Eligibility groups are based on “PERCs” which stands for
program eligibility resource codes. People are assigned PERCs based on the reason(s) they are eligible for OHP, such as age, income, pregnancy, disability status, etc.
See how PERCs have been categorized into the eligibilty groups desribed below.
Descriptions of major categories:
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ABAD (Aid to the Blind/Disabled) includes people with disabilities who meet federal criteria. Some of these individuals are also covered by Medicare.
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Adult Temporary Plan was an eligibility group used before OHP Bridge fully launched in July 2024. This category covered people meeting requirements for OHP Bridge coverage prior to the full launch of the program. This eligibility group ended after December 2024.
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Breast and Cervical Cancer is a program that includes people who have been diagnosed and do not have access to other health insurance.
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CHIP (Children's Health Insurance Program) provides coverage to children in families whose income is above the usual Medicaid eligibility limit (up to 300% of the federal poverty level) but have no other health insurance.
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"CHIP to Medicaid" are children whose families earn above the Medicaid income limit that was in place before the Affordable Care Act expanded Medicaid eligibility (133% of the federal poverty level).
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HOP (Healthier Oregon Program) expanded OHP coverage to people who were otherwise ineligible due to their immigration status. (Note: "HOP other" includes individuals who are assigned outdated PERCs such as CWM or CAK for various administrative reasons. These members are assumed to be in the HOP program currently and are included in HOP counts throughout this dashboard).
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MAGI (Modified Adjusted Gross Income) is a method for calculating income that was established by the 2010 Affordable Care Act. "MAGI Adults" have a household income up to 133% of the federal poverty level and are sometimes referred to as the ACA Expansion population. "MAGI Child" is a category for those live in a household with income up to 133% of the federal poverty level.
- Medicare Savings Programs (MSP) is a program that helps people who are enrolled in Medicare pay their premiums and deductibles. These members are sometimes also referred to as "partially dual eligible" for Medicaid. They do not receive OHP benefit services.
- OHP Bridge - Basic Health Program are members who earn up to 200% of the federal poverty level. Members in this category are all enrolled in CCOs
- OHP Bridge - Basic Medicaid are American /Alaska Native members who earn up to 200% of the federal poverty level and have the option to choose between CCO and Fee-for-Service (Open Card).
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TANF (Temporary Assistance for Needy Families) is a cash assistance program for low-income families. Families who receive TANF are automatically also eligible to receive OHP benefits. "TANF Extended" means the person is no longer in the TANF program but is receiving up to one additional year of OHP.
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Other: This category includes people who have not yet been assigned PERCs or are assigned PERCs that relate to outdated programs.
What about Veteran Dental and COFA Dental eligibility groups? This dashboard page only includes people who have their physical health care covered through OHP (or none at all, in the case of partially dual eligibles enrolled in Medicare Savings Programs). Thus, people who are enrolled in a
dental-only program are excluded. As of January 2024, there were around 2,180 people enrolled in Oregon’s Veteran Dental program and 12 people enrolled in COFA Dental. To request a recent count, please use the Health Analytics
General Request Form.