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.
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
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.
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.
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