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

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

Fewer than 1 in 13 people’s benefits ended. 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 members’ responses. Many of those OHP members are likely to retain their coverage once they respond. 

The renewed 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 Renewals

During the COVID-19 pandemic, the federal government allowed states to keep people on Medicaid once they became eligible and did not require annual eligibility renewals. This flexibility ended when the public health emergency ended, and Oregon is currently going through the process of making sure everyone on OHP is still eligible.  

Everyone who has 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 keep their coverage. 

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

July OHP Renewals

As of July, 543123 people have come up for renewal since April, representing 37% of OHP and Medicaid members. For the first time, we also have data on members who responded to requests for information in previous months. 

• 419,663 people (77.3%) were fully renewed.
• 39,610 individuals, (7.3%) were found ineligible and received 60-day notices of termination. The first losses of coverage began to occur at the end of June.
• 11,027 members (2%) had a reduction in benefits. 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%) have responded to their renewals, which the state is currently processing.

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, contact the ONE Customer Service Center at 800-699-9075 (toll-free, all relay calls accepted) and let us know. If the information on file for you is correct and you disagree with the decision, you can request a hearing. Learn more about hearings 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 Human Resources department to see if you qualify. You will have a special enrollment period to enroll mid-year due to loss of OHP benefits.
• If you have or are eligible for Medicare: For help understanding Medicare options, go to OregonHealthCare.gov/GetHelp to find an insurance agent or a 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 enroll 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 help through the Health Insurance Marketplace. Visit OregonHealthCare.gov/WindowShop to answer a few quick questions and find out how much you can save and how much coverage may 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? Visit OregonHealthCare.gov/GetHelp to find professional help near you.

Keep Covered Oregon

There are now free materials available for partners to order on KeepCovered.Oregon.gov.

The online library of materials can help our partners reach OHP members and other Medicaid recipients. The following are now available for downloads and free orders: poster, table tent, 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 also short videos and audio messages as well as a downloadable art for a popup banner.    

Finding help

1. Learn more about how to renew your Oregon Health Plan medical coverage.
2. Call the ONE 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 find their local office at:  https://www.oregon.gov/odhs/Pages/office-finder.aspx
4. Visit a community partner for free, in-person help. To find one near you visit OregonHealthCare.gov/GetHelp (English) or orhim.info/ayuda (Spanish).

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

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

• To learn more about the marketplace, visit http://oregonhealthcare.gov/ or call 833-699-6850 (toll-free, all relay calls accepted).
• To sign up for Medicare, call the Social Security Administration at 800-772-1213 or go to ssa.gov/medicare/sign-up