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Oregon Health Insurance


Oregon Medical Insurance Pool (OMIP)

HomeQualifying Conditions | EligibilityProvider Directory | Exclusions | Plan information and Enrollment Form

Benefits: OMIP Plan 750 | OMIP Plan 1000 | OMIP Plan 1500 | FMIP Plan 500 | FMIP Plan 750

Rates: OMIP Plan 750 | OMIP Plan 1000 | OMIP Plan 1500 | FMIP Plan 500 | FMIP Plan 750

Oregon Medical Insurance Pool (OMIP)

FMIP Benefit Limitations And Exclusions OMIP Benefit Limitations And Exclusions

FMIP contracts place some exclusions and limitations on the benefits available for the treatment of certain conditions and the use of certain procedures. These exclusions and limitations are explained in the FMIP contract under Benefit Exclusions and Benefit Limitations.

Under no circumstances will FMIP pay more than $2 million in lifetime benefits for any enrollee. This amount applies to all contracts and is reduced by benefits paid under any prior FMIP contract.

Following is a BRIEF list of contract exclusions:

  • Abortion (except as defined in the FMIP Contract)
  • Acupuncture
  • Appliances or equipment primarily for comfort or convenience
  • Charges in excess of reasonable amounts for services and supplies
  • Chiropractic care
  • Cosmetic or reconstructive surgery
  • Custodial care
  • Dental examinations and treatment
  • Experimental or investigational procedures
  • Family planning services and supplies
  • Hearing aids (except as defined in the FMIP Contract), eyeglasses, and contacts
  • Massage or massage therapy
  • Naturopathic medicine and treatment
  • Off the shelf orthopedic shoes and orthopedic inserts
  • Orthognathic surgery (except as defined in the FMIP Contract)
  • Transplant ($250,000 max. per transplant)
  • Treatment for obesity or weight control (except as defined in the FMIP Contract)

OMIP contracts place some exclusions and limitations on the benefits available for the treatment of certain conditions and the use of certain procedures. These exclusions and limitations are explained in the OMIP contract under Benefit Exclusions and Benefit Limitations.

Under no circumstances will OMIP pay more than $2 million in lifetime benefits for any enrollee. This amount applies to all contracts and is reduced by benefits paid under any prior OMIP contract.

Following is a BRIEF list of contract exclusions:

  • Acupuncture
  • Appliances or equipment primarily for comfort or convenience
  • Charges in excess of reasonable amounts for services and supplies
  • Chiropractic care
  • Cosmetic or reconstructive surgery
  • Custodial care
  • Dental examinations and treatment
  • Experimental or investigational procedures
  • Family planning services and supplies
  • Hearing aids (except as defined in the OMIP Contract), eyeglasses, and contacts
  • Massage or massage therapy
  • Naturopathic medicine and treatment
  • Off the shelf orthopedic shoes and orthopedic inserts
  • Orthognathic surgery (except as defined in the OMIP Contract)
  • Treatment for obesity or weight control (except as defined in the FMIP Contract)

 

But please remember to read through the OMIP packet carefully before making a decision.

This information is taken from the Oregon Department of Consumer and Business Services web site. Every reasonable effort is made to assure the accuracy of the information provided here.  InsuranceQuest, LLC is a licensed and independent agency that can assist consumers in securing this coverage.

Oregon Health Insurance

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Oregon Health Insurance