2014: Opening the Oregon Health Plan to more people
Providing health care coverage for low-income Oregonians
What is happening
The Oregon Health Plan (OHP) is available to more low-income adults. Many of these adults are uninsured and work part-time or in low-wage jobs without access to health insurance.
What it means
More low-income Oregonians now have access to health care coverage, providing them better access to care and more financial stability. Medical debt to providers will be reduced.
- No more waiting list for the Oregon Health Plan.
- Income limits are changing. Before, the income limit to qualify for the Oregon Health Plan was very low. A person’s incomehad to be at or below 100 percent of the Federal Poverty Level (FPL) to qualify. Now coverage is available to people who earn up to 138 percent of FPL. That’s about $15,800 a year for a single person or $32,500 a year for a family of four.
Why this is happening
This is happening because Oregon is opening the Oregon Health Plan to more people, as allowed under the federal health care law.
Fast-track enrollment - Most people who are eligible for OHP have already been screened
Fast-track enrollment is an easier way for qualified Oregonians to enroll in OHP. People who are eligible for fast-track enrollment do not need to apply through Cover Oregon or any other means because they have already been screened through other services. All they have to do is send back a completed "fast-track" form to enroll in coverage.
Fast-track enrollment is available to Oregonians who meet income and residency qualifications for the Oregon Health Plan, and:
- Are enrolled in the Supplemental Nutrition Assistance Program (SNAP), or
- Have children enrolled in Healthy Kids/OHP.
The Oregon Health Authority will contact qualified Oregonians directly to let them know how to enroll. Learn more about fast-track enrollment.
For all types of coverage: Cover Oregon is one-stop shop
Cover Oregon is an online marketplace where Oregonians can learn more about available health coverage. Anyone, regardless of income, can apply using a paper application with Cover Oregon. You can request a paper application at your local DHS Branch Office or by calling 1-855-CoverOR. There is also an online application form on CoverOregon.com that can be printed out. The form needs to be mailed or faxed to Cover Oregon. The fax number and mailing address are on the form. Cover Oregon includes the Oregon Health Plan, Healthy Kids and private insurance plans.
Paper applications are available in multiple languages, and community partners are available to help people with the application if needed. A list of community partners and agents is available on CoverOregon.com. Help is also available by calling 1-855-CoverOR (1-855-268-3767) or at all Oregon Health Authority and Department of Human Services offices.
Coordinated care – the Oregon difference
Coordinated care organizations work for better health, better care and lower costs by focusing on prevention, chronic disease management, earlier interventions, and reduction of waste and inefficiency in the health system.
- Improved care
Coordinated care organizations are required to meet quality standards or “metrics” that are posted publicly four times a year. The Oregon Health Authority uses these metrics to assess CCOs on how well they are doing in key areas such as access to care, prevention and health screenings, mental health care, and many other metrics.
- Cost containment
Under an innovative agreement with the federal government, Oregon will reduce waste and inefficiency in health care and create a more sustainable system. This will allow us to hold down per capita costs while providing better care.
Financial assistance to pay for health care coverage
For people who earn too much for the Oregon Health Plan, there may be assistance available for paying for health insurance through Cover Oregon. Go to www.coveroregon.com to learn more about what options are available. To apply, request a paper application at your local DHS Branch Office or by calling 1-855-CoverOR. There is also an online application form on CoverOregon.com that can be printed out. The form needs to be mailed or faxed to Cover Oregon. The fax number and mailing address are on the form.