Healthier Oregon: Health Insurance Expanded through OHP

As of July 1, 2022, adults 19-25 and 55 and older are now eligible for full Oregon Health Plan (OHP) benefits and other services and supports, regardless of their immigration status. OHP is free health coverage for people who live in Oregon and who meet income and other criteria. It covers health care services like medical, mental health, dental, prescriptions, tests, x-rays, hospital care, and rides to and from health care appointments. The expansion is the result of House Bill (HB) 3352, which put into law a program called “Cover All People.” The program is now known as “Healthier Oregon.”

The U.S. Census Bureau estimates reports that 12.2% of residents in Malheur County under age 65 are without health insurance, compared to 8.6% in Oregon. With expanded OHP coverage, hopefully more people will have health insurance and receive the health care they need.

Eligibility is open to people who live in Oregon who:

  • Meet income and other criteria,
  • Don’t qualify for full OHP benefits because of their immigration status, and
  • Are 19-25 years old or 55 years and older.

For example, before, a 22-year-old without a qualifying immigration status could only get CWM benefits (also known as emergency Medicaid). As of July 1, 2022, this person is eligible for full OHP benefits. If someone is a lawful permanent resident (LPR), ​​they will not need to wait five years before they are eligible for ​full OHP benefits through Healthier Oregon. ​OHP does not affect immigration status. OHP is not considered public charge.

Lisa is here to help!

For more information visit Oregon.gov/HealthierOregon or call Lisa Almaraz, OHP Application Assister and Health Specialist at the Malheur County Health Department at 541-889-7279 x136 or email lisa.almaraz@malheurco.org.

Download flyers in English and Spanish, or simply click on the images below.

Oregon to provide 12 months of continuous postpartum medical coverage to OHA members

Federal decision ‘critical to ensuring health and well-being of mothers and their babies’

The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), has approved Oregon’s request to expand Medicaid and Children’s Health Insurance Program (CHIP) coverage, known as Oregon Health Plan (OHP), to one year postpartum.

The change, approved and announced Wednesday, will allow individuals to maintain continuous OHP coverage and access medically necessary physical, oral and behavioral health services for 12 months after childbirth.

Currently, most states continue pregnancy-related Medicaid coverage for only 60 days after childbirth. The expansion of coverage was made possible by a new state plan opportunity included in the American Rescue Plan.

Medicaid covers 42% of births in the nation. A report published by the HHS Office of Assistant Secretary for Planning and Evaluation (ASPE) highlights the inequity that rates in pregnancy-related deaths are two to three times higher among black non-Latino and American Indian/Alaska Native populations compared to white populations. The report further explains that one in three pregnancy-related deaths occur between one week and one year after childbirth. The extension of coverage is aimed at advancing Oregon Health Authority’s goal of eliminating health inequities by 2030.

The postpartum period is an important time for physical recovery; addressing pregnancy spacing and family planning needs; managing chronic conditions that may have been exacerbated during pregnancy; providing breastfeeding support; and ensuring mental health.

“Providing postpartum support and care is critical to ensuring the health and well-being of mothers and their babies,” states Interim State Medicaid Director Dana Hittle.

Visit Medicaid.gov to learn more about the Medicaid and CHIP state plan amendment extensions of postpartum coverage in Oregon.

For assistance applying for the Oregon Health Plan, contact the Malheur County Health Department at 541-889-7279.

Current and former OHP members sought for task force

The Oregon Health Authority is looking for a current or former Oregon Health Plan (OHP) member to join a new work group. The “Bridge Program Task Force” will guide OHA in creating a new health plan for people who may not qualify for OHP. The new program, with advice from the work group, is expected to be easy to afford, easy to access care, and will help prevent loss of insurance coverage for those who may lose OHP due to an increase in income.

Are you interested in making an impact on the health of Oregonians?

Bridge Program Task Force members will include people from a variety of backgrounds, including: community members, people who work in health care, people who work for health plans, people who work in behavioral health, and people who have helped others sign up for health insurance. The members will use their experience to ensure that the new health plan will promote continuous health care coverage, covers all essential health benefits, is easy to afford, and is available to anyone in Oregon who qualifies.

Next steps

Bridge Program Task Force members will be appointed by the Governor in early April, and the proposal describing how the program could best work for Oregonians is due Sept. 1, 2022. The Bridge Program Task Force will also draft recommendations for how to minimize increasing costs to the health insurance market and monthly premiums for its members which could be caused by the bridge program no later than Dec. 31, 2022. To accomplish all of this in such a short timeline, the Task Force will likely meet at least once every 3 weeks for 3 hours during the afternoon. There will be 2 meetings in April. Starting in May, the group will meet every 3 weeks. Some members of the Task Force may be able to receive funds for their time or expenses.

Applying for the Task Force

To apply, please complete the Bridge Program Task Force application through the Governor’s Workday portal (https://bit.ly/3InfXtm) by March 31, 2022.

For questions about the Bridge Program Task Force application, please contact Katie Button at katie.button2@dhsoha.state.or.us.

COVID-19 home tests available for Oregon Health Plan members

Starting Nov. 8, 2021, the Oregon Health Plan covers COVID-19 at-home tests for OHP and CAWEM (Citizen/Alien Waived Emergency Medical) members.

  • OHP and CAWEM members who have signs of COVID-19 or have had close contact with someone with COVID-19 can get COVID-19 at-home tests.
  • The COVID-19 at-home tests do not replace COVID-19 testing done in clinics and labs.
  • Click here to read more about using COVID-19 at-home tests.

The Malheur County Health Department strongly suggests OHP members talk to their doctor if they have signs of COVID-19 or may have been exposed. A physician will not be able to write a note to your employer or your child’s school if an at-home test result is positive. If you use an at-home test and it is positive, please contact the Malheur County Health Department at 541-889-7279.

OHP and CAWEM members can get up to four COVID-19 at-home tests per month without a doctor’s order.

To get more than four tests in a month, OHP and CAWEM members need to get a doctor’s order.

Please contact your PCP if you need more than four at-home tests per month.

All types of COVID-19 at-home tests are covered.

OHP covers all COVID-19 at-home tests that are approved by the U.S. Food and Drug Administration, including COVID-19 at-home tests that require an internet connection or smartphone to read the results.

Pick up COVID-19 at-home tests at a pharmacy or retail store.

Members should bring the COVID-19 at-home test to the pharmacy counter to check out and let the pharmacy know they are an OHP or CAWEM member. Members will not be charged for COVID-19 at-home tests.

Due to limited supplies, not all pharmacies or retail stores may have COVID-19 at-home tests. Members may want to call the pharmacy or retail store to ask if COVID-19 home tests are in stock.

OHP covers at-home tests picked up at the pharmacy counter, not tests purchased online.

Have OHP coverage questions?

If you have questions about OHP coverage for COVID-19 at-home testing:

• Contact your CCO. To find CCO contact information and resources click here.

• If you are not in a CCO, call OHP Care Coordination at 800-562- 4620. Native American and Alaska Native members can also call CareOregon Tribal Care Coordination at 844-847-9320.

Learn more about OHP and CAWEM coverage during COVID-19.

Click here for more information for OHP CAWEM Members on COVID-19.

• Visit OHP’s COVID-19 page for members for more information. If you don’t have health coverage, apply for OHP today. You can apply online at ONE.Oregon.gov.

• Trained community partners across the state can help you fill out an application. It’s free. Visit OregonHealthCare.gov to find community partners in your area.

Not sure if OHP is right for you?

• Go to OregonHealthCare.gov and answer the screening questions. This will help you find the application that works best for you and your family.

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