More than 80% keep coverage as Oregon Health Plan eligibility checks near completion

By Nick Budnick (The Lund Report)
July 2, 2024 6 a.m.

Oregon health officials are nearing completion of a reinstated program of eligibility checks for the roughly 1.4 million people covered by the Oregon Health Plan, and 82.5 percent of those checked have been renewed so far.

Now, the state is reaching out to the remaining members of the program, which provides free care to low-income Oregonians using state and federal Medicaid funds. And it’s urging members of the program to check their mail for renewal notices, as well as their online benefits account.

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During the pandemic a federal rule intended to maintain coverage caused  states to pause their Medicaid eligibility checks. Last April, they resumed, and Oregon was expecting to disenroll as many as 300,000 people from the program.

So far about 230,000 have been disenrolled, and a survey by KFF, a nonprofit advocacy group, found that Oregon has been among the states the most successful at keeping people covered. In part that’s due to a  new program approved by the Legislature called “OHP Bridge” that launches next week and is intended to provide the working poor with coverage even if they don’t meet Medicaid eligibility standards. About 27,000 people who would have been found ineligible kept their coverage instead.

For those awaiting their renewal notices or seeking help with new coverage, the state offers the following advice:

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Need help renewing your benefits?

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.

This story was originally published by The Lund Report, an independent nonprofit health news organization based in Oregon. You can reach Nick Budnick at nick@thelundreport.org or at @NickBudnick on X.

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