OHA: Latest data shows more than 7 of 10 Oregonians keeping medical benefits as state reviews eligibility

SALEM, Ore. (KTVZ) – The latest renewal data continues to show that more than 7 out of 10 Oregonians are keeping their Oregon Health Plan or other Medicaid benefits. So far, around 1 in 8 people’s benefits are ending.  

Compared with other states, Oregon has the third-lowest benefit closure rate in the nation among  completed renewals. Learn more about the steps Oregon is taking to expand access to health coverage.

OHP renewals after the pandemic

During the COVID-19 pandemic, the federal government allowed states to keep people on Medicaid and did not require annual eligibility renewals. This ended when the public health emergency ended, and Oregon is currently 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.

OHP renewals so far

Between April and September 21, 807,765 people have come up for renewal. This represents 55.3% of all the OHP and Medicaid members whose eligibility will be reviewed.

• 522,613 people (70.1%) were renewed. Some of these members will also need to provide information to keep their benefits; these members will be recategorized in an upcoming update to our Medical Redeterminations Dashboard.
• 96,530 people (12.0%) were found ineligible and received 60-day notices of termination. Losses of coverage began at the end of June.
• 23,770 people (2.9%) had a reduction in their benefits. Most of these members lost full OHP but were able to continue our Medicare Savings Programs that help pay their Medicare costs.
• We are currently awaiting responses from 12,262 people (1.5%).
• Renewals for 109,218 people (13.5%) are awaiting state action. For instance a member has responded to their renewals and the information needs to be reviewed.

September OHP renewal requests

In September, renewal letters were sent to an additional 142,934 people. 

• 102,700 of those people (71.9%) were renewed without any action needed.
• 30,922 people (21.6%) were asked to provide some information to renew. The most common requests are for income-related proof, like paystubs, or forms of identification, like a government identification or birth certificate.
• 11,231 people (7.9%) were asked to fill out a renewal form.
• 8,123 people (5.7%) had previously reported that they no longer met income limits or other requirements, so received a notice that their benefits will be ending in 60 days.

What to do if OHP is ending:

• First, review the case summary in your letter to make sure the information used to make the decision was correct. If that information has changed, notify the state. You can call the ONE Customer Service Center at 800-699-9075 (toll-free, all relay calls accepted) or find other options to connect at benefits.oregon.gov. 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 counselors and insurance can help you choose the right Medicare options if you’re losing OHP coverage.

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 Oregon 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.

Act right away when it’s your turn to renew

Renewal notices are going out through mid-2024. If you have OHP or other Medicaid benefits, check your mail often for a letter from the state of Oregon. When receiving a letter, you should do what it asks right away to protect your benefits.

The large number of OHP renewals, along with renewals of long-term services and supports, may cause greater wait times, delays, and possible interruptions to people’s OHP benefits. OHP members are encouraged to respond as quickly as possible after they receive a request for information to avoid any possible delays. The fastest way members can provide an update is by going to benefits.oregon.gov and logging into their ONE online account. 

Find help for renewing your benefits

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).

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 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