OAR 945-040-0020: Eligibility for Enrollment in a Qualified Health Plan in the Individual Market

(1) To qualify for enrollment in a qualified health plan in the individual market, an applicant must: (a) Be a United States citizen or national, or a lawfully present non-citizen; (b) Be a resident of Oregon; and (c) Not be incarcerated. Incarceration pending the disposition of charges is not a disqualifying factor. (2) To qualify for enrollment in a qualified health plan that is a catastrophic plan, in addition to meeting the requirements of (1), an applicant must either: (a) Have not attained the age of 30 before the beginning of the plan year; or (b) Have a certification showing that he or she is exempt from the requirement to maintain minimum essential coverage for the plan year for which he or she is applying by reason of: (A) Lack of access to affordable coverage, in accordance with §5000A(e)(1) of the Internal Revenue Code; or (B) Hardship, in accordance with §5000A(e)(5) of the Internal Revenue Code.