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1.    What is FHIAP?

FHIAP is a program enacted by the Oregon Legislature in 1997 designed to provide direct subsidies to pay private health insurance premiums for uninsured individuals and families whose income is at or below 185% of the federal poverty level.  The purpose of the program is to extend health coverage to families who are currently ineligible for Medicaid but who are unable to afford private health insurance.  The program does not pay deductibles, co-pays, or other co-insurance.

2.    Who is Eligible for FHIAP?

In order to be eligible to receive a subsidy a family or individual:

·        May not have been covered by private health insurance for at least 6 months. (This does not include the Oregon Health Plan (OHP))

·        Must have savings/investments of less than $10,000.  A primary residence, vehicles, and qualified retirement plans like IRAs and 401 Ks are excluded

·        Must have income at or less than 185% of the federal poverty level

·        May not be eligible for Medicare

·        Must be an Oregon resident

·        Must be a U.S. citizen or a non-citizen who has been or is:

(1)            A person who was admitted as a qualified non-citizen on or before August 22, 1996

(2)            A person who entered the U.S. on or after August 22, 1996 and it has been five years since he or she became a qualified non-citizen

(3)            A person who has obtained their qualified non-citizen status less than five years ago, but entered the U.S. prior to August 22, 1996. The non-citizen must show that he or she has been living in the U.S. continuously for five years from a date prior to August 22, 1996 to the date the non-citizen obtained their qualified status and did not leave during that five year period. If the non-citizen cannot establish the five-year continuous residence before he or she obtained their qualified status, the person is not considered to have entered the U.S. prior to August 22, 1996

(4)            Regardless when they were admitted, a person with one of the following designated statuses:

(a)               A person who is admitted as a refugee under section 207 of the INA;

(b)               A person who is granted asylum under section 208 of the INA;

(c)                A person whose deportation is being withheld under section 243 (h) of the INA;

(d)               A Cuban or Haitian entrant who is either a public interest or humanitarian parolee;

(e)               A person who was granted immigration status according to the Foreign Operations Export Financing and Related Program Appropriation Act of 1988;

(f)                 A person who is a victim of a severe form of trafficking

(5)            Regardless of when they were admitted, a qualified non-citizen who is:

(a)               A veteran of the U.S. Armed Forces, who was honorably discharged not on account of alien status and who fulfills the minimum active-duty service requirement; or

(b)               On active duty in the U.S. Armed Forces (other than active duty for training)

(c)                The spouse or unmarried dependent child of the veteran or person on active duty described in (5) (a) and (b)

(6)            An American Indian born in Canada to whom the provisions of section 289 of the Immigration and Nationality Act (8 U.S.C. 1359) apply; or

(7)            A member of an Indian tribe (as described in section 4(e) of the Indian Self-Determination and Education Act (25 U.S.C. 450b(e))

(8)            Any legal non-citizen who was approved for a FHIAP subsidy prior to November 1, 2004

An adult in the family will not be able to use a FHIAP subsidy unless all children in the family are covered under either FHIAP or another insurance program.

OAR 442-004-0050

3.    If I am eligible will I automatically receive a subsidy?

No.  FHIAP is not an entitlement program.  Funds exist to provide only a limited number of subsidies.  Subsidies are given on a first come, first serve basis, so applying early is recommended.

The Insurance Pool Governing Board, which is the agency administering the FHIAP program, maintains a waiting list of people who want to apply for FHIAP.  It is important to get on the list as early as possible.

OAR 442-004-0080

4.    How are Subsidies Determined?

A family's income is determined by averaging the previous three months of total earnings.  Subsidies are than given based on that income figure.

·        50% of premiums are paid for families with income from 170% to 185% of the federal poverty line

·        70% for families with income from 150-170% of the federal poverty line

·        90% for families with income from 125-149% of the federal poverty line

·        95% for families with income at or below 125% of the federal poverty level

OAR 442-004-0060

5.    How do I Apply?

·        First you must reserve a spot for yourself by placing your name on the reservation list.  This can be done by calling
1-888-564-9669 or filling out and mailing a reservation card.  Reservation cards can be found in many government offices or with approved insurance providers

·        An application letter with an application form will be mailed out as space in the program becomes available.  Once the application is received, it must be returned within 60 days from the date of the application letter

·        Once accepted to the program, you must choose a health insurance plan

OAR 442-004-0080

6.    What Type of Insurance Plan must I Choose?

·        If you are employed and your employer offers an insurance plan and contributes any money toward the premium, you are required to accept that health plan

·        If the employer does not contribute to the health plan, you are free to choose any FHIAP certified health insurance plan

·        If you are unemployed you may choose any FHIAP approved insurance program

OAR 442-004-0090

7.    Must all members of my family be covered under FHIAP?

No.  Different members of the family can be covered by different plans.  The only requirement is that children in the family must be covered by some insurance plan, FHIAP or another plan, before adults in the family will be eligible to receive a subsidy for health care coverage

OAR 442-004-0090; 442-004-0120

8.    Where can I get more information?

For more information, call the Public Benefits Hotline (1-800-520-5292) or your local Legal Aid Services Office for possible advice or representation.  Go to HERE for a directory of legal aid programs.