Oregon

In Oregon, various health insurance options are available to help cover the costs of pregnancy and childbirth care. These include private insurance plans, Medicaid, and specialized programs aimed at ensuring expectant parents have access to necessary medical services. Here are some key programs and services:

1. State Plans and Programs

Oregon Health Plan (Oregon Medicaid)
The Oregon Health Plan (OHP) provides comprehensive coverage for low-income individuals, including pregnant people. Services covered by OHP include:

Prenatal and postpartum care,
Labor and delivery services,
Hospital stays,
Infant care up to one year after birth,
Dental and vision services during pregnancy,
Behavioral health and substance use prevention,
Doula care, and
Travel assistance for medical appointments.

Eligibility is based on income and household size. Learn more and apply at Oregon's Medicaid Program.

1. Employer-sponsored Plans

Pregnant consumers can enroll in coverage through an offer of employer-sponsored coverage (ESC) from their own employer or a spouse’s job. Many employers offer health insurance that includes maternity and newborn care. Coverage typically includes prenatal visits, ultrasounds, labor and delivery, and postpartum care.

1. Oregon Health Insurance Marketplace

Through the Health Insurance Marketplace, pregnant individuals can explore various health insurance plans that cover pregnancy and childbirth. Under the Affordable Care Act (ACA), all marketplace insurance plans are required to cover maternity and newborn care as essential health benefits. Alaskans can compare and enroll in plans through the federal marketplace at HealthcareOregon.gov.

1. Private/Individual Insurance Plans

Private health insurance purchased outside the marketplace may also provide coverage, though benefits can vary. Parents' health insurance plans (if they offer dependent coverage) can also cover pregnant dependents before their 26th birthday.

Employer-sponsored coverage for dependents usually ends during the month of the child’s 26th birthday. If the dependent is covered under their parents' Marketplace plan, they can stay on their parents' plan until December 31 of the year they turn 26.

1. Other Assistance Programs:

a. Sliding Fee Scale Clinics: Federally Qualified Health Centers (FQHCs) and community health clinics offer maternity care at reduced costs based on income.

b. Indian Health Service (IHS): Alaska Native and American Indian individuals are eligible for healthcare services through the Indian Health Service (IHS) or tribal health organizations, which include maternity and childbirth care. Services are typically free or low-cost.