Cover Oregon Changes and Effects on Oregon Health Plan/Medicaid
OHA Information Update – April 29, 2014
The Cover Oregon Board of Directors has made the decision to stop further development on the current state website for private health care coverage. Instead, beginning with the November open enrollment period, Cover Oregon will use the federal exchange technology.
Additionally, the Oregon Health Authority will take over Medicaid eligibility determinations later this year. That means new enrollments will happen through an OHA portal rather than through Cover Oregon.
Nothing is changing immediately. There will be a transition period this year. Until the transition occurs, Cover Oregon will continue to be the portal for new enrollments.
There are approximately 920,000 Oregonians who count on the Oregon Health Plan for their coverage, and about 300,000 of them gained coverage since January 1.
When will the Oregon Health Authority begin determining eligibility for OHP?
It is planned that OHA will assume responsibility for OHP eligibility determinations before the end of 2014. Nothing is changing at this time. OHA will create a transition plan and will keep staff, potential clients, stakeholders and community partners informed about the process.
Where can people get information about this change?
More information about this change and client enrollment information is available at OHP.Oregon.gov. This site will be routinely updated.
Does this change affect the benefits that Oregon Health Plan clients receive?
OHP client benefits will not be affected in any way. People who are enrolled in the Oregon Health Plan will continue to be enrolled.
Will OHP clients who enrolled through Cover Oregon have to do anything?
OHP clients who enrolled through Cover Oregon do not have to do anything at this time. Their benefits remain active. When it is time for an OHP client’s annual redetermination, OHA will send them a notice with more information.
Where should people go today to apply for new OHP benefits?
People should continue to apply for OHP through Cover Oregon. The current enrollment process will remain until the transition occurs.
If people have already submitted an application to Cover Oregon, do they need to apply again?
People who have already applied do not need to apply again. Cover Oregon is still open for business and will process applications. There is no need to apply again.
Will CoverOregon.com continue to be a website for people to get access to health care coverage?
People will still be able to go to CoverOregon.com and learn how to enroll in Oregon health care coverage through the Oregon Health Plan or private plans.
Will OHA and DHS go back to processing Medicaid eligibility through the DHS field offices?
The eligibility process will continue to be centralized through OHA.
How many OHP enrollments are coming through Cover Oregon?
About half of the new OHP enrollments since Jan. 1, 2014, came through the Cover Oregon system. Most of the rest came through the "fast-track" enrollment process.
How will this transition be managed?
OHA will work with a cross-agency project team, the state CIO, and a system integrator to determine how to adapt the Cover Oregon Medicaid eligibility system and maintain the client-facing application portal.
If someone is enrolled in a private plan and applied for through Cover Oregon, what do they need to do?
Anyone who has enrolled in a private health plan through Cover Oregon does not need to do anything at this time. Their private health coverage remains active. More information is available at CoverOregon.com.
What does this change mean for Cover Oregon?
Cover Oregon will retain front-end customer outreach and education, initial management of private insurance plans and some oversight of those private plans. More information about the staff structure of Cover Oregon and any changes that will impact Oregonians will be available in the coming months. The overarching goal is that Oregonians will have a seamless online experience when enrollment opens for private insurance in November 2014.
Who should people call with questions about applying for coverage or benefits?
OHP clients who have questions about their benefits can call the OHP Client Services team at 1-800-273-0557.
For more information about applying for coverage, visit CoverOregon.com or call 1-855-CoverOR (1-855-268-3767) or 711 (TTY).