The Cheapest Oregon Health Insurance for Individuals and Families
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If your job does not provide health insurance and you do not qualify for Medicare or Medicaid via the government, you can purchase a private health insurance plan on the Oregon insurance exchange.
It can be challenging to find a health insurance plan with affordable costs and sufficient coverage. The deductibles and out-of-pocket maximums for lower-cost insurance policies are higher than those for high premiums. A plan with low premiums costs less each month, but it provides less coverage for medical expenditures. As a result, you will have to pay more for medical expenses out of your pocket.
MoneyGeek found the cheapest and best health insurance plans in Oregon for various plan types and age groups by analyzing the health insurance exchange. Our study can assist individuals seeking the best coverage at the lowest possible cost.
The Cheapest Health Insurance in Oregon by Metal Tier
Catastrophic, Expanded Bronze, Silver and Gold are the metal tiers in Oregon’s private insurance exchange. The premiums and cost-sharing for the plans depend on which tier the policy is in. Gold plans have the highest insurer cost-sharing, while Catastrophic plans have the lowest. As a result, Gold plans have much higher premiums.
Plans with lower monthly premiums have higher deductibles and out-of-pocket maximums, while plans with higher premiums offer more coverage with lower deductibles and out-of-pocket maximums.
The average monthly health insurance premiums for the four tiers are as follows:
- Catastrophic: $250 per month
- Expanded Bronze: $371 per month
- Silver: $486 per month
- Gold: $550 per month
If you're in good health, you may have minimal medical costs. Your medical expenditures can be covered by a low-cost insurance plan, such as an Expanded Bronze plan, which doesn’t need you to pay high monthly premiums. Individuals with higher medical costs, on the other hand, will likely benefit from choosing a Gold plan in Oregon. Although your monthly premiums will be higher, you will get broader coverage, and your deductibles will be significantly lower.
Rates, deductibles and out-of-pocket maximums for plans can vary within each metal tier in the Oregon insurance market. The table below shows the cheapest average monthly premium available for each metal tier.
If you have a low income, you may be eligible for cost-sharing reductions (CSR), which you can obtain through a Silver plan. These plans have lower premiums, affordable deductibles and more comprehensive coverage than the lowest tier policies.
MoneyGeek calculated rates for all types of plans available in Oregon based on a sample profile of a 40-year-old male. The costs are for EPO or PPO policies, with EPO being the most common kind of insurance plan in the state.
Cheapest Health Insurance in Oregon by Metal Tier
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- Metal TierPlanCompanyMonthly CostOOP Max
- CatastrophicNavigator CatastrophicPacificSource Health Plans$244$8,550
- Expanded BronzeKP OR Bronze 8550/75Kaiser Permanente$301$8,550
- SilverKP OR Silver 4500/40Kaiser Permanente$410$8,550
- GoldKP OR Gold 1500/30Kaiser Permanente$421$7,900
The Cheapest Health Insurance in Oregon by Age and Metal Tier
While assessing the Oregon health exchange plans, we found age to impact the health insurance cost significantly. As you become older, your insurance premiums increase. A Silver plan will cost an average of $389 per month in Oregon for a 26-year-old, but a 60-year-old will pay about $1,031 per month for the same policy.
Health Insurance Costs in Oregon by Age and Metal Tier
A Bronze plan may cost you less money in premiums each month. However, if your medical bills rise suddenly, the plan will cost you more in terms of out-of-pocket payments and deductibles.
These health insurance prices in the Oregon insurance marketplace are just averages based on sample profiles. The price varies greatly depending on your age and income. Because insurers consider tax premiums and other variables, seniors in Oregon may obtain rates that are lower than the sample rates. However, you won't know your exact rate until you apply for a health insurance plan.
The table below explains how costs vary depending on metal tier plans and age groups. See our full guide to Oregon health insurance to learn more about the four insurance metal tiers and make an informed decision.
Cheapest Health Insurance in Oregon by Age And Metal Tier
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- PlanCompanyMonthly Rate
- CatastrophicPPOPacificSource Health Plans$121
- CatastrophicPPOPacificSource Health Plans$130
- Expanded BronzeEPOKaiser Permanente$149
- Expanded BronzeEPORegence BlueCross BlueShield of Oregon$153
- Expanded BronzeEPOKaiser Permanente$153
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The Cheapest Health Insurance in Oregon by County
The cost of health insurance in Oregon varies depending on where you live. Oregon and other US states are divided into rating areas. To determine your insurance premiums, health insurance firms use the rating area to which your county belongs. Premiums for counties that are part of the same rating area will be computed in the same way.
Oregon's 36 counties are classified into seven rating areas. Providence Health Plan provides the most affordable health insurance plan in Multnomah County, the state's most populous county. On average, the company’s cheapest Silver plan, Connect 4500 Silver, costs $402 per month.
Use the table below as a reference to find the cheapest plan in your county for each metal tier.
MoneyGeek calculated the average premiums across all tiers using the profile of a 40-year-old male.
Cheapest Health Insurance Plans in Oregon by County
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- Metal TierCompanyCheapest PlanMonthly Premium
- ClackamasCatastrophicPacificSource Health PlansNavigator Catastrophic$237
- MultnomahCatastrophicPacificSource Health PlansNavigator Catastrophic$237
- WashingtonCatastrophicPacificSource Health PlansNavigator Catastrophic$237
- YamhillCatastrophicPacificSource Health PlansNavigator Catastrophic$237
- BentonCatastrophicPacificSource Health PlansSmartChoice Catastrophic$253
The Cheapest Health Insurance in Oregon With High Out-of-Pocket Maxes
Because their medical expenses are generally minimal, healthy young individuals in Oregon may want a low-cost health insurance plan. Although these plans feature low premiums, you will have to pay more out of pocket if you need the insurance for a medical emergency or frequent doctor visits.
PacificSource Health Plans’ Navigator Catastrophic is the cheapest health insurance plan in Oregon with a high out-of-pocket maximum. The plan will cost an average of $195 a month for a 26-year-old.
MoneyGeek defined a high out-of-pocket maximum as a plan with a yearly maximum out-of-pocket cost of $8,250 or higher.
PacificSource Health Plans
This plan is in the Catastrophic category and is not available to everyone. Catastrophic plans are only available to people under the age of 30 or those who qualify for a hardship or affordability exemption. These exemptions are available to anyone unable to get health insurance due to personal or financial circumstances.
The Cheapest Health Insurance in Oregon With Low Out-of-Pocket Maximums
If you frequently make doctor visits or have more medical costs than the average person, a health insurance plan with a low out-of-pocket limit and higher premiums may be the best option. Although such plans have higher monthly premiums, the expense of regular doctor visits and prescription medicines could soon make you meet the plan's low out-of-pocket limit. Your insurance provider will then cover your medical expenses.
PacificSource Health Plans’ Navigator Gold 1500 is the most affordable health insurance plan in Oregon with a low out-of-pocket limit. For a 40-year-old male, this plan will cost around $539 per month.
MoneyGeek defined a low out-of-pocket maximum as a plan with a yearly maximum out-of-pocket cost of less than $4,250. In the case of Navigator Gold 1500, this rate is $5,500. However, this is the lowest out-of-pocket maximum in the state.
PacificSource Health Plans
Since Navigator Gold 1500 is a Gold plan, you can expect high monthly premiums with low limits and deductibles.
Cheapest PPO/EPO Health Insurance Plan in Oregon
You must evaluate your healthcare needs and preferences to obtain the best health insurance plan in Oregon. Most plans in the Oregon insurance marketplace are Exclusive Provider Organization (EPO) plans. The state also offers Preferred Provider Organization (PPO) plans.
The EPO plans, Oregon's baseline plan, cover medical services obtained through in-network health providers, except in an emergency. However, unlike an HMO plan, you don't always need a referral to consult specialists within the network. On the contrary, a PPO plan allows you to receive healthcare services from both in-network and out-of-network doctors without requiring a referral. The plans, however, can be costly due to the flexibility they provide.
The following are the cheapest health insurance plans in Oregon for these plan types:
- Cheapest EPO Silver Plan: KP OR Silver 4500/40 provided by Kaiser Permanente, costing an average of $410 per month for a 40-year-old male
- Cheapest PPO Silver Plan: PacificSource Oregon Standard Silver Plan NAV offered by PacificSource Health Plans, costing $473 a month for an average 40-year-old man
Cheapest Plan in Oregon With an HSA
Several Oregon health insurance policies are HSA or Health Savings Account plans. HSAs are tax-free funds that may be used for deductibles, copayments and other expenditures. HSA insurance plans come with high deductibles and are perfect for people in good health who rarely have medical expenses. These plans will cost you less per month and provide you with more pre-tax contributions for medical benefits. If you don’t use the money for medical expenses, you can add it to your savings.
The cheapest insurance plan with a Health Savings Account (HSA) in Oregon is:
- Cheapest HSA Expanded Bronze Plan: KP OR Bronze 6900/0% HSA provided by Kaiser Permanente at an average cost of $309 per month for a 40-year-old male
Because HSA plans have higher deductibles, you must be willing to spend a big chunk of your savings if you experience a medical emergency.
What to Know About Health Insurance in Oregon
MoneyGeek's analysis calculated sample health insurance rates using private plan data from Oregon's insurance marketplace. The rates shown in our analysis are not always the cheapest options available. Residents from low-income households or seniors may be eligible for Medicaid or Medicare, which are usually much more affordable than most marketplace plans.
Private Health Insurance on the Oregon Marketplace
The Oregon insurance exchange categorizes healthcare plans into several metal tiers. The Catastrophic and Expanded Bronze plans offer the lowest premiums but the highest out-of-pocket maximums. Although the monthly premiums for Gold plans are higher, the overall cost to you for purchasing this plan will be cheaper if you have extensive medical needs.
All the metal-tier plans listed below comply with state and federal health insurance standards. They do, however, come with some differences.
- Catastrophic: Catastrophic plans are the least expensive of the metal tiers, but they are not available to everyone. To apply for a Catastrophic insurance plan, you must be under the age of 30 or qualify for a financial hardship exemption. These plans offer the lowest monthly rates, but they provide limited coverage and have higher deductibles. They do, however, offer the same essential health coverage as the majority of other insurance policies.
- Expanded Bronze: These plans are for those who do not anticipate significant medical costs but want to get the most out of their insurance plan from the start. Before you reach the deductible maximum, the plan covers at least one of the essential health benefits. With an Expanded Bronze plan, your insurer will cover expenses up to 65%.
- Silver: If you want your insurance to cover more of your usual medical expenses, choose a Silver plan. These plans feature lower out-of-pocket maximums and higher premiums than Catastrophic and Expanded Bronze policies. They're ideal for people who qualify for cost-sharing reductions. These plans can help you save hundreds or even thousands of dollars every year if you have many medical costs.
- Gold: Gold plans have higher monthly premiums and lower out-of-pocket maximums and deductibles than Catastrophic, Expanded Bronze or Silver policies. These plans are for those who require frequent medical care and are willing to pay higher premiums to cover the bulk of their medical expenditures. The overall costs incurred by choosing a Gold plan will be significantly lower than those incurred by choosing a lower-tier plan if you have extensive medical needs.
MoneyGeek's data only represents sample rates; you may qualify for cheaper plans or additional coverage. Your family's income level has a significant impact on insurance premiums. Premium tax credits are available if your monthly household income is between 100% and 400% of the federal poverty line. In Oregon, a two-person household earning between $17,420 and $69,680 per year is eligible for these tax credits. You can find more information regarding this through the HealthCare.gov calculator.
The period during which you can enroll in a new health insurance plan through the health insurance exchange is open enrollment. Although the enrollment period is normally between November and December, due to the COVID-19 pandemic, the government extended it. Life events like marriage, losing health insurance, having a baby or moving may entitle you to a special enrollment period. Enrollment periods for job-based insurance plans may differ. There is no specific period for enrolling in Medicaid or the Children's Health Insurance Program (CHIP).
If your household income falls between 138% and 250% of the federal poverty line, you may be eligible for cost-sharing reductions (CSR) under a Silver plan. Qualifying residents may be able to get the coverage of a Gold plan for the price of a Silver plan. These discounts will significantly reduce the plan's deductible, copayments or coinsurance and out-of-pocket maximums. A two-person household earning $24,040–43,550 in Oregon may be eligible for these lower rates in 2021.
Medicaid in Oregon
Medicaid is free and is hence the cheapest insurance plan for eligible residents. Oregon is a Medicaid expansion state, which means that you can qualify for free Medicaid based only on your income if your household income is less than 138% of the federal poverty level.
Medicare in Oregon
Medicare, a federal healthcare program, may be available to Oregon citizens 65 and older, as well as younger people with a disability or illness. In contrast to Medicaid, which can be free, you may need to pay for certain Medicare plan benefits. However, as compared to private insurance plans, Medicare plans are far less expensive.
Medicare is divided into three sections that cover different services.
- Part A: Otherwise known as hospital insurance, Part A covers hospital stays, skilled nursing facility care, hospice care and some home health care services.
- Part B: Part B is your medical insurance covering certain doctors’ services, outpatient treatments, medical supplies and preventive care services.
- Part D: This covers your prescription medications and several essential vaccines. Another name for it is prescription drug insurance.
Methodology
MoneyGeek's research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in Oregon for you
MoneyGeek collected plans and premiums for health insurance in Oregon from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups.
Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.
About Mark Fitzpatrick
sources
- HealthCare.gov. "Catastrophic Health Plans." Accessed June 15, 2021.
- HealthCare.gov. "Open Enrollment Period." Accessed June 15, 2021.
- HealthCare.gov. "The metal categories: Bronze, Silver, Gold & Platinum." Accessed June 15, 2021.
- Medicare.gov. "What’s Medicare?." Accessed June 15, 2021.