Changes coming for health plan enrollment in two weeks

"The great thing in the world is not so much where we stand, as in what direction we are moving."
~Oliver Wendell Holmes

​About 95 percent of Oregonians now have health care coverage, which is a phenomenal accomplishment for our state. The gains in coverage this year came because of a lot of hard work by staff at OHA, Cover Oregon and DHS, managing through a manual application process.

Now we are getting ready to leave that manual process behind for most people.

Starting November 15, Cover Oregon will no longer accept new applications for health insurance coverage. Instead, the federal marketplace at HealthCare.gov will provide Oregonians an automated application and enrollment process for both OHP and private coverage. ​

Here is what the federal website provides for consumers:​

1. Fully automated application and enrollment. People will be able to apply and enroll in one sitting online.
2. Instant notification of eligibility. Most people who complete the application will learn on the spot what they are eligible for and the day on which their coverage will start.
3. People don’t have to know whether they are eligible for OHP or private coverage. The system will tell them. If they make too much income to qualify for the Oregon Health Plan, they will learn what financial assistance they may be eligible for and can shop for private plans on the spot.
4. Support for households that have different kinds of coverage. Households with some members eligible for OHP and others eligible for private coverage will learn who qualifies for what without needing to complete separate applications. Household members who are eligible for private coverage can shop and compare plans and learn what financial assistance they may be eligible for.
5. Reduced workload for OHA staff who are currently processing PDF and paper applications.

​OregonHealthCare.gov – a new website to work with HealthCare.gov.

Most applicants will be best served at the federal website. But not everyone. That is why we have created a new screening webpage: OregonHealthCare.gov.

OregonHealthCare.gov works with the federal site to get people to the best place to apply for coverage. That is because some people who are eligible for OHP will receive better service by filling out an application directly through the Oregon Health Authority. There are two ways to do that: an online PDF application or a paper application. This is especially true for tribal members, pregnant women, refugees and other who have situations that require special processing. In addition, county and state Aging & People with Disabilities or Area Agency on Aging (AAA) offices are a resource for seniors or people who are blind or living with disabilities.

One important change from last year is that this application is only for OHP. All private coverage consumers must apply through the federal website, HealthCare.gov.

​To learn more about this change you can go to the new Medicaid 101 web page, where we have posted fact sheets and other materials. Over the next two weeks we will be adding to this information. Our goal is to provide clear information so everyone has what they need to help our clients and partners through this transitional time. Many thanks to everyone who has been working so hard to make this happen.