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Learn About CHIP in Oregon

Oregon CHIP is a program dedicated to providing health insurance to low-income residents throughout the state. Each state in the U.S. administers its own version of the Children’s Health Insurance Program. In Oregon, the program is referred to as the Oregon Health Plan. This program is unique because the CHIP insurance provided to low-income children is also grouped together with the benefits provided to residents through Medicaid, creating the all-encompassing Oregon Health Plan. The state’s Health Authority is responsible for establishing eligibility for the program, determining the types of coverage that will be offered to qualifying residents and administering these benefits to program enrollees.

The benefits provided through the Children’s Health Insurance Program in OR include important medical services, such as X-rays and checkups. The coverage is offered to residents without monthly premiums, but most services require beneficiaries to pay copayments before treatment is provided. Before completing the application process, residents should learn more about how CHIP and Medicaid work in conjunction to offer the Oregon Health Plan, including the eligibility requirements set for potential beneficiaries. To find out more about how low-income children and families can receive important health insurance coverage for free, review the following information.

What is CHIP in Oregon?

Low-income residents who are responsible for minors may ask, “What is CHIP in Oregon and can it cover my child?” This program is designed to provide health insurance coverage to residents younger than 19 years of age who are not already insured by other government or private insurance policies or programs. To qualify for this coverage, parents or guardians must complete the application process for the Oregon Health Authority to determine CHIP eligibility. Once enrolled, these children can seek medical treatment or preventive care through participating medical providers for little to no cost.

In addition to health insurance for kids through this program, the Oregon Health Plan also includes Medicaid coverage. This type of government health insurance coverage is open to a broader age range. However, the income eligibility guidelines for this program are usually stricter than for the children’s insurance program, so some residents may not qualify. A child cannot be covered by both programs at one time. If he or she qualifies for Medicaid, CHIP benefits are not provided.

Who does Oregon CHIP cover?

When completing the CHIP application in OR, one of the most important questions asked is about the income earned in the household. To qualify for Oregon Health Plan benefits, a household must earn an income that prevents it from being able to afford private insurance or other types of health insurance options. These income guidelines can change each year because they are based on the Federal Poverty Level (FPL), which is set by the U.S. government. The income guidelines also depend on the number of household members. Additionally, recurring expenses can sometimes be deducted from the income total for some households.

In addition to the low-income CHIP eligibility guidelines, an applicant must also be:

  • A resident of the state of Oregon.
  • A U.S. citizen, legal alien or permanent U.S. resident.
  • Not covered by any other medical insurance, including Medicaid.
  • Younger than 19 years of age.

An applicant cannot qualify for the child health insurance plan in Oregon if he or she is eligible for Medicaid coverage. While this coverage is still considered part of the Oregon Health Plan, it involves a different set of government assistance benefits that provide health insurance coverage to low-income residents. CHIP coverage is provided to children in families that earn incomes that are too high for Medicaid but too low to afford private health insurance.

How to Apply for CHIP in Oregon

If you are wondering who qualifies for CHIP in Oregon and are unsure if you will be eligible to obtain coverage through the Oregon Health Plan, contact the Health Authority. The department offers a pre-screening tool that can help you to understand if you qualify for benefits or if you should seek health insurance through a private company. The online pre-screening tool asks you questions about your age, residency status, household income, expenses and medical needs.

To find out more about CHIP, download and review our informative guide.

You can find an application for CHIP online, but you must submit the printed and completed form to the Health Authority office by mail or in person. The form on the website is a PDF fillable form, so you can type your answers in before printing and submitting it. Keep in mind that you may be responsible for providing proof of the information you stated on the application, such as:

  • Proof of income
  • Proof of residency status or citizenship status
  • Proof of identity

You can call the OR CHIP number to check the status of your application after submitting it. However, the department should contact you to let you know about eligibility.

What is included with Oregon CHIP coverage?

OR CHIP dental coverage is included with the Oregon Health Plan, in addition to vision coverage and comprehensive medical benefits provided by the health insurance. Some of the most common uses of this coverage include:

  • Prescription drugs.
  • Hospital visits.
  • Annual doctor’s checkups.
  • Immunizations and vaccinations.
  • Mental health care.

To utilize CHIP insurance in Oregon, an enrolled program beneficiary must bring his or her insurance card to a participating medical provider to seek treatment. If a beneficiary visits a medical provider who does not accept Oregon Health Plan benefits, he or she may be responsible for paying out of pocket for medical expenses. The Health Authority provides all beneficiaries with information on local health care providers that accept this insurance.

How much is CHIP health insurance in Oregon?

Oregon CHIP is a free health insurance program offered to eligible applicants. No monthly premiums are charged to participating beneficiaries. However, Oregon Health Plan participants may be responsible for copayments when seeking treatment or care.

The CHIP office provides all beneficiaries with information on copayments. These are the fees charged when program enrollees seek treatment and services through participating medical providers. Copayments are usually small and affordable, even for emergency services or surgeries, but may vary depending on the treatment needed.

To find out more about these copayments, review our comprehensive guide.

How long do CHIP benefits last in Oregon?

The Oregon Children’s Health Insurance Program (CHIP) usually provides coverage for beneficiaries for one year. Before the term expires, the department provides renewal information, if applicable. Some insurance policies renew automatically, if all eligibility guidelines are still met by program enrollees. In some cases, however, beneficiaries must complete the renewal process if they wish to continue receiving benefits.