See your Oregon health insurance coverage options.

You can buy a health plan through the Oregon exchange if:⁶

• You reside in Oregon.
• You are a U.S. citizen or national.
• You are not incarcerated.
• You are not already enrolled in Medicare.

To qualify for financial assistance (premium subsidies and cost-sharing reductions), you must meet additional requirements: 

• Your eligibility for premium subsidies depends on your income and how it compares with the cost of the second-lowest-cost Silver plan in your area. The cost of that Silver plan varies based on your age and location. 
• You must not have access to affordable health coverage offered by an employer. If your employer offers health insurance, but you feel it’s too expensive, you can use our Employer Health Plan Affordability Calculator to see if you might qualify for premium subsidies in the Marketplace. 
• You must not be eligible for Medicaid or CHIP.
• You must not be eligible for premium-free Medicare Part A.⁷

In Oregon, open enrollment for ACA Marketplace individual and family health coverage is from November 1 through January 15. 

Enrolling in an exchange plan or changing your coverage outside of the open enrollment period is possible if you meet the criteria for a Special Enrollment Period (SEP).⁸ This means you must have a qualifying life event, such as losing your health insurance, getting married, or having a baby.

If the open enrollment deadline has passed and you don’t meet the SEP requirements, you can still sign up for an ACA plan. However, specific conditions need to be met, such as:

• Your income falls at or below 150% of the poverty level, and you’re eligible for premium tax credits. In this scenario, you can enroll anytime until at least the end of 2025 (HHS has proposed extending this indefinitely.⁹ However, Oregon will no longer be using the HealthCare.gov enrollment platform after 2026, so will have some flexibility to set its own SEP rules¹⁰).
• Native Americans can enroll or switch plans year-round.

For people who lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, there’s an extended SEP available for enrollment.¹¹

Oregon also received federal approval to not disenroll people from Medicaid if their income isn’t more than 200% of the poverty level (the normal limit is 138%), while the state waits to implement a Basic Health Program that’s expected to be up and running by July 2024. So some people have been able to remain on Medicaid in Oregon even though they would have been disenrolled in most other states.

Here are the main ways to enroll in a Marketplace health plan in Oregon:

• Online: You can visit OregonHealthCare.gov to learn more about health insurance plans and eligibility.¹² When it’s time to apply and enroll, you’ll be redirected to the federal Marketplace website, HealthCare.gov. (Oregon’s new state-run Marketplace platform is expected to debut in the fall of 2026.)
• By Phone: Dial 1-800-318-2596 (TTY: 1-855-889-4325) to enroll with a Marketplace representative. The call center is available 24 hours a day, seven days a week, but it’s closed on holidays.
  
• In-person: Enrollment assistance is also available from trained Navigators and assisters who can answer your questions. Go to localhelp.HealthCare.gov or OregonHealthCare.gov/GetHelp to find local help in your area.¹³

Assistance is available from local Navigators and brokers. Enrollments can also be completed via an approved enhanced direct enrollment (EDE) entity, using the EDE’s website.¹⁴

Oregon’s ACA Marketplace (HealthCare.gov) is a one-stop shop where individuals and families can find affordable health insurance coverage in Oregon. There are two types of financial assistance available through the Marketplace:

• Premium subsidies: You may qualify for income-based subsidies known as Advance Premium Tax Credits (APTC) that help lower your monthly premiums through the ACA Marketplace. About eight out of 10 Oregon exchange enrollees qualified for premium subsidies in 2023, saving around $503 monthly. People who receive these subsidies pay an average monthly premium of $155 in 2023.¹⁵
• Cost-sharing reductions: You may be eligible for cost-sharing reductions (CSR) if your income is no more than 250% of the federal poverty level,¹⁶ and you enroll in a Silver-level plan through the Oregon Marketplace. CSRs help lower your out-of-pocket costs, making coverage more affordable.¹⁷

Oregon implemented a reinsurance program starting in 2018, using a 1332 waiver that allows the state to capture federal savings generated by the program.¹⁸ Reinsurance is designed to keep unsubsidized (full-price) premiums lower than they would otherwise be. Although most enrollees do qualify for premium subsidies, the reinsurance program helps to minimize premiums for those who don’t.

Oregon also requires all state-regulated health plans, including Marketplace plans, to cover both female and male contraception (including vasectomies), as well as abortion, all without out-of-pocket costs.¹⁹

Medicaid: Oregon residents may qualify for Medicaid coverage if eligible based on income. Medicaid in Oregon is called Oregon Health Plan, and has no monthly premiums.²⁰

Basic Health Program — available starting mid-2024: Oregon is working to create a Basic Health Program that is expected to be available by July 2024, pending federal approval. Coverage under this program would be available to Oregon residents with income above 138% of the poverty level but not above 200% of the poverty level.²¹

Short-term health insurance: If you’re not eligible for subsidies, Medicare, or Medicaid, short-term health insurance, available in Oregon with terms of up to three months, might be an affordable temporary solution.

Six insurers offer plans through Oregon’s exchange²²

Throughout Oregon, residents can choose from at least four insurers for 2024 coverage, and in most counties, there are at least five insurers offering coverage through Oregon’s health insurance exchange.²³

The following average rate changes were approved for 2024 for Oregon’s individual/family market health insurers, amounting to an overall weighted average rate increase of 6.2%:²⁴

Source: Oregon.gov²⁴

The average rate changes apply to full-price premiums. However, about 81% of Oregonians who enrolled in ACA plans received subsidies in 2023 – which means they did not pay the full rate.¹⁵

In addition, subsidy amounts are adjusted each year based on the cost of the second-lowest-priced Silver plan. So, as coverage costs increase, subsidies may also grow to offset part of the change.

If your plan’s rates are increasing next year, consider exploring other options on the ACA Marketplace. You may find a more affordable plan that still meets your coverage needs.

For perspective, here’s a summary of how average full-price (unsubsidized) premiums have changed in Oregon’s individual market over the years:

• 2015: Average decrease of 5%.²⁵
• 2016: Average increase of 24.2%.²⁶
• 2017: Average increase of 26.5%.²⁷
• 2018: Average increase of 15.7%.²⁸ (reinsurance took effect;¹⁸ Federal CSR funding eliminated²⁹)
• 2019: Average increase of 7.3%³⁰
• 2020: Average increase of 1.5%.³¹
• 2021: Average increase of 2.1%.³²
• 2022: Average increase of 1.5%.³³
• 2023: Average increase of 6.7%.³⁴

During the 2023 open enrollment period, 141,963 people signed up for individual/family health coverage through the Oregon exchange.¹⁵

 Enrollment in Oregon declined slightly from 2022 to 2023, although enrollment nationwide hit a record high. 

Source: 2014,³⁵ 2015,³⁶ 2016,³⁷ 2017,³⁸ 2018,³⁹ 2019,⁴⁰ 2020,⁴¹ 2021,⁴² 2022,⁴³ 2023⁴⁴

OregonHealthCare.gov
A state-run service that connects Oregon residents with health coverage options.

HealthCare.gov
The Marketplace for individuals and families buying their own health coverage; premium subsidies and cost-sharing reductions are available for eligible enrollees who use the Marketplace.

Oregon Division of Financial Regulation
Licenses and regulates health insurance companies in Oregon, as well as agents and brokers. Can address consumer questions and complaints about regulated entities.

Medicare Rights Center
A nationwide resource that can answer questions about Medicare and provide information that beneficiaries need.

Oregon Senior Health Insurance Benefits Assistance
A local service that can provide assistance, information, and enrollment counseling to Medicare beneficiaries and their caregivers.