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Many Oregonians already on OHP 'fast track'

Published On: Sep 24 2013 06:06:29 PM CDT   Updated On: Sep 25 2013 01:36:31 AM CDT
Cover Oregon

Cover Oregon's Website offers information on the new health insurance exchange opening this fall

About 260,000 adult Oregonians have already been screened for the Oregon Health Plan and do not have to apply through Cover Oregon for coverage under the Affordable Care Act, officials advised Tuesday.

Oregon will be opening the Oregon Health Plan to more adults as allowed by federal health reform. People can begin enrolling next week for coverage to start January 1.

Cover Oregon is the one-stop shop for health coverage in Oregon, including those enrolling in the Oregon Health Plan (OHP).

Fast-track enrollment is available to resident Oregonians who meet qualifications for OHP and have already qualified for food benefits through the Supplemental Nutrition Assistance Program (SNAP), or health care benefits for children through Healthy Kids/OHP.

State officials are urging fast-track-eligible Oregonians to return their forms and get enrolled in health care coverage. To help, starting this week the Oregon Health Authority will begin mailing "fast-track" enrollment forms to people who are qualified. About 260,000 total packets will be mailed.

"If you are a pre-screened Oregon resident, you do not have to go through the application process at Cover Oregon," says Bruce Goldberg, M.D., director of the Oregon Health Authority. "Just fill out the simple form and return it to us, and you will be signed up for health care coverage that starts January 1, 2014."

Income limits

Like other benefit services, eligibility for the adult Oregon Health Plan is based on the Federal Poverty Level. For the 2014 benefits, the income limit is 138 percent of the FPL. That's about $1,317 per month - $15,800 per year - for an individual. The limit increases depending on the number of people in a family. For example, it's $1,784 per month - or $21,408 per year - for a family of two.

Some adults who receive SNAP or whose children are enrolled in Healthy Kids will not qualify for the Oregon Health Plan. They will not receive a letter and instead should go to Cover Oregon to learn what financial assistance is available to them and their families to purchase health care coverage.

"Opening health care coverage to more adults will have a profound effect on people's lives and their communities. Research shows that with coverage people receive the care that they need, the treatment that they need, and medical debt is decreased," says Dr. Goldberg.

New Oregon Health Plan members will be enrolled in a local coordinated care organization made up of providers of physical care, mental care and other services. Coordinated care organizations are part of Oregon's movement to build a system that delivers better health and better care and a lower cost.

Under Oregon's agreement with the federal government, health care costs will be lowered by 2 percentage points per capita in the 2013-2015 budget.


Cover Oregon Touts Roster of Certified Insurance Agents

DURHAM, OR – Thousands of Oregonian individuals, families and small businesses are getting ready to sign up for insurance through Cover Oregon. For many, the wait for health coverage has lasted months or even years. No one can be denied coverage, even if they have a pre-existing health condition.

Starting in October, individuals, families and small businesses will be able to apply for health insurance and access savings to help to pay for premiums through a statewide, on-the-ground network of Cover Oregon certified insurance agents, community partners or Tribal organizations. Customers who want to buy commercial plans have until December 15 to enroll for coverage to kick in January 1, 2014.

While all Cover Oregon certified community partners, Tribal organizations and agents can assist and enroll Oregonians in coverage starting October 1, only insurance agents are able to recommend a specific health insurance plan that fits their needs and budget.

“Cover Oregon is proud to partner with insurance agents who can help us offer better access to health coverage for all Oregonians and Oregon small businesses,” said Rocky King, Cover Oregon’s Executive Director. “The Agents’ knowledge of the health care market is a huge added value for those enrolling in coverage.”

Cover Oregon is certifying 2,000 insurance agents by October 1 to help Oregonians enroll. To become certified, agents need to take part in a two-part training program. Once certified, agents with Cover Oregon can sell all plans offered through Cover Oregon to individuals, families and small businesses.

“Insurance agents are important partners in this effort, and benefit from selling through Cover Oregon,” said Ronald Carter, a Chartered Life and Health Underwriter in Tigard. “Becoming an affiliated Cover Oregon insurance agent can give agents a new tool for assisting their current clients and an opportunity to expand their book of business. For me that means helping more Oregonians enjoy all the essential health benefits, including a greater focus on prevention and wellness.”

Working with a Cover Oregon certified insurance agent is free. On October 1, Oregonians can to go to to search for an agent in their area or can call 1-855-CoverOR (1-855-268-3767) to be connected to a certified agent. Agents can also go to the site to learn how to become certified.


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