Oregon Medical Insurance Pool - OMIP There For You
Am I Eligible?
You may be eligible for coverage if you are an Oregon resident and you meet any of the following medical or portability requirements.
Medical requirements
Within the last six months:
I have received a declination of individual health insurance coverage due to health reasons.
I have one or more of the medical conditions listed in Section C of the OMIP application.
I was offered individual health insurance coverage that contained a restrictive waiver that substantially reduced the coverage offered by excluding coverage for a specific medical condition.
I was offered individual health insurance coverage but was limited by the choice of plans the carrier was willing to offer me due to a specific medical condition.
Portability requirements
To be eligible under Portability criteria, you must apply to OMIP within 63 days of losing COBRA, losing Portability coverage from another insurer in Oregon, or losing group health benefits coverage because you moved from another state to Oregon. Coverage must be continuous from the termination of your prior coverage and premium is due from the effective date of the OMIP coverage.
I have exhausted my COBRA benefits.
No COBRA or Portability coverage available through my previous plan. Previous plan did no qualify for COBRA or Portability
I am eligible for Oregon Portability coverage but moved from the prior insurance carrier's service area.
I was covered by Portability coverage, but my insurance carrier no longer serves the area where I live.
I am moving to Oregon and have been continuously covered by health insurance for 18 or more months, with no single gap in coverage greater than 63 days and the last coverage was group coverage.
How do I apply?
Application to the Oregon Medical Insurance Pool is simple. Just call our office at 800-821-9876 to request an application or you can download an application from this website. You can also download the member handbook, rates and plan comparison here. Of course we are here to help when needed. Just give us a call.
What Plans are available?
There are Four Plans to choose from. All OMIP Plans are preferred provider plans (PPO) so you will be required to use providers withing the OMIP network in order to received the highest level of benefit. You have a choice of deductibles, $500, $750, $1000 and $1500. See the OMIP Plan Summary and Rate Sheet.
There are some cases where benefits will not be available for the first six months for expenses resulting from a pre-existing condition. "A Pre-existing condition is any medical condition for which you sought professional medical advice, diagnosis, care, or treatment was recommended or received or a treatment plan was prescribed in the six months prior to your OMIP effective date." Pregnancy is considered a pre-existing condition for determining whether benefits are payable during the first six months of coverage. See the Member Handbook.
Which Plan is right for me?
You may want to consider the following when choosing a plan:
How much can you afford to pay each month? See the premium rates and instructions (.pdf) to find out how much the plans cost.
What prescription drugs are you taking? Are they brand or generic?
Do you have family members who need coverage? If so, they may be eligible for lower cost coverage other than the Oregon Medical Insurance Pool.
How much out-of-pocket expense can you afford. The higher the deductible the greater the co-insurance amount. See the OMIP Plan Summary.
While this information is useful in choosing a plan you should read the Member Handbook for additonal information. Or you can have one of our licensed and trained agents assist you. There is no additional cost to you for this service.
You can also contact the Oregon Medical Insurance Pool directly at:
Oregon Medical Insurance Pool
c/o Regence BlueCross BlueShield of Oregon MS 5K
P.O. Box 1271
Portland, OR 97207-1271
800-848-7280
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