Abortion Access Plan

What is the Abortion Access Plan?

The Oregon Health Authority’s Abortion Access Plan will pay for abortion services for most people who have health insurance through Providence, or whose religious employers provide insurance that does not cover abortion. Please note that only members of Oregon-based health insurance plans that meet one of the two criteria below are eligible for coverage through the Abortion Access Plan.

In 2017, Oregon passed the Reproductive Health Equity Act (RHEA). RHEA requires health insurance plans regulated by the state of Oregon to cover reproductive health services, including abortion, without any out-of-pocket costs to the member. A full list of the health insurance plans that must comply with RHEA can be found under 'RHEA plan information' on the Department of Consumer and Business Services' website. However, RHEA specifically excluded the following health plans from these requirements:

• Health insurance plans that didn’t cover abortion in 2017. The main insurer that falls under this category is Providence. 

• Health insurance plans purchased by religious employers that do not include coverage for abortion because of their religious beliefs.

In order to ensure that these Oregonians have equitable access to coverage, RHEA directed the Oregon Health Authority to establish the Abortion Access Plan.

For People Seeking Abortion Services

The Abortion Access Plan may pay for your abortion services if:

• You have a Providence health insurance plan that doesn't cover abortion;

OR

• Your religious employer provides insurance that does not cover abortion;

AND

• You receive services from a provider who agrees to bill the Abortion Access Plan for services.

Get more information about where to find an abortion provider.

If you have any questions about the Abortion Access Plan, please email rh.billing@oha.oregon.gov

For Abortion Providers 

You are eligible to receive reimbursement for providing abortion services to people enrolled in a health insurance plan described above if you meet at least one of the below criteria:

• You are enrolled with the Oregon Health Authority as an OHP provider.

• You are certified with the Oregon Reproductive Health Program as an AbortionCare agency.

• You have an active vendor account with the state of Oregon.

If you don’t meet one of these criteria but you want to become eligible to receive reimbursement, please contact us at rh.billing@oha.oregon.gov prior to submitting a claim so that we can determine your eligibility and create a vendor account for you.

To submit claims to the Abortion Access Plan for reimbursement, please:

• Review the Oregon Administrative Rules 333-004-4000 through 333-004-4130 that describe the Abortion Access Plan’s eligibility requirements and terms for participation.

• Download the Abortion Access Plan claims form.

• Complete the yellow shaded fields of the claims form. 

• Submit the claims form via email to rh.billing@oha.oregon.gov. Please do not include any individually identifiable client information in the email.

Payments are typically processed within 45 days of receiving the claims form.

Additional tools for providers:

• Abortion Access Plan Benefit Check Flowchart
  

• Abortion Access Plan Information, FAQs, and Scenarios
  

• Instructions for Completing the Abortion Access Plan Claims Form

Email us at rh.billing@oha.oregon.gov if you have questions. Please do not include any individually identifiable client information in the email.