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Low-Cost Family Insurance

Please help Megan with any suggestions you may have:

I'm new to Oregon and am looking for low-cost insurance for my family.  I'm looking for a good insurance agent that can help me navigate the Oregon Health Plan or other options for my kids, one has cerebral palsy.

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My understanding is that for OHP you would either go through a Department of Human Services office to apply - http://www.oregon.gov/DHS/healthplan/app_benefits/main.shtml or you could apply for Social Security and that would possibly help qualify your child with cerebral palsy for OHP. http://www.ssa.gov/ssi/

Many hospitals have financial counselors who can help you with this...I work at Adventist Medical Ctr and I know their financial counselors are able to help people get hooked up w/OHP and various other programs/insurance plans as well as certain types of charity care and discounts.

http://www.adventisthealthnw.com/pages/PtBilling_FinAssistPol.asp

Providence has a similar program (i think they all do) and I know sometimes it is easier to navigate all that paperwork with some help!
http://www.providence.org/oregon/Programs_and_Services/Financial_Assistance_Program/default.htm

Welcome to Oregon! There is general information about the Oregon Health Plan and other public benefits posted at www.oregonlawhelp.org (Click on "Government Benefits" and then on "Medical Benefits" for OHP info).

You may want to contact the Oregon Advocacy Center (OAC), a non-profit law office serving people with disabilities, for more information on accessing Oregon Health Plan benefits for you and your kids. Call 503-243-2081 to be scheduled for a phone appointment with one of their intake specialists. The intake specialist can also advise you about applying for services that your child with CP may be eligible for, either from the school district or from the county developmental disability program.

It is generally easier for kids to qualify for OHP than adults, so you may not need to establish that your child with CP is a person with a disability in order for him/her to qualify for OHP. However, if you do need to establish his/her disability, and she/he is not already receiving SSI or Social Security, I would recommend holding off on the SSI/Social Security application process until after you have gone through the OHP application process. The reason for this is that if your child is denied SSI/Social Security (which is extremely common at the initial application stage, regardless of the severity or extent of disability), the state is bound by that denial and cannot offer OHP on the basis of disability. On the other hand, if there has been no denial by the Social Security Administration, the state must do its own evaluation of disability, and their process tends to be much faster and more favorable than SSA's process.

If you or your kids are denied any of the benefits or services you apply for, contact OAC or Legal Aid Services of Oregon for further advice and possible free legal representation to appeal the denial. Good luck!

Great! Thanks so much everyone! - Megan

Hey thought I would put in my two cents: We had something crazy happen with my husbands insurance for our son and had to go find insurance on our own until next year. My naturopath mentioned this woman. All insurance agents of course have something to gain, but my naturopath is someone who's opinion I really trust. Sue was very nice, didn't try to up sell me anything, and was very straight forward. I haven't talked to her since so I am not super budy-budy with this lady but she did her job well and outside of the stereotype.

Sue Ober
phone: 503-642-2706

Just to add regarding Social Security applications. If you are denied, appeal ASAP. Continue through the appeals process until you get accepted. In many cases, they will award you payment retroactively to the date of first application. It is typical for SS to deny the majority of applicants on their first or second try. The burden of proof is on the disabled person. Good luck. I am a community social worker and I think all the resources listed here are excellent.

It is good to hear that one can now apply for a low cost insurance. It's a reality that not everyone can afford for an insurance with a much higher value.

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