Parents tell us...
"Why is this so complicated?!" "I had no idea Oregon had a department to help solve insurance issues." " My teen turns 18 soon. How can I keep him on our insurance?" "I was so confused but with help we got it figured out." "Welcome to my other part-time job: Insurance Appeals Expert."
Where to get insurance
The Oregon Health Authority website lists other places you may find a plan for your child. They also provide insurance assisters and trained community partners to help you find a plan and/or see if your child qualifies for a subsidized plan.
If your child qualifies for Developmental Disability services, she may be eligible for the Oregon Health Plan as secondary coverage. Speak to your child's case manager about this.
Don't have insurance? Try:
HRSA Health Centers (also called Community Health Centers) care for you, even if you have no health insurance. Some health centers also provide mental health, substance abuse, oral health, and/or vision services.
School Based Health Centers offer health care for the whole family.
Community health fairs may offer free screenings or care on a first come, first served basis. Contact your county health department, dial 211 toll free, text your zip code to 898211, or e-mail 211 and ask about upcoming health fairs.
Employee Assistance Programs (EAP): Contact your human resources department to see if they offer free or reduced-cost mental health services for their employees.
Many hospitals and clinics offer discounts, so before any procedure, ask for a financial screening to see if you qualify, even if you doubt you will.
See tip sheet When Insurance Won't Pay.
Explore Financial Help.
How does insurance work?
Insurance is complicated but necessary for you to understand. We have provided some great resources to learn the basics, but if you need to find an expert to help you with a specific insurance concern, call us at 855-323-6744.
Who can help me coordinate with my insurance plan and care?
If your child has OHP and requires a lot of providers, medications, or appointments, you may be eligible for help coordinating that care from an Exceptional Needs Care Coordinator, Intensive Care Manager, or Community Health Worker. You can also ask for Family Peer Support Worker, who is a trained family member and will understand what you are going through. See our tip sheet for instructions on how to request care coordination help.
Some plans that are not OHP, may also provide help. Call the number on your child's insurance card and ask if there is someone on her plan.
What if I need to appeal a denial?
Many families have children with two insurance plans. For example, children who receive Developmental Disability (DD) services may have OHP, and a policy through their parents' work, as well. Or, if both parents have insurance through their work, the child may be on both plans. Double coverage is good, but can get confusing. In general, whenever there are two policies, the private insurance pays their part first and then OHP pays second. If you have two private insurance plans, it is important to let your providers know and find out which one pays first and which one pays second.