March 5, 2024

OHA says more than 3/4 of Oregon Health Plan recipients keep benefits when eligibility is reviewed

SALEM, Ore. (KTVZ) – The latest renewal data shows that more than 3 out of 4 Oregonians who have come up for renewal on the Oregon Health Plan in recent months have kept their health coverage.

Less than 1 in 13 people ended benefits. In the remaining 13% of cases that have come up for renewal so far but have not yet been resolved, state workers are seeking more information or reviewing member responses. It is likely that many of those OHP members will keep their mask when they respond.

The renewal eligibility figures include people whose cases were determined to be eligible through automated reviews of income and other factors, as well as responses from people who were required to review and sign their renewal applications or respond to requests for information.

OHP renewal

During the COVID-19 pandemic, the federal government allowed states to keep people on Medicaid when they were eligible and annual eligibility renewals were not required. This flexibility ended when the public health emergency ended, and Oregon is going through the process to ensure that everyone on OHP is still eligible.

Everyone with OHP or other Medicaid-funded services and supports will receive a renewal notice by mid-2024. The notice will explain whether the member needs to provide additional information or take action to maintain coverage.

Oregon can process many renewals automatically. Some members need to provide additional information so we can determine if they are still eligible. Additional information requested of members may include documents such as pay items or a renewal packet that they are asked to review, sign and return.

July OHP renewal

As of July, 543,123 people came up to renew from April, which is 37% of OHP and Medicaid members. For the first time, we also have data on members who have responded to requests for information in previous months.

  • 419,663 people (77.3%) were fully renewed.
  • 39,610 people, (7.3%) were found to be ineligible and received 60 day termination notices. The first cover losses began at the end of June.
  • 11,027 members had a reduction in benefits (2%). Most of these members lost full OHP but were able to move to our Medicare Savings Programs that help pay their Medicare costs.
  • We are currently awaiting responses from 23,994 members (4.4%).
  • 48,859 members (9%) responded to their renewal, which is currently being processed by the state.

Are you or someone you know losing OHP?

  • First, review the case summary in your letter to make sure the information we used to make the decision was correct. If that information has changed, please contact the ONE Customer Service Center at 800-699-9075 (toll free, all relay calls accepted) and let us know. If the information on your file is correct and you disagree with the decision, you can request a hearing. Learn more about auditions here.
  • Explore options through an employer. If you, your spouse, or a parent are working, you may be eligible for health coverage through that employer. Talk to your manager or HR department to see if you qualify. You will have a special enrollment period to enroll in the middle of the year due to the loss of OHP benefits.
  • If you have or are eligible for Medicare: To help understand Medicare options, go to OregonHealthCare.gov/GetHelp to find an insurance agent or counselor at the Senior Health Insurance Benefits Assistance Program (SHIBA), or call SHIBA at 800-722-4134. SHIBA can help you choose the right Medicare options. If you need to sign up for Medicare for the first time, contact the Social Security Administration (SSA) at 800-772-1213 to sign up by phone or find a local office. You can also enroll in Medicare online at ssa.gov/medicare/sign-up
  • Nearly 80 percent of Oregonians qualify for financial assistance through the Health Insurance Marketplace. A visit OregonHealthCare.gov/WindowShop answer a few quick questions and find out how much you can save and how much coverage could cost you. You can also call the Marketplace Transition Help Center at 833-699-6850 (toll free, all relay calls accepted).
  • Need free local help figuring any of this out? A visit OregonHealthCare.gov/GetHelp to find professional help near you.

Keep Oregon Covered

Free materials are now available for partners to order KeepCovered.Oregon.gov.

The IS online library Materials can help our partners reach OHP members and other Medicaid recipients. The following are now available for free download and order: poster, marquee, flyer, and fact sheet, FAQs and toolkits available in Arabic, English, Korean, Russian, Simplified Chinese, Somali, Spanish , Tagalog, Traditional Chinese, Ukrainian, and Vietnamese. Coming next: Chuukese, Hmong, and Marshallese. There are short videos and audio messages as well as downloadable art for a pop-up banner.

Looking for help

  1. Learn more about how to renew your Oregon Health Plan medical cover.
  2. Call the ANY Customer Service Center: 800-699-9075 (all relay calls are accepted, and help is available in multiple languages).
  3. Stop by or call a local office. People can contact their local office at: https://www.oregon.gov/odhs/Pages/office-finder.aspx
  4. Visit a community partner for free personal help. To find one near you visit OregonHealthCare.gov/GetHelp (English) or orhim.info/ayuda (Spanish).

Get help finding alternative health coverage at OregonHealthCare.gov/GetHelp.

The Oregon Health Authority (OHA) and the Oregon Department of Human Services (ODHS) are committed to transparency and will continue to send monthly information about health coverage among Oregonians as the agencies continue to track the state progress in renewing eligibility for medical programs.

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