NWPC Blog

Limited Income? Disabled? Medical Open Enrollment.

Health insurance enrollment can be complicated to understand, but it does not have to be.  There are a variety of programs that cover millions of individual and families with limited incomes and disabilities. Read on to learn about open and special enrollment periods, Medicaid, and the Children’s Health Insurance Program (CHIP).

Open Enrollment & Special Enrollment Periods

Medical open enrollment is the yearly period where people can apply for a health care insurance plan.  Outside of the open enrollment period, you can typically only apply for health insurance during a special enrollment period.  Special enrollment periods allow you to apply for health insurance if you experience a major life change such as a birth or adoption, a death, a job change, got married, got divorced or legally separated, or lost your previous health care coverage.

Open enrollment for 2017 runs from November 1, 2016 through January 31, 2017.

Medicaid and the Children’s Health Insurance Program (CHIP) coverage allow applications at any time and do not require special enrollment circumstances or open enrollment periods to be eligible.  Coverage, if you qualify, can begin immediately, any time of year.

Medicaid

Medicaid provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.  Oregon and many other states offer Medicaid programs to cover people below certain income levels.  To find out if you qualify for Medicaid based on income alone, click here.  You can apply for Medicaid through the Health Insurance Marketplace or through your state’s Medicaid Agency.

Children’s Health Insurance Program (CHIP)

The rates of uninsured children are at a record low today, but there are still 7.6 million kids, one in 10, who do not have any insurance.  If your children need health coverage, they may be eligible for the Children’s Health Insurance Program (CHIP) at low-to-no cost.  CHIP also provides low-cost health coverage to children in families that earn too much income to qualify for Medicaid. Every state offers CHIP coverage and the coverage works closely with the state’s Medicaid program.  There are two ways to apply for CHIP.  You can Call 1-800-318-2596 (TTY: 1-855-889-4325) or you can fill out an application through the Health Insurance Marketplace.

Medicare

The difference between Medicaid and Medicare is worth noting here, to alleviate any confusion.  While the terms sound similar, they are actually very different programs.

Medicare is health insurance for individuals over the age of 65; people under 65 with certain disabilities; or people of any age with End Stage Renal Disease (“ESRD”, permanent kidney failure).

Medicaid is a program that assists with health insurance coverage for individuals with limited income and resources.  It is not restricted to groups of certain age ranges or existing medical conditions.

Some people are eligible for both Medicare and Medicaid.  These individual are called “dual eligible” and are likely to have most of their medical expenses and coverage paid.

Oregon

Oregonians can apply for the Oregon Health Plan (OHP) here.  This program is the state program for Medicaid coverage.  The OHP provides free or low-cost coverage for individuals who meet the eligibility requirements for income, residency, and other factors. Oregonians may also qualify based on age and disability status.  For individuals who qualify for OHP, coverage may include doctor visits, hospital care, mental health services, dental, some vision care and more.

Your Care

Regardless of which plan(s) you sign up for, rest assured that you will receive the best care your medical practitioner can provide.  At Northwest Primary Care we strive to provide the best care for every patient, every day, at every stage of life in times of wellness and illness. As your health partner, we pledge to be respectful and strive to be timely, to take responsibility, to deliver excellence, and to honor your confidentiality.

Special Note:  If you already have a doctor that you see regularly, please check with your doctor’s office to be sure of what insurances they accept.