Learn about short-term health insurance in Oregon.
Availability of short-term health insurance in Oregon
Oregon limits the duration of temporary health insurance plans to three months
Oregon law limits short-term plans to three months, including renewals. And a subsequent short-term plan purchased within 60 days of the termination of a short-term plan is considered a renewal.1 Federal rules that allow for longer plans do not apply to short-term health insurance in Oregon.
Although new federal rules are applicable as of September 2024 in most states, Oregon’s rules will continue to apply, as they are a little stricter than the new federal rules. So short-term health plans in Oregon will continue to be limited to total durations of no more than three months.
As of 2024, at least three insurers are selling short-term health insurance plans in Oregon.
Frequently asked questions about short-term health insurance in Oregon
Is short-term health insurance available for purchase in Oregon?
Yes. As of 2024, there are at least three insurers offering short-term health insurance in Oregon, with terms of up to three months.
How much does short-term health insurance cost in Oregon?
The average monthly premium for a short-term health insurance plan sold in Oregon was $258.23 in 2023, according to data from IHC Specialty Benefits.
Which short-term plan durations are permitted under Oregon rules?
Short-term health insurance in Oregon is limited to a duration of no more than three months, including renewal periods. (See ORS 743B.005(25)(a).)
The state statute (ORS 743B.005(16)(c)) also clarifies that “renewal” includes a scenario in which a person buys another short-term health plan from the same insurer within 60 days of the termination of a previous short-term health plan.
As long as a short-term plan doesn’t have a total duration of more than three months, and there’s at least a 60-day gap before the insurer issues an additional policy to the same person, the short-term plans are exempt from Oregon’s definition of “health benefit plan” and the associated state regulations.
In 2021, Oregon enacted HB2046. It requires short-term health plans to provide a disclosure to enrollees informing them that the plan is not regulated by the ACA, and that when it expires the person may have to wait until the next annual open enrollment period for ACA-compliant plans (November 1 to January 15) to purchase health coverage.
Who can buy short-term health insurance in Oregon?
The Oregon Division of Financial Regulation has a list of 11 questions that they advise people to ask before enrolling in a short-term health insurance plan. They provide specific information for each question to help consumers understand the limitations of short-term plans and the availability of other coverage options.
Short-term health insurance in Oregon can be purchased by residents who can meet the underwriting guidelines the insurers use.
In most cases, this means being under 65 years old and not having a medical condition that will result in a declined application.2 But the specific underwriting rules are set by the insurance companies that offer short-term coverage.
Short-term health insurance plans typically exclude all pre-existing conditions, and they often use post-claims underwriting. This means that if a claim is filed, the insurer can go through the person’s medical records to make sure the claim isn’t related to a pre-existing medical condition.3
Short-term health plans often exclude coverage for some of the ACA’s essential health benefits (most commonly, maternity care, prescription drugs, and mental health care),2 and impose dollar limits on the coverage they do provide.
But short-term health plans can vary considerably from one plan to another, so it’s important to carefully understand what’s covered and what’s not covered before you purchase a policy; you don’t want to find out that a particular service is not covered after you need it.
If you need to purchase health insurance coverage in Oregon outside of the annual open enrollment period (November 1 to January 15), first check to see if you’re eligible for a special enrollment period. If so, that would allow you to enroll in an ACA-compliant individual major medical plan through Oregon’s marketplace (Obamacare). Multiple qualifying life events can trigger a special enrollment period and allow you to buy an ACA-compliant plan.
ACA-compliant healthcare plans are purchased on a month-to-month basis; you won’t have to enroll for the entire year. So you can purchase one (during open enrollment or a special enrollment period) even if you only need a few months of coverage before another policy takes effect. For example, if you’ll soon be eligible for Medicare or a plan offered by a new employer, you’ll be able to cancel the ACA-compliant plan when your new coverage takes effect.
And if your total annual household income makes you eligible for a premium tax credit (premium subsidy), you can get that benefit even if you only need the plan for a short while (note that your household income will be based on your income for the full year, and reconciled on your tax return using that amount, even if you only need coverage for a few months).
The American Rescue Plan has made premium subsidies larger and more widely available, and that’s been extended through 2025 by the Inflation Reduction Act. So it’s worth checking your options in Oregon’s marketplace if you haven’t done so recently.
Depending on your household income, you may find that you’re eligible for Medicaid in Oregon, or for OHP Bridge, which is Oregon’s Basic Health Program.
When should I consider buying short-term health insurance in Oregon?
From Eugene to Pendleton, there are times when a short-term health coverage might be the only realistic option, such as if:
- You missed open enrollment for individual ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
- You’ll soon be enrolling in Medicare, the open enrollment window for ACA-compliant plans has closed for the year, and you don’t have access to any other type of coverage.
- You’re newly employed and your employer will provide health coverage, but you’re in a waiting period that can last up to three months and you don’t qualify for a special enrollment period to purchase ACA-compliant coverage.
- You’re not eligible for Medicaid or a premium subsidy for an ACA-compliant plan in the exchange.
People ineligible for premium subsidies include:
- Oregonians who earn too much to qualify for a subsidy. This is less common than it was before the American Rescue Plan.
- People who can’t enroll in a plan through the exchange/marketplace because of their immigration status (a valid lawfully present immigration status is required to enroll in a plan through the exchange, and premium subsidies are only available if you get your plan through the exchange).
How has Oregon historically regulated short-term health insurance?
The Trump administration’s regulations that took effect in 2018, which allow for longer short-term healthcare plans, do not apply in Oregon. The federal rules are clear in noting that a state can impose stricter guidelines, and the Oregon Department of Financial Regulation has published guidance relating to short-term health insurance, clarifying that the state’s rules remain in force.
The Biden administration finalized a new rule in 2024, applicable to plans sold or issued starting in September 2024. It caps initial terms at three months, but allows for a total duration, including renewals, of up to four months. Since Oregon’s rules are still stricter, the state’s three-month limit on total duration will continue to apply.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.
Footnotes
- ”Guidance for short-term health insurance” Oregon Division of Financial Regulation. Accessed July 15, 2024 ⤶
- ”ACA Open Enrollment: For Consumers Considering Short-Term Policies” KFF.org. Oct. 25, 2019 ⤶ ⤶
- ”Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage” U.S. Department of Health and Human Services. April 3, 2024 ⤶
