Open Enrollment for the purchase of qualified individual/family health insurance will run from November 1, 2026 to January 15, 2027. If you enroll in a plan between November 1 and December 31, your plan will be effective January 1, 2027. If you enroll between January 1 and January 15, your plan will be effective February 1, 2027. For those of you who purchase your own health insurance, this is likely the only opportunity for you to buy or change an Affordable Care Act qualified health plan.
Special Enrollment Periods are available for people who lose coverage due to life-changing events such as job loss or moving out of the plan’s service area. Please note that you will not be able to enroll in a qualified insurance plan after the open enrollment period unless you first lose coverage and enroll within 60 days of the event.
Beginning in 2027, the State of Oregon will have its own health insurance marketplace – Explore Health. We will no longer use the Federal marketplace (healthcare.gov). If you used healthcare.gov in 2026, Explore Health will establish an account for you, and you will use it much like your account on healthcare.gov. Through your account, you will be able to update your information and enroll in or change your health insurance plan.
If you purchased your health insurance through healthcare.gov in 2026 and your plan will no longer be offered, Explore Health will crosswalk you to a suggested new plan. Crosswalking is the process of automatically moving a consumer into a similar health plan when their current Marketplace plan is no longer available for the upcoming plan year. Explore Health will use crosswalking to help make sure consumers don’t lose coverage simply because their current plan is no longer offered. During open enrollment, you should review the suggested plan and determine if you should change to a different plan.
If you purchased your coverage directly from the insurance company, you are not affected by the change to Explore Health. However, you will need to enroll in new coverage if your health insurance company no longer offers plans in your county.
Kaiser, Moda and Regence will continue to be offered in many Oregon counties. Providence Health Plans and PacificSource will no longer be available to individuals buying their own insurance. If you are losing coverage because your insurance company is no longer offering plans, Regence or Moda will likely cover your medical provider.
The average rate increases for the companies offering individual and family insurance are as follows. Please note that these are averages, meaning that you may see lower or higher increases for your coverage.
- Moda – 25%
- Regence – 12.2%
- Kaiser – 12.2%
Please note:
- All Bronze plans offered in the individual market will continue to be Health Savings Account (HSA) qualified, allowing consumers to contribute to a special savings account that can be used to pay for eligible medical expenses with pre-tax dollars.
- Some plans continue to offer the first three primary care doctor office visits for $5 per visit.
- Check to be sure that your doctors remain in-network. Doctors can leave certain networks, and insurance carriers can change their networks as well.
- Other than increased premiums and higher deductibles, co-pays, and out-of-pocket maximums, your plan may not have changed much.
- The shopping tool developed specifically for Oregon may provide more Oregon-friendly plan information. You can access this site at www.OregonHealthCare.gov/WindowShop.
Helpful Hints
Establish your primary care doctor before you get sick. It can take 6 weeks or longer to get an appointment with a new primary care doctor. If you have not established your primary care doctor and need to see a provider quickly, you may need to seek treatment at an urgent care clinic.
Many insurance carriers now offer telemedicine and express care options at low or no cost for minor ailments. Be sure to review what your plan offers before you get sick or injured so you know when and how to use these services.
Stay in-network. Most individual plans offer in-network coverage only – except in the case of an emergency. If you go to an out-of-network provider in a non-emergency situation, you’ll likely pay the full cost of that service.
Review the benefits your plan offers. Many of the insurance carriers offer benefits not included in the summaries you look at when you’re selecting your plan.
In Conclusion
Remember, agents and brokers are available to you at no cost. Feel free to reach out for a second opinion if you are unsure of the person you are working with or the product they are offering. Select Wisely is local, we know the market and we’re happy to help you.
As always, our goal is to help you Select Wisely, so please give us a call to schedule a time to review your health insurance options. We look forward to hearing from you.
