En español
What Members Need to Know
Most members will keep their benefits.
The federal government will require changes to Oregon Health Plan (OHP). These changes will start in late 2026 through 2028. For current OHP members, what changes apply to you will vary.
Changes for Nearly All Members in Late 2027
Almost all OHP and Medicare Savings Program members will need to renew more frequently starting in 2027. Oregon is waiting for federal guidance on exactly when this will start. When this change applies to you depends on when your household renews.
- Many adult OHP members age 19 to 64 will need to renew every six months.
- All other OHP and Medicare Savings Programs members will need to renew once a year. This includes children and OHP programs based on disability.
- If you report changes that result in you no longer being eligible for OHP, benefits may end sooner.
Currently, most OHP members renew every two years, and children under 6 don't need to renew until their sixth birthday. This will end in late 2027.
Starting Jan. 1, 2027, OHP will cover recent medical bills from a shorter time period for new members. Currently, new members can get help with up to three months of medical bills. This will change in 2027.
- Only one month of past bills for adults without children
- Up to two months for all other members, including children
Changes that Affect Some Adults (Age 19-64) in 2027 and 2028
Work or activity rules will not apply to many OHP members, including:
- Children and youth under 19,
- Adults who are age 65 and older,
- OHP members with Medicare, or who qualify for an OHP program ased on disability or pregnancy.
If the new rules apply to you, when you apply or renew you will be reviewed for:
- An exemption: a list is below.
- Qualifying work or activity, which can be:
- More than $580 per month of household income
- Being in school at least half-time
- A combination of work, volunteer, education, or training programs that add up to 80 hours a month.
There are many exemptions. The federal government will share more details about exemptions, including medical exemptions, by the end of June 2026. Right now, we know exemptions will include:
- Main caretakers of children under age 14, or someone with a disabling health condition of any age
- People who have a disability
- People with certain medical conditions
- People who have chronic substance use disorders or are currently in treatment
- People who are American Indian/Alaska Native
- During pregnancy, and for one year after
- People who were incarcerated in the last three months
Starting in 2027 at the earliest, many adult OHP members will need to renew every six months. Six-month renewals will only apply to adults who:
- Are between the ages of 19 and 64.
- Do not have Medicare or an OHP program based on a disability.
- Are not American Indian/Alaska Native.
All other OHP members, including children, will need to renew once per year. Oregon is waiting for guidance on when in 2027 more frequent renewals will begin.
Starting in October 2028, some adults will need to pay a small fee for certain types of health care. This is called a “copayment" or “copay".
- These fees will not apply to adults who have Medicare or OHP based on a disability.
- Members with incomes under $15,000 a year will not need to pay the fees.
- Members will not need to pay fees for checkups, emergency care, or mental health care.
- These fees will not apply to prenatal care, substance use treatment, or care at community health clinics.
Changes that Affect Immigrants in Late 2026 and 2027
The federal government will require some changes to OHP for many immigrants in late 2026 and 2027.
In Oregon (unlike other states), this does not mean people will lose OHP. Oregon has a program called Healthier Oregon that provides full OHP benefits regardless of immigration status.
In October 2026, some OHP members will move to Healthier Oregon. Healthier Oregon is an OHP program and has the same benefits. This will affect adults with these immigration statuses that include:
- Refugees
- Asylees
- Survivors of domestic violence or human trafficking
- Some humanitarian parolees
These changes will not affect children, or adults with these statuses who qualify for OHP Bridge.
Members who have OHP through Healthier Oregon will move to OHP Open Card in January 2027. OHP Open Card is a type of OHP for members who are not in a coordinated care organization (CCO). CCOs are a group of health care providers that care for OHP members in their area.
OHP Open Card has the same OHP benefits. The health care providers you can see through OHP Open Card may differ. You can ask your current health care providers if they accept OHP Open Card. To learn more about OHP Open Card read the handbook, visit OHPcc.org, or call 800-562-4620.
Members who have coverage through Healthier Oregon may be affected by other changes, including more frequent renewals and work or activity rules for some adults.
How to Keep Your Coverage
Please keep your contact information up to date so OHP can reach you when it is time to renew. Tell us if your mailing address, email, and phone number, or other information changes. OHP will send you notices when it is time to renew.
The federal government has not released details about all these rules yet. As we learn more, Oregon will share what you need to do.
Here’s how to get help: