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Health Care Benefits: Oregon

Health Care Benefits requirements for other states

Federal law and guidance on this subject should be reviewed together with this section.

Author: Iris Tilley, Barran Liebman LLP

Summary

  • Oregon initially chose to establish a wholly state-based Marketplace under the Affordable Care Act, but then switched to a state-based, federally-supported Marketplace. See Health Insurance Marketplaces Under the ACA.
  • Oregon has taken steps to preserve certain benefits made available under the Affordable Care Act. See Preserving ACA Benefits.
  • Same-sex marriage is legal nationwide. Oregon also recognizes domestic partnerships. See Same-Sex Partner Benefits.
  • Group health plans must provide mental health and drug abuse parity. See Alcoholism, Chemical Dependency and Mental Health Parity.
  • Group health plans must include coverage for certain pregnancy, maternity, and dependent coverage. See Maternity and Dependent Coverage.
  • Health services provided through synchronous two-way interactive video conferencing must be covered in certain circumstances. See Telemedical Health Services.
  • Insurance policies providing coverage for prescription drugs are required to cover specified drugs. See Prescription Drug Coverage.
  • Group health plans must provide coverage for certain cancer screenings and treatments. See Cancer Screenings and Treatments.
  • Insurers providing coverage for a mastectomy must also provide coverage for reconstructive surgery. See Mastectomy and Reconstructive Breast Surgery.
  • Health benefit plans must provide payment for hearing aids that are medically necessary for covered children. See Hearing Aids.
  • Individual and group health insurance plans must cover maxillofacial prosthetic services. See Prosthetic Services.
  • Group health plans must provide coverage for telemedical services for diabetes in certain circumstances. See Diabetes Coverage.
  • Health benefit plans must provide coverage for medical expenses (including rehabilitation services) for children under the age of 18. See Developmental Disorders.
  • Health benefit plans are prohibited from discrimination based on certain factors. See Discrimination Protections.