Oregon Has 2nd Highest Medicaid Renewal Rate

With more than 85 percent of the state’s 1.5 million renewals complete, 5 out of 6 Oregonians are keeping their Oregon Health Plan (OHP) or other Medicaid benefits.

Oregon’s 85 percent renewal rate continues to be the second highest in a national comparison of state renewal rates by KFF, a nonpartisan health policy organization. KFF analysis also shows Oregon also has saved more people from unnecessary renewal paperwork than any other state via the automated renewal process. Oregon’s high renewal rates are also due to proactive efforts by the state to keep people covered, such as structuring the renewal schedule, extended response timelines, and the upcoming OHP Bridge program for adults with higher incomes.

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

At this point in the PHE unwinding process, Oregon has sent the initially planned 10 waves of renewal letters. About 6 percent of members are still responding to those initial waves. The remaining renewals, about 8 percent of the total, will occur over the summer.

Members who have not received a renewal yet should:

  • Keep their address and contact information up to date.
  • Check their mail or online ONE 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 via one of the ways to find help listed below.

Although most people are keeping coverage, approximately 200,000 people will lose or have reduced OHP 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 Oregon Health Insurance Marketplace is sending information to people who are no longer eligible for OHP benefits, advising of potential coverage options through the Marketplace.
  • People who have recently lost OHP benefits can enroll anytime until July 31, 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.

Extended unwinding schedule

On February 13, the federal government approved Oregon’s plan for the remaining roughly 107,000 renewals.

Many of these renewals were affected by a federal request for more than 30 states to review automated renewal processes, or restorations of some Oregon Supplemental Income Program Medical (OSIPM) benefits. A May 2024 update to Oregon’s automated renewal process will enable Oregon to use the new process for the remaining renewals.

Renewal letters will be sent to members in four waves between June and September. Members will still receive 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.

In the meantime, data about these renewals does not appear in the Medical Redeterminations Dashboard. For consistency, data below continues to use the December total number of members affected by unwinding.

February OHP renewal data

As of Feb. 17, 2024, 1,241,196 people have completed the renewal process. This represents 85.3 percent of all OHP and Medicaid members.

  • 1,029,357 people (83.6 percent) were renewed and kept their benefits.
  • 187,789 people (15.1 percent) were found ineligible.
  • 15,076 people (1.2 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.

Find help renewing your benefits

  1. Learn more about how to renew your Oregon Health Plan medical coverage.
  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.
  3. Visit or call a local Oregon Department of Human Services 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).

The large number of OHP renewals, along with renewals of long-term services and supports, may cause greater wait times, delays, and possible interruptions to people’s OHP benefits. The fastest way members can provide an update is by going to benefits.oregon.gov and logging into their ONE online account.

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. You can call the ONE Customer Service Center at 800-699-9075 (toll-free, all relay calls accepted) or find other options to connect at benefits.oregon.gov. 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 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 https://OregonHealthCare.gov/GetHelp to find professional help near you.

The Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) are committed to transparency and will continue to send monthly information about medical coverage among Oregonians as the agencies continue to track the programs. 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.

Source: Oregon Health Authority

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