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Benton County Health Services – Finances

Financial Resources

Family Health Insurance Assistance Program (FHIAP)

The Family Health Insurance Assistance Program (FHIAP) offers state-paid subsidies to Oregonians who are unable to afford health insurance coverage and who have been uninsured for at least six months with the exception of those leaving OHP-Medicaid. The subsidies pay between 70-95% of the premium cost for health insurance plans offered by employers or in the private insurance market. This means that members will pay 5%, 10%, or 30% of their premium costs. Members who are responsible for the usual co-payments and deductibles of the private insurance market.

Oregon Medical Insurance Pool (OMIP)

Oregon Medical Insurance Pool (OMIP) provides coverage to anyone who has been turned down for health individual insurance because of a medical condition. OMIP is not a low-cost health insurance program. However, FHIAP subsidies can be applied to any of the four insurance plans offered through OMIP. Pricing varies by age and geographic location.

Oregon Health Plan (OHP) Medicaid

Oregon Health Plan (OHP) Medicaid is an insurance plan for Oregonians who cannot afford health insurance. Medicaid coverage is paid for entirely by federal and state dollars. The Children's Health Insurance Program (CHIP) is a part of the Medicaid program.

Children's Health Insurance Program (CHIP)

Children's Health Insurance Program (CHIP), which is part of the Medicaid program, covers uninsured children under the age of 19 whose families are at or below the figurines of Column B above. The program is a combination of state and federal funding and offers the same benefits package and choice of providers as OHP Medicaid. There are no monthly premiums, co-payments, or deductibles. Vision and dental care are included, and pre-existing conditions are covered.

Medicare

Medicare is a federal program of hospital and medical insurance for people who are 65 and older, disabled, or with permanent kidney failure.  Medicare does not cover long-term care and usually does not cover all medical expenses.

Note: Each of the programs listed have other eligibility criteria that apply. This information is provided as a service to consumers – you need to call the numbers listed to get current eligibility and application information.

Eligibility

Average Monthly Guidelines for Publicly Sponsored Programs

First, find the line in the 2003 Income Guidelines below that shows your family size in the first column of numbers. Follow that line across the page until you find your family's maximum total average monthly gross income for program eligibility - Column A is the maximum for some programs while Column B is the maximum for others. For example, if you have a family of three, the maximum income requirements for some programs is $1272 (Column A) or for other programs $2353. Then look at Table 2 below on this page for the description that matches your situation.

Table 1

Family Size	Column A	Column B
1	$748	$1384
2	$1010	$1869
3	$1272	$2353
4	$1533	$2837
5	$1795	$3321
6	$2057	$3805
7	$2318	$4289
8	$2580	$4773

Note: This table reflects average monthly gross income maximums--the amount of money your family made from all sources before taxes. Figures are effective as of February 7, 2003.

Health Resources for You and Your Family

Eligibility for most of the programs above is based on your family's average monthly gross income. For more specific information on your situation, you'll need to contact a program representative at one of the toll-free numbers listed in Table 2 below. For program information and income guidelines, see second table.

Table 2

Who's Eligible?	Where's Your Family Income	What resources are available/whom do you contact?
Pregnant Women	Family Income less than Column B	Oregon Health Plan Medicaid 1-800-359-9517 Family Health Insurance Assistance Program (FHIAP) 1-888-564-9669
Children birth to 19 years old	Family Income less than Column B	Oregon Health Plan Medicaid/Childrens Health Insurance Program (CHIP) 1-800-359-9517 Family Health Insurance Assistance Program (FHIAP) 1-888-564-9669
Adults	Family Income less than Column A Family Income less than Column B	Oregon Health Plan Medicaid 1-800-359-9517 Family Health Insurance Assistance Program (FHIAP) 1-888-564-9669 Family Health Insurance Assistance Program (FHIAP) 1-888-564-9669
Any family member denied insurance for health reasons	No income requirements. See other side of page for program description.	Oregon Medical Insurance Pool (OMIP) 1-800-848-7280
Adults over 65 years old	No income requirements for those over 65 years old	Medicare/Social Security Administration 1-800-722-4134 or 1-800-772-1213
Anyone on Social Security Disability for 2 years or who has permanent kidney failure	There are income requirements for disability portion. Call the numbers listed here for more information.	Medicare/Social Security Administration 1-800-722-4134 or 1-800-772-1213

Note: Each of the programs listed at the top of this page have other eligibility criteria that apply. This information is provided as a service to consumers – you need to call the numbers listed in Table 2 to be assured the most current eligibility and application information.