Oregon Health Plan members to receive notices on changes to Medicaid

BEND, Ore. (KTVZ) -- About 600,000 Oregon Health Plan members are beginning to receive notices about federally required changes to Medicaid coverage, including new work or activity rules that will affect some adults beginning January 1st, 2027.

The Oregon Health Authority said the notices being sent this month are informational only, and members do not need to take action yet. The agency said members will receive more specific instructions before their next coverage renewal if information is needed.

Who may be affected

Starting January 1st, some Oregon Health Plan members ages 19 through 64 will need to meet work or activity requirements when applying for or renewing coverage.

Those requirements can be met through work, school, volunteer service, caregiving, job training or other qualifying activities. State information says people may meet the standard through at least 80 hours a month of qualifying activity, enrollment in school at least half-time or household income above $580 a month before taxes and deductions.

However, many members will not be subject to the new rules or may qualify for an exemption. The rules do not apply to several groups, including children and teens, people who are pregnant, people with Medicare or Supplemental Security Income, and people who qualify for Oregon Health Plan coverage based on disability or other factors.

Oregon also must send the initial notice to people who may ultimately qualify for exemptions, such as parents or caregivers of children younger than 14.

What members should do

OHA is encouraging Oregon Health Plan members to make sure their mailing address, phone number, and other contact information are current so they do not miss future notices.

Members can update their information through Benefits.Oregon.gov, by calling 800-699-9075, through the ONE Mobile app or by visiting a local Oregon Department of Human Services office.