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Oregon Health Insurance Cons

Written by Kathleen Gagne
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There are 67 health insurance companies licensed in the state of Oregon, and they offer a wide variety of plans and rates that can get pretty confusing, especially if you don't understand the pros and cons of each plan you are considering. Some of the factors you will want to investigate are the kinds of plans that might work for you, their benefits, and the costs both to you as an individual (or as a small business owner) and to your employees. You must look for a plan that offers appropriate benefits at a reasonable cost.

Consider a traditional indemnity plan. These are easy to use, but they often have a high deductible. They work well if you rarely visit a doctor and need little more than an annual checkup. With an indemnity plan, participants have their choice of doctors. The downside is that, if you need more extensive medical care, you are responsible for all costs up to the time you meet your deductible.

HMO plans are also relatively easy to use. For employees, they are less expensive because they require only a small co-pay for each doctor visit. The biggest complaint about HMOs is that participants must use doctors who are in the HMO network. This can mean changing a primary physician and generally includes getting a referral to visit a specialist.

Other Oregon Health Insurance Cons

If you're thinking about going with a Preferred Provider Organization (PPO), you will find a much wider choice of physicians and specialists. Unlike an HMO network, PPOs allow you relatively easy access to health care when you travel. The Oregon health insurance cons related to a PPO are that, if your primary physician is not in the network, your out-of-pocket costs will be higher by as much as 20%.

Think about adding a Flexible Health Spending Account. These accounts require an employee contribution up to a set amount to be deducted from their paycheck for one year. One great aspect of these accounts is that you can use the account money for some non-traditional medical treatments. Many employees set the amount at the same level as their deductible. Employees must submit a request for a reimbursement each time they pay for medical services. This can be considered a negative aspect of the plan, but the employee will receive the reimbursement for the money they paid until their annual deducted amount is exhausted, even if they have not yet made the full contribution. The real downside of these plans is that, if you don't use all of the money you have deducted from your pay, it is not returned to you at the end of the year.


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