. You can find one at www.CoverOregon.com or by calling the Cover Oregon call center at 1-855-268-3767. For help with enrollment, you can call the federal call center at 1-800-318-2596.