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Health insurance for $1/month? Subsidies make it possible for many Oregonians

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SALEM, Ore. (KTVZ) -- In new video ads highlighting the annual open enrollment period for health insurance, Oregonians talk about the subsidies that allow them to fit health insurance into their budgets.

Karl B., an Oregon resident, says in one, "Having the subsidy, having the benefits, through OregonHealthCare.gov, that really alleviates a lot of the pressure on me."

Many single Oregonians making about $19,000 a year can qualify for a basic plan costing them, after a subsidy, $1 a month. People qualifying for deep subsidies are among the nearly 104,000 Oregonians who are estimated to qualify for financial help with their coverage but remain uninsured. Among that group, about 25,000 people are estimated to have access to basic plans for a net premium of between $1 and $150, depending on income and family size.

The amount of a person's premium subsidy—the price break they get on the monthly cost of coverage—varies according to income and some other criteria. The $1 plans are available amid other subsidized choices, many with higher premiums and richer benefits, and all sold by private insurance companies and certified by the Oregon Health Insurance Marketplace.

The Marketplace is a part of state government, and it helps people get coverage when they do not qualify for the Oregon Health Plan and do not get health insurance through their job. Its online home is OregonHealthCare.gov, the first stop for Oregonians seeking subsidies.

Deductibles on the lowest-cost plans are substantial, but some benefits are available before a person has to pay it.

"I always want my clients to know if a plan includes benefits they can access regardless of a high deductible, even when they haven't met that deductible," said Tina Kennedy of Healthwise Insurance Planning in Portland. "Every plan through the Marketplace covers certain preventive care right away, at no extra cost to you, and on some large-deductible plans, you get office visits for a copay even when you haven't dented the deductible."

In Oregon, plans with the words "standard bronze" in their name all cover primary care office visits for a flat $45 copay, even when the plan's $7,900 deductible has not been met. This plan type is among the options with a net cost of $1 per month for people making around $19,000 a year and meeting a few other qualifications.

You can estimate your own qualification for a subsidy and browse plan options at OregonHealthCare.gov/windowshop. A certified community partner or licensed insurance can, at no cost to you, help you apply for a subsidy and translate the coverage details into dollars and cents for you. They are listed in a directory at OregonhealthCare.gov/gethelp.

Only a licensed insurance agent can recommend the best plan for you. To hear more from Karl B. and other Oregonians who got subsidies, visit https://youtu.be/LVcL2jTZ8A, https://youtu.be/WZM5-JiTI4M, and https://youtu.be/-CNhrAFpHdE.

The Oregon Health Insurance Marketplace, a part of state government, helps people get health insurance when they do not have job-based coverage, and do not qualify for the Oregon Health Plan or another program. The Marketplace is the state-level partner to HealthCare.gov, and a division of the Department of Consumer and Business Services (DCBS). For more information, go to OregonHealthCare.gov.

Community

Barney Lerten

Barney is the digital content director for NewsChannel 21. Learn more about Barney here.

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