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March 19, 2003 Contact: Jim Sellers (503) 945-5738 Program contact: Jim Edge (503) 945-5769 State reminding 27,535 to pay Oregon Health Plan premiums Letters are being mailed today warning 27,535 Oregon Health Plan "Standard" clients that they will lose coverage if their February premiums aren’t paid by March 25. This is a result of the Health Plan’s new policy of requiring those it insures to pay premiums by the 25th of the following month or lose coverage. "We’re operating more like a private insurance plan," said Lynn Read, state Medicaid director in the Oregon Department of Human Services (DHS). "Loss of coverage would be a consequence of not paying premiums to an insurance company." Those who fail to pay February’s premiums by March 25 will be required to wait six months and to pay the owed premium before they can re-enroll. The Standard plan covers more than 100,000 low-income adults whose sliding-scale monthly premiums range from $6 to $20, with nearly half paying the lowest premium. Read said clients had received two billings and five notices explaining that coverage would be lost if premiums were not paid. Other Feb. 1 changes in the Standard plan included co-pays and a somewhat slimmer benefit package. Unlike insurance companies, Read said, the Health Plan still has no deductible or co-insurance requirements. "The revenue from these premiums is part of the reason we can cover as many people as we do," Read said. About $847,000 in premiums is billed each month. Read said the Health Plan has a record of 30 percent of clients paying premiums on time, and that for February the rate more than doubled. She said it is impossible to know how many of those who haven’t paid have decided not to continue coverage because they landed a better job or are no longer attracted to the plan because of further reduced benefits. (As a result of DHS budget cuts, dental, outpatient mental health, outpatient chemical dependency treatment, and medical equipment and supplies were eliminated from Standard coverage on March 1.) Prior to Feb. 1, the Health Plan permitted people not to pay premiums for six months, after which non-waivered premiums had to be paid in full if the individual wished to continue coverage or to re-enroll. Persons who have lost earlier billing notices may mail their premiums to OHP Premium Billing Office, P.O. Box 3949, Portland 97208-3949. If you don't have a billing statement to include with your payment, then include identifying information such as a Social Security number. More than 300,000 people who qualify for the Health Plan because of age, disability, pregnancy or receiving public assistance pay no premiums and are therefore unaffected. |
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