In Oregon, to apply for health insurance, you must:

• Be 18-64 years of age and not eligible for Medicare
• Live in the plans selling area (See the Providence Selling Area)
• Fill out an application, including the “Oregon Standard Health Statement.” This asks about your medical history. Make sure you have contact information for your doctor, details on medical conditions and all medications.
• Read about pre-existing conditions and understand how they affect your application and coverage.

Pre-existing conditions

A pre-existing condition is any health condition that existed before you applied for coverage. It can be anything from pregnancy to high blood pressure to allergies.

• Adults age 19 and older may be denied coverage due to a pre-existing condition.
• Even if you are approved for coverage, you may also have a waiting period before services for a pre-existing condition are covered.

Children under age 19

As a provision of health care reform, insurance companies can no longer deny coverage for children and applicants under age 19 due to health status/pre-existing condition. In Oregon, special open enrollment periods have been established for children under age 19 to apply for coverage. Check with each insurance company for specific application guidelines.

What if you are denied coverage?

Each health insurance company has their own rules about denying coverage. If you are denied with one company, you may still get coverage with another. You may also be eligible for insurance through the Oregon Medical Insurance Pool (OMIP): 800-848-7280. In addition to OMIP, health insurance for children may also be available through Healthy Kids: 877-314-5678 or the Oregon Health Plan: 800-257-5772.

« Step 1: Why you need coverage Step 3: Learn the lingo »

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Looking to start
a family?

Apply for health insurance before you start planning a family. In Oregon, pregnancy is considered a pre-existing condition and if you are already pregnant, you will be denied coverage.

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