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What about pregnancy and maternity coverage in Oregon?

If you are planning to get pregnant in the future, you don't have health insurance right now, and haven't had any in the last 63 days; to be safe you need to apply for individual coverage 12 months in advance of getting pregnant. In some cases you may be covered if you get pregnant during the first year, but only if the baby, the doctor bills, and the hospital bills all arrive after the 12-month waiting period.

If you are planning to get pregnant in the future and you are applying for individual health insurance because you are losing other coverage or will have less than a 63-day break in coverage, you may be okay. If you have had a total of 12 months coverage, pre-existing credit and new coverage, you should have satisfied the 12-month waiting period.

If you are already pregnant your options are severely limited and may not be practical, but there are three ways to get an existing pregnancy covered.

1. You may be able to qualify for the Oregon Health Plan because of low-income.
Oregon Health Plan

2. You may be able to go to work full-time for a company that offers group health insurance. After the employer's waiting period (most commonly 90 days), maternity would be covered without a pre-existing condition limitation in accordance with state law.

3. You may also be able to apply to the Oregon Medical Insurance Pool (OMIP). This is a program for individuals who can't qualify for health insurance because of existing health conditions. Pregnancy is considered an existing health condition.

There is a 6-month waiting period after the policy takes effect before pre-existing conditions, including maternity care, would be covered. Policies usually take effect on the 1st or 15th of the month after application is received. This would only help if the baby were over 6 months away.

You can also look at your rates for OMIP in the Individual & Family section of this website. When you select a deductible, OMIP is one of the selections in the list

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