| Applying to OMIP |
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| Are you eligible for OMIP coverage? |
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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.
- 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.
Federal health care tax credit eligibility requirements
To be eligible for Federal Health Care Tax Credit, you must have been certified by the US Department of Labor as being affected
by competition from foreign trade, and are receiving a Federal Health
Care Tax Credit under Section 35 of the Internal Revenue Code.
If you qualify for OMIP under this eligibility category, OMIP is assuming you
are eligible for a Federal Health Care Tax Credit (HCTC), which pays
65% of the cost of your monthly OMIP premium. However, the federal
government will make the final determination about eligibility for the
HCTC. You must apply for OMIP coverage within 63 days of losing your
most recent prior health insurance coverage and you must have had the
prior coverage in place for a period of not less than 90 days. Please
provide a copy of your HCTC Eligibility Notice and a Certificate of
Creditable Coverage from your prior health insurance carrier proving
that you have 90 days of prior health insurance coverage and are
applying within 63 days of losing your most recent prior health
insurance coverage.
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| How do I apply? |
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It's simple. Just call our customer service department number at (800) 848-7280 and ask for an "OMIP Packet" or download an application at our site. When you get the packet, read the booklet carefully and complete the enclosed application.
The OMIP packet contains further details on eligibility and
coverage, including the application, premium rates, and Provider
Directory.
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| What are the plans? |
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We have four plans to choose from. All four plans are preferred provider plans, which require you to use a provider within the plan network in order to receive the best benefit possible. The plans offer a range of deductibles including $500, $750, $1,000 and $1,500.
In some cases benefits will not be provided during the first six months of enrollment for expenses resulting from a pre-existing condition. Pregnancy is considered a pre-existing condition for determining whether OMIP benefits are paid during the first six months of coverage. Please read the OMIP packet or call member services at (800) 848-7280 for additional information.
Go to plans (.pdf)
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| Choosing a plan |
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When selecting a plan, you may also want to consider the following:
- What are your prescription drug needs?
- Do your family members need to be covered by OMIP or can they obtain less expensive coverage elsewhere?
- How much of a deductible would you prefer to pay each year?
- How much annual out-of-pocket expense can you afford in the event you reach the maximum out-of-pocket amount?
Each of the above points is worth consideration when choosing a
plan. But please remember to read through the OMIP packet carefully
before making a decision.
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| Find a health insurance producer/agent in Oregon |
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Insurance producer/agent search
All firms licensed by the Oregon Insurance Division as insurance producers/agents, insurance consultants, independent insurance adjusters and life settlement brokers are included. Information is updated weekly.
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| Application forms |
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FAX your application to: (503) 225-5474 or mail to:
Oregon Medical Insurance Pool
c/o Regence BlueCross BlueShield of Oregon MS 5K
P.O. Box 1271
Portland, OR 97207-1271
Note about the OMIP application:
There will be periodic updates to the application. Any applications submitted on an outdated form will be returned to the prospective member along with a current application for completion and resubmission. This may delay the effective day of the OMIP coverage. It is best to use this site for the most current OMIP application.
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| Quickstart guide |
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