Report from the Citizens Advisory Council of COVER OREGON

Cover Oregon Consumer Advisory Committee, Jan. 3, 2014

Application forms: Cover Oregon’s advisory committee met Jan. 3, spending most of its time gathering suggestions for yet another revision of its application form. A new one, now operational and available on the website Jan. 1, made a correction that some members of Mid-Valley Health Care Advocates had sought. The question about income of self-employed people changed to  requesting “net profits” (rather than gross profits). Another tricky issue concerns the definition of “household.” Often this refers to individuals who comprise a single unit for income tax purposes, but not all groups of people living together and sharing resources file taxes. Needless to say, not all issues were resolved, but all parties – Cover Oregon staff and members of its CAC – came to a greater understanding of the complexities of the process of requiring everyone to have health insurance.  Many asked: wouldn’t universal coverage be more manageable?

Important OHP information: Cover Oregon has qualified many people for expanded Medicaid, i.e., for the Oregon Health Plan, but some of these have not been notified (as of Jan. 5). We learned that after Cover Oregon makes the eligibility determination, it passes information to the Oregon Health Authority. Rather than sending an immediate notification to the applicant, it appears that the OHA sends information to the relevant CCO, and the CCO sends enrollment information to applicants. Applicants who were certified before the end of December were officially covered beginning Jan. 1, and can expect to (or, should I say, can hope to) hear from their CCO, in January, and it is important that they know they are covered, retroactively if need be, beginning Jan. 1.  Amy Fauver, a Cover Oregon employee, told the CAC that if an individual needs, for instance, to go to Urgent Care before notification happens, s/he should ask the provider to check on his or her coverage with the Oregon Health Authority.

Another meeting is set for the first Friday in February. If questions come up at any time, as an unofficial Mid-Valley representative to CAC, I will seek answers for you.  Click here to contact me.

Roberta Hall