OPCA Renewal Notes

Current Oregon Health Plan Renewal Process/Outcomes
(Post-November 15, 2015)
2014 Expedited Renewals (simple form - most Oregonians)
I.
Completed forms
i.
If no changes were reported – individual stays on OHP.
ii.
If changes were reported - OHA will respond with another letter directing individuals to complete a
II.
III.
full application by first visiting oregonhealthcare.gov to answer screening questions
Incomplete forms
i.
If individuals did not take action by the date requested, they will experience a gap in coverage. To
get their coverage back they must call OHP within 90 days to verbally report answers to the
renewal questions.
a. If no household or income changes are reported – will have their benefits “switched on”
that day.
b. If a household or income change is reported - will be directed to oregonhealthcare.gov to
answer screening questions.
Completed form but still dropped from coverage
i.
Individual must contact OHA ASAP.
a. If no household or income changes are reported - will have their benefits “switched on” and
back dated so that there would be no gap in coverage.
b. If a household or income change is reported - will be directed to oregonhealthcare.gov to
answer screening questions to complete a full application.
Fast-Track Renewals (full application – SNAP & Healthy Kid Oregonians)
I.
II.
Completed full applications
i.
Individuals must visit oregonhealthcare.gov to answer screen questions that will then guide the
applicant to complete an oregonhealthcare.gov or healthcare.gov application by the appropriate date.
a. If no household or income changes - will renew via oregonhealthcare.gov within the time
frame expressed on the renewal notice.
b. If significant household or income changes – will complete an application through
healthcare.gov before the 15th of the month for health coverage on the first of the follow
month and had paid their first premium for no gap in coverage.
Incomplete full applications
i.
Individuals who do not complete an application through oregonhealthcare.gov or healthcare.gov by
the suggested date will experience a gap in coverage.
a. If no household or income changes - will experience gap in coverage until an
oregonhealthcare.gov is completed. Submission date of application will become the
individual’s new start date.
a. If significant household or income changes – will experience gap in coverage until a full
application through healthcare.gov is submitted and first QHP premium payment is made.