SALEM, Ore. (KTVZ) – The Oregon Health Authority and Oregon Department of Human Services are committed to transparency and will be sending monthly information about medical coverage among Oregonians as the agencies continue to track the state's progress in determining eligibility for medical programs.
When the COVID-19 pandemic began, the federal government allowed states to keep people on Medicaid once they became eligible and did not require annual eligibility renewals. During this historic health emergency, the Oregon Health Plan (OHP), Oregon’s Medicaid program, grew to nearly 1.5 million people.
In April, Oregon began the process of redetermining eligibility for everyone on OHP. While most people will continue to qualify for existing benefits, OHA is required to review eligibility for all OHP and Medicare Savings Program (MSP) members by mid-2024.
OHP redeterminations started in April
In April, Oregon began processing eligibility redeterminations for all 1.5 million members receiving OHP and other Medicaid-funded services and supports. The federal government requires Oregon to disenroll any members who are no longer eligible or fail to respond to renewal notices.
All OHP households will receive a renewal notice over the next 10 months. People are encouraged to check that their contact information is up to date so that they can be contacted by the state and receive renewal notices.
Oregon will be able to process many renewals automatically. This means that every OHP member will receive a renewal notice, and the notice will explain whether the member needs to provide additional information or take action to keep their coverage.
OHP members encouraged to respond quickly
Although the state has taken many steps to prepare, the large number of OHP redeterminations, along with renewals of long-term services and supports, is expected to 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 account.
Members losing OHP coverage have other coverage options and will receive at least 60 days advance notice. Many people will be eligible to enroll in health plans through the Oregon Health Insurance Marketplace (OHIM) with financial help. Other people may be eligible for Medicare or employer coverage.
April OHP redeterminations data
- April was the first month Oregon began processing medical renewals, during this reporting period: 133,232 individuals, or 75,436 cases have had their OHP renewed.
- 46,894 individuals, or 29,072 cases needed to provide more information to complete the process.
- 13,208 required individuals to review, sign and send back their renewal packet.
- 8,394 people were ineligible and received a 60-day notice of termination of coverage. When people are ineligible, they are referred to the Oregon Health Insurance Marketplace for other options for health care coverage.
Early data for May shows 66% of people will retain benefits.
Members losing coverage should report changes to their income or household information immediately if any of the information used to make the decision is inaccurate. They also should apply for other health coverage as soon as they know their coverage ending date to prevent a gap in coverage.
Data dashboards in place for tracking progress
Two new dashboards became available in April for the public to track Oregon’s progress.
- Medical Redeterminations Dashboard for tracking the state's progress in determining eligibility for medical programs. This dashboard is updated daily. The types of data in this dashboard will expand over the next few months.
- ONE Customer Service Center Dashboard for monitoring the customer service experience for people calling the ONE Customer Service Center to apply for or ask for help with medical, food, cash and child care benefits. The ONE Customer Service Center Dashboard is updated every day.
Extending health coverage
To get help, people can also:
- Learn more about how to renew your Oregon Health Plan medical coverage.
- Call the ONE Customer Service Center: 800-699-9075 (all relay calls are accepted, and help is available in multiple languages).
- Stop by a local ODHS office or Area Agency on Aging Office. People can find their local office at: https://www.oregon.gov/dhs/Offices/Pages/one-services.aspxm
- Visit a community partner for free, in-person help. To find one near you visit https://oregonhealthcare.gov/GetHelp (English) or orhim.info/ayuda (Spanish).
Get help finding other health coverage at OregonHealthCare.gov/GetHelp