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Oregon’s Medicaid Renewal Struggles: How to Get Healthcare if You Were Left Behind

Understand the steps to take if you find yourself without Medicaid in Oregon, and explore the possibilities for reinstating your healthcare coverage.

by Carlos Loria
November 16, 2023 10:00 am
in Present
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In Oregon, a significant number of low-income individuals, including many children, have faced disruptions in their Medicaid healthcare coverage. The Oregon Health Authority revealed on October 28 that 2,268 people had incorrectly lost medical benefits at the end of September, and an additional 1,226 individuals were mistakenly notified that their benefits would cease at the end of October. The affected individuals still qualify for free health and dental insurance.

The situation raises concerns, particularly for families with children who may encounter hardships, especially if they require specialized or intensive care. While county and federally supported clinics offer some care to low-income residents, the absence of certain services like dialysis or surgery centers may pose challenges. Emergency rooms in hospitals can address immediate medical needs, but Oregon’s Medicaid system aims to prevent people from using them as a primary care service.

What if You Get Left Without Medicaid Coverage?

The disruption in Medicaid coverage stems from a glitch during the automatic renewal process, as noted by the Centers for Medicare and Medicaid Services (CMS) on August 30. The glitch predominantly affected children in households with at least one adult enrolled in Medicaid and households required to submit eligibility documents. CMS directed states, including Oregon, to halt renewals for affected families and reinstate those who lost benefits due to the glitch.

On September 21, CMS reported that 500,000 children nationwide, including an undisclosed number in Oregon, had lost health coverage due to the glitch. Despite inquiries by the Capital Chronicle, the Oregon Health Authority has been slow to provide specific information about the affected children, prompting concerns about the lack of transparency.

The Oregon Health Authority’s recent update on October 28 stated that 668,000 people in the state retained coverage out of nearly 808,000 reviewed. However, it failed to address several questions about the affected children. According to the authority’s spokeswoman, Erica Heartquist, 619 children were among the 2,268 who lost benefits in September, but it remains unclear how many minors were impacted by the October notification.

Heartquist assured that all potentially affected individuals’ benefits would be restored or prevented from closing, and notices would be sent in November to inform them of the changes. However, families whose coverage is reinstated should remain vigilant, as each family member’s eligibility will be subject to review. As the Medicaid renewal process continues, affected individuals are advised to stay attentive to Medicaid notices in the coming year when renewals resume. The Oregon Health Authority faces scrutiny for its handling of the situation, particularly the delayed response to inquiries and the lack of detailed information regarding the impact on children.

Claiming Back Your Medicaid Coverage in Oregon Made Simple

If you’ve been left out of Medicaid coverage in Oregon, start by confirming that you meet the eligibility criteria. Being a resident of Oregon, a U.S. national, citizen, permanent resident, or legal alien is a prerequisite. Additionally, you must be in need of health care/insurance assistance, falling into the low-income or very low-income category. If you have a disability or a family member with a disability in your household, you may qualify. The annual household income should be below specified thresholds based on household size.

The first tangible step in claiming your Oregon Medicaid coverage is acquiring the application form. These forms can be procured from local Department of Human Services (DHS) branches or the OHP Application Center. For seniors aged 60 and above or individuals with disabilities, applications are available at local DHS offices catering to Seniors and People with Disabilities or the respective Area Agency on Aging.

Once you’re on the Oregon Health Plan, regularly check for renewal notices that outline the necessary steps to maintain your benefits. It’s advised to keep your contact information updated to avoid any lapses in benefits. Respond promptly to any information requests and submit renewal forms without delay. Oregon has resumed the critical process of income verification for Medicaid recipients. Ensure that your income doesn’t surpass the defined threshold.

Tags: medicaid
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