OHA: Most Oregonians have been able to keep their Oregon Health Plan, Medicaid benefits; system update will help

SALEM, Ore. — With over 91 percent of the state’s 1.5 million renewals complete, more than four out of five Oregonians are keeping their Oregon Health Plan (OHP) or other Medicaid benefits.  

An update this month to the ONE Eligibility system will enable Oregon to use an improved process for the remaining renewals. These changes are a substantial set of small adjustments to the renewal process that together will make it easier for the people of Oregon to keep their medical benefits. 

During the COVID-19 Public Health Emergency (PHE), which ended in April 2023, the federal government allowed states to keep people on Medicaid benefits. This ended when the pandemic emergency ended, so over the last year Oregon has been making sure everyone on OHP is still eligible. 

At this point in the PHE unwinding process: 

• Just 443 members, about 0.03 percent, still need to respond to renewal requests. 
• 7,473 members, about 0.5 percent, have responded to their renewal but are awaiting state action on the response. 
• The remaining renewals, about 8.3 percent of the total, will occur over the summer. 

Oregon’s 82 percent renewal rate continues to be the third highest in a national comparison of state renewal rates by KFF, a nonpartisan health policy organization. Oregon’s high renewal rates are due to proactive efforts by the state to keep people covered, including extended response timelines, and the upcoming launch of OHP Bridge for adults with higher incomes. 

Members who have not received a renewal yet should: 

• Keep their address and contact information up to date. 
• Check their mail or ONE Online account for their renewal letter. 
• Do what the renewal letter asks as soon as possible. Anyone concerned they missed their letter should get help with their renewal using one of the options listed below. 
• Members who did not respond to renewals can still re-open their case three months after it closes if they are still eligible, and they can reapply at any time. 

Although most people are keeping coverage, approximately 240,000 people will lose or have reduced medical benefits and need to consider other coverage options. 

• People who do not have coverage through an employer or Medicare may be able to enroll through the Oregon Health Insurance Marketplace and get financial help. Most people who enroll through HealthCare.gov qualify for this help. 
• The Marketplace is sending information to people who are no longer eligible for OHP benefits, advising of other potential coverage options. 
• People who have recently lost OHP benefits can enroll anytime until November 30, 2024, or within 60 days of their benefits ending. 
• For more information and ways to get help signing up for Marketplace, Medicare, or employer coverage, see “What to do if OHP is ending” below. 

Remaining renewals

Renewal letters will be sent to members in four waves between June and September. Members will still have 90 days to respond, and 60 days’ advance notice before any termination or reduction in benefits. This means the final responses would be due in December 2024, and the final closures will happen in February 2025. 

Data about pandemic unwinding renewals appears in the Medical Redeterminations Dashboard.  The dashboard data and these press releases will not include renewals for OHP members who have already renewed early in the unwinding process, who are coming up for renewal again. Over time, Oregon is switching to renewing most OHP members every two years instead of annually. 

May OHP renewal data

As of May 17, 2024, 1,323,772 people have completed the renewal process. This represents 91.2 percent of all OHP and Medicaid members. 

• 1,085,635 people (82 percent) were renewed and kept their benefits. 
• 224,014 people (16.9 percent) were found ineligible. 
• 14,123 people (1.1 percent) had a reduction in their benefits. Most of these members lost full OHP but were able to continue Medicare Savings Programs that help pay their Medicare costs. 

Need help renewing your benefits?

1. Learn more about how to renew your Oregon Health Plan medical coverage.  You can log into your online portal and complete your redetermination work at benefits.oregon.gov.  
2. Call the ONE Customer Service Center at 800-699-9075. All relay calls are accepted, and help is available in multiple languages. Wait times are lowest between 7 and 8 a.m., PST. 
3. Visit or call a local Oregon Department of Human Services (ODHS) 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). 
5. Download the ONE Mobile application via the app store to keep track of your renewal, find a local office, or upload a document. 

What to do if your 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 via one of the options above If the information on file for you is correct and you disagree with the decision, you can request a hearing. Learn more about hearings. 
• 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 and choosing the right Medicare options, go to https://OregonHealthcare.gov/GetHelp to find an insurance agent or a counselor at the Senior Health Insurance Benefits Assistance Program (SHIBA). You can also call SHIBA at 800-722-4134. 

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, find out how much you can save and find out 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 finding other coverage? Visit OregonHealthCare.gov/GetHelp to find professional help near you. 

OHA and ODHS are committed to transparency and will continue to send monthly information about medical coverage among Oregonians. Check our ONE Eligibility Operations Dashboards for more frequent updates on medical renewal data and wait times for callers to the ONE Customer Service Center.