Oct. 26, 2023
In this update:
 
8 out of 10 people are keeping their medical benefits
More than half of all Oregon Health Plan (OHP) and Medicaid members have come up for renewal. Of these members:
- 668,265 people (82.5%) were renewed and kept their benefits.
- 111,998 people (13.8%) were found ineligible and received 60-day notices of termination. Losses of coverage began at the end of June.
- 25,714 people (3.2%) 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.
Oregon Department of Human Services (ODHS) also recategorized some renewals in the Medical Redeterminations Dashboard. People who renewed but still need to submit some information were previously categorized as completed renewals with continuing benefits. These renewals now appear as initiated renewals awaiting member response. With this change, renewal data can now focus on completed renewals.
This allows for state-by-state comparisons, which now show Oregon has the fourth-lowest benefit closure and reduction rate in the nation.
To learn more, including a summary of October renewal letters and how ODHS and Oregon Health Authority (OHA) are responding to renewal issues, read the latest news release:
Halfway point: What do the data tell us?
Oregon is now halfway through sending and processing renewals for people with OHP and other Medicaid benefits. The Medical Redeterminations Dashboard tells us that “Missing Requested Information” is one of the top reasons for closures during renewal. Oregon Health Authority (OHA) reviewed data about who is not responding to these requests. Certain groups seem to respond less than others:
- People who are houseless
- People with long-term services and supports
- Members over age 65
- People in North Coast, Portland metro, Hood River and Central Oregon
The most common requests not getting a response are:
- Annual income verification
- Earned income
- Interview
- Social Security number
- Pursuit of unemployment insurance (UI)
 The Marketplace Transition Project Dashboard shows that of the more than 61,000 people referred to the Marketplace, more than 54,000 may qualify for private health insurance through the Marketplace.
How to support members: Encourage them to send requested information or ask for help
Keeping members covered is our highest priority. Anyone who knows or works with Oregon Health Plan (OHP) members can help by encouraging members to respond to Requests for Information and renewal notices — even if they think they don’t qualify, don’t know if they got a notice, or don’t know how to respond.
- If members don’t think they qualify, we still want to help them get other health coverage if they don’t have any.
- If members don’t know if they got a notice, they may need to update their address with OHP.
- If members don’t know how to respond to a notice or what information to send, they can ask for help.
Some members may first get a letter saying their OHP is renewed, then get a Request for Information. Members need to respond to these requests, too.
Resources to help partners support members
The Keep Covered Partner Toolkit has key messages, phone script, social media posts and other resources you can use to support communications with members.
The ONE Notices Guides include examples of requests for information members may get in their renewal letter or a separate request for information letter. Guides are available in English and Spanish.
Incorrect approval notices update: Phone outreach and mailings completed
ODHS/OHA completed phone outreach to the 11,700 members who should have received a close notice in August, but instead got approval notices. The calls let members know what happened and what to do to keep their coverage beyond Dec. 31, 2023. The outreach:
- Made 10,561 calls to 8,455 numbers, including redials and calls to authorized representatives on file. 81 percent of these calls successfully reached the member, authorized representative or their voicemail.
- Included a redial campaign for the unsuccessful calls. This also included outreach to authorized representatives. Of the 2,106 redials, 548 resulted in successful outreach.
The member mailings about the incorrect approval notices are complete. Around 11,700 members received notices asking them to provide requested information to complete the renewal.
It will be here before you know it: open enrollment for 2024 health insurance.
- Open enrollment is the primary time of year when people who do not have coverage through a job, OHP, or Medicare can enroll through the Marketplace.
- People losing OHP benefits can enroll without waiting for open enrollment, and through July 31, 2024.
The Oregon Health Insurance Marketplace offers quality private health plans from well-known health insurance companies: Bridgespan, Kaiser Permanente, Moda Health, PacificSource Health Plans, Providence Health Plan, and Regence. All Marketplace health plans:
- Include a robust set of health benefits, even before deductibles are met.
- Include services like preventive and wellness care, and little-known services like visits to naturopaths, chiropractic and acupuncture.
The only way to know if your doctor or prescription is covered is to look. OregonHealthCare.gov offers a quick and easy-to-use window-shopping tool for people to:
- Preview what plans and savings are available to them.
- See which plans cover their prescription drugs.
- See which plans network with their preferred doctors or hospitals.
OregonHealthCare.gov also has a tool to help you figure out if coverage offered from an employer is considered unaffordable. This may open the gate for financial help through the Marketplace.
Health coverage experts are available to make signing up for health coverage and choosing a plan less stressful. Their help is entirely free. Find licensed insurance agents and trained community groups at OregonHealthCare.gov/GetHelp.
Oregon issuing an additional $43 million in Pandemic EBT food assistance to 99,000 young children
Families who received Supplemental Nutrition Assistance Program (SNAP) benefits between Sept. 1 2022, and May 11, 2023, will receive these P-EBT food benefits for each child aged 5 or younger:
- An extra $67 for every month between September 2022 and April 2023, and
- An extra $30 for May 2023.
Families can receive up to $566 in P-EBT food benefits for each child who is eligible.
- If they still receive SNAP benefits, families got the P-EBT benefits on their EBT card Oct. 17.
- If they no longer receive SNAP benefits, families will get a notice in the mail. ODHS will add the P-EBT benefits to the EBT card associated with each family’s household. If families no longer have their EBT card they can request a replacement card by calling 855-328-6715.
ONE Customer Service Center wait times and alternate options
The ONE Customer Service Center is where people can get help with their medical, food, cash and child care benefits over the phone.
Right now, call wait times for people are high for two reasons:
- An unprecedented number of people have applied for benefits.
- The federal COVID-19 Public Health Emergency has ended, and the state must make sure that people are still eligible for OHP and other Medicaid benefits.
Please consider sharing a new flyer that lists all the ways people can get help with benefits. It’s available in English and Spanish at Benefits.Oregon.gov.
For people who want to call, the ONE Customer Service Center is open Monday through Friday from 7 a.m. to 6 p.m. Pacific Time.
Call wait times are lowest in the morning between 7 and 8, especially on Tuesdays.
That number is 1-800-699-9075.
People also can call one of 16 toll-free numbers to get services in their chosen language. Callers who use a Help in Your Language line will hear a greeting in their chosen language. They will be connected with an interpreter before their call is sent to ONE Customer Service Center staff.
Dashboards with the latest wait times and medical renewal information are available online here.
Join ODHS and OHA for webinars about how the two agencies are working together to wind down the COVID-19 Public Health Emergency.
- Food benefit updates: P-EBT and SNAP Able-Bodied Adults Without Dependents (ABAWD) time limits
- Medical renewals updates: Current status and recent issues
- Open enrollment through the Marketplace
Webinars are held in English and Spanish from 10 to 11 a.m. Pacific Time.
Language and disability access:
American Sign Language and live captioning will be available for these webinars.
Everyone has a right to know about and use ODHS and OHA programs and services. ODHS and OHA provide free help. For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. If you would like help to participate in the webinar, contact the Feedback Team at 503-945-5488 or feedback@odhsoha.oregon.gov at least two business days before the webinar. All relay calls accepted.
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