| Applicant and Member Information |
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| What is FHIAP? |
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FHIAP is a state program that helps uninsured Oregonians buy health insurance. FHIAP is not an insurance company. Instead, the agency gives subsidies (grants of money) to help pay the monthly cost of your health insurance premium.
This helps individuals and families pay for insurance at work or buy individual health plans if insurance is not available through an employer.
FHIAP members pay part of the premium. They also pay other costs of private health insurance such as co-payments and deductibles.
Once approved for FHIAP, members are eligible to remain in the program for 12 months. Three to four months before the member's eligibility ends, FHIAP sends a new application and members may re-apply.
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| Example of the subsidy |
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The amount of money FHIAP pays for the health insurance premium depends on your family size and income. FHIAP pays from 50 percent to 95 percent of the premium. Here's an example of how the program works.
In this case, a parent with children faces a monthly premium cost of $500 without help from FHIAP but only $25 a month with FHIAP.
Monthly premium cost
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$500
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FHIAP subsidy level
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x .95%
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Amount FHIAP pays
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$475
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Individual pays
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$25
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Bottom line: FHIAP members, on average, pay $25 or less a month for the insurance premium.
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| Who is eligible? |
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You or someone in your family must:
- Be uninsured for the previous six months, unless you are leaving the Oregon Health Plan (OHP)/Medicaid program.
- Meet income guidelines
- Live in Oregon
- Be a U.S. citizen or qualified non-citizen
- Have investments and savings less than $10,000 (including rental property)
- Not be eligible for or receiving Medicare
Also, if you enrolled in your employer's plan less than 120 days ago, you may still be able to apply to FHIAP. Call 1-888-564-9669 (Toll-free in Oregon) for details.
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| How do I apply? |
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- Call our toll-free in Oregon number: 1-888-564-9669. There is a waiting list at this time; we will mail you an application as soon as there is an opening. We mail applications in the order we receive requests.
Habla espanol? Por favor, llame al 1-888-564-9669.
Be sure and call us BEFORE you sign up for health insurance. We can only provide money to you if you have been without insurance for the past six months or are leaving Oregon Health Plan.
When you receive the application, you may have questions. Call us: 1-888-564-9669 (Toll-free in Oregon). We have someone to answer your questions from 9 a.m. to 5 p.m. Monday through Friday. Also, we can put you in touch with a local health insurance agent (producer) who can help you with the application.
Mail your completed application to FHIAP. FHIAP will let you know within 30 days whether you qualify for a subsidy or we need more information. If you qualify for a subsidy, your FHIAP approval letter will tell you the amount of your subsidy and explain how to sign up for health insurance.
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| Now I have my FHIAP subsidy, how do I apply for health insurance? |
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Once you are approved for a FHIAP subsidy, this is how the program works.
Group Insurance (for those who get insurance at work):
- You and/or family members sign up for health insurance at work. (Your employer will take money out of your check for health insurance).
- You mail or fax FHIAP a copy of your pay stub every time that you get paid. Within four business days, FHIAP sends you a check for its share of the premium.
Individual Insurance (if your family doesn't get insurance through an employer):
- Select a health plan from the list we send with your approval letter. If you want, call us for the name of an insurance agent (producer) who will help you. This help is free! 1-888-564-9669 (Toll-free in Oregon).
- Contact the insurance company for an application. Fill out the insurance company application. Send the "Certificate of Eligibility" with your insurance application. (We send the certificate with your approval letter).
- The certificate tells the insurance company not to bill you. Instead, FHIAP will send you a bill for your share of the monthly premium.
FHIAP "roadmap" to individual insurance (.pdf)
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| Other program information |
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- Producer referral program: If you need the assistance of a health insurance producer to help you sort out the many insurance options available to you, please feel free to call our toll-free in Oregon number at (800) 542-3104, ext. 85244. This service is available at no cost to you. Our trained producers can show you options for both the self-employed business owner (individual plans) or Small Employer Health Insurance (SEHI) plans that can fit the needs of your business.
- Insurance companies: These are the insurance companies offering individual coverage to FHIAP members.
- Publications and forms: Publications and forms for applicants and members in FHIAP.
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| Frequently asked questions |
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Why do I have to be uninsured for six months to qualify for the FHIAP program?
About 17 percent of Oregonians are uninsured. FHIAP is attempting to reach those who have the most desperate need for insurance.
What months pay stubs do I need to send to FHIAP as proof of income?
For proof of income, send three full months worth of pay stubs. For example, if you sign your application in March, send proof of income received for December, January and February. We do not need March information. Self-employed persons, farmers, fishermen and ranchers have different income rules. Call 1-888-564-9669 (Toll-free in Oregon).
What counts as investments and savings?
Investments that FHIAP counts toward the $10,000 asset limit include checking accounts, savings accounts, cash, certificates of deposits, stocks, bonds, money market accounts and property that you do not live in. FHIAP does not count retirement accounts such as IRAs, vehicles or the house you live in. We do count any other real property that your family owns. Real property includes residential, commercial, rural and timber property.
When is my application due?
When applying to FHIAP for the first time, you have 60 calendar days to return the completed application to FHIAP. The 60 days start when FHIAP mails the application; the due date is on a letter that comes with the application.
Subsidy eligibility is good for a year. When you re-apply to see if you qualify for the program another year, you have 30 calendar days to complete and return the application. The due date will be on your application letter.
I have diabetes or other health issues and I can't get insurance - can you help me?
Your FHIAP subsidy can be used to help pay the premium for the Oregon Medical Insurance Pool (OMIP). This program is for people who have been turned down for health insurance due to "pre-existing medical conditions." However, OMIP benefit plans have a six-month wait before coverage begins on pre-existing conditions, including pregnancy.
What happens if I am on an employer-sponsored (group) plan and I lose my job?
Contact FHIAP immediately. Your FHIAP subsidy may be able to help you continue health coverage. You must notify FHIAP of this change within 10 calendar days. See your Member Guide for a complete list of changes that must be reported within 10 calendar days.
If my income changes, do I need to report that?
Once you are enrolled in FHIAP, you do not need to report income changes during the year. However, once a year, each member must re-apply to FHIAP to continue in the program. At this time, changes in income will be looked at to determine your continued eligibility and subsidy level.
How do I let you know if my employer changes insurance companies or if my rate changes?
Contact FHIAP Member Account Services toll-free at 1-888-564-9669 (Toll-free in Oregon). We will send you a new "Enrollment Verification" form to have your employer complete.
Who do I contact if I have questions about my health insurance policy?
Your insurance company or the producer who sold the policy. The phone number for your insurance company is on your insurance card. Remember: FHIAP is not an insurance company; FHIAP is a subsidy program.
When I become eligible for Medicare, can I continue to receive a FHIAP subsidy?
No. If you are in FHIAP and become Medicare eligible, you can keep FHIAP until your original approval date expires. At that time, you will not be eligible for FHIAP.
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