Facing the need to renew your healthcare coverage through the OHP Redetermination process can be a bit daunting. However, with the right information and guidance, the process can be smoother than you think. In this guide, we’ll take you through every aspect of OHP Redetermination, ensuring you have the knowledge and confidence to successfully renew your healthcare coverage.
What is OHP Redetermination?
OHP Redetermination is the process through which Oregon residents need to renew their eligibility for the Oregon Health Plan (OHP), a state-funded healthcare program that provides coverage for eligible individuals and families. The redetermination process ensures that those who still qualify for OHP continue to receive the benefits they need.
Interruption of Medicaid Renewals due to the COVID-19 Public Health Crisis
The year 2020 saw the federal government pronouncing the COVID-19 outbreak as a public health crisis, which consequently halted the proceedings of Medicaid renewals. This decision allowed individuals to retain their Medicaid privileges without the necessity of undergoing the typical renewal procedure. Subsequently, the government has repeatedly extended the duration of the public health emergency post-2020. Consequently, a significant number of beneficiaries have refrained from renewing their entitlements since that time.
Recent Enactment by Congress Mandates Resumption of Medicaid Renewals in 2023
Recently, Congress enacted legislation mandating that states recommence the Medicaid renewal process in the year 2023.
OHP Redetermination: Timelines and Significant Dates
When will the renewal process begin?
Following April 1, 2023, states have a maximum of 12 months to initiate the renewal process. In the event that OHA decides that you no longer meet the eligibility criteria for full OHP benefits, you will have a 60-day period before your coverage ends.
How do I get a letter about my renewal?
Prior to April 1, 2023, ensure that your state Medicaid office possesses your up-to-date mailing address, telephone number, and email. This way, they can reach out to you regarding your renewal.
You will receive a notice in the mail from OHA between April 1, 2023, and January 4, 2024. You will have 90 days to respond.
OHP Redetermination Process
Your state’s Medicaid office will assess the information you provided to determine whether you and your family members continue to meet the eligibility criteria. If you still meet the requirements, you may not need to complete any forms.
In case your state requires additional information to determine your eligibility, they will communicate with you through a letter, either by mail or online. This letter will inform you whether you need to complete a renewal form and specify the deadline for your response. If your state requests it, promptly fill out the renewal form through either mail or online submission. Make sure to promptly submit the renewal form and any necessary documents requested by the state to avoid any interruption in your coverage.
What steps should you take if you do not receive a renewal letter?
If you believe you should have received a renewal letter but haven’t, get in touch with your state’s Medicaid office.
What type of information will your state require from you?
Your state will provide you with a list of the specific information they need. This might include:
- Evidence of citizenship for any new household members
- Recent pay stubs for employed individuals
- Verification of any non-work-related income
- Documentation proving the conclusion of employment if you have stopped working.
What choices do I have if I lose my coverage due to OHP Redetermination in 2023?
DON’T PANIC! There are some great options for you even if you do not qualify for full OHP benefits.
If you become ineligible for Medicaid as a result of the reassessment process, you have the possibility to explore affordable coverage alternatives, such as a subsidized plan from the ACA Marketplace, an employer-provided plan, or Medicare.
Dual Eligibility Medicare and Medicaid
Dual Eligible Special Needs Plans (D-SNPs) represent a category of Medicare Advantage plans, akin to HMOs or PPOs, designed for individuals receiving benefits from both Medicare and Medicaid. Eligibility for a D-SNP hinges on having active Medicaid coverage. If you meet the criteria for both Medicaid and Medicare, you fall under the ‘dual eligible’ category.
Enrolling in a D-SNP could provide you with additional advantages and reduced expenses in comparison to original Medicare.
Ready to start a plan? Call us (971) 233-3637. Our assistance is at no cost to you.