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Oregon Medical Insurance Pool / Federal Medical Insurance Pool


Are you eligible for OMIP/FMIP coverage?

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.

You may be eligible for FMIP if you meet the medical requirements: Must be a U.S. citizen or lawfully present in the U.S.; and you have not had creditable health coverage within the last six months prior to applying for risk pool coverage.

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.

What plans are available?

We have four OMIP 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.
 
There are two FMIP plans to choose from.  Both 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 plan deductibles are $500 and $750.
 
The FMIP benefits DO NOT have a pre-existing condition(s) exclusionary period.

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