There are a few reasons why you may qualify for Oregon Health Plan (OHP) benefits mid-year: you are pregnant and meet income eligibility, you experience a sudden drop in income or lose your job, or your household size increases, but your income does not. You may also begin qualifying for OHP mid-year if you now meet immigration status requirements for the program. If you are now eligible for OHP and were previously enrolled through the Marketplace, there are some things you need to know.
- If you reported a change to the Marketplace, you may find out that you are potentially eligible for OHP benefits. This is not a guarantee of coverage through OHP. Your information will be sent to the state for assessment and you will receive additional information directly from OHP.
- If you find out you are getting OHP benefits, you must report your new coverage to the Marketplace. The Marketplace will not get this information right away and it will affect your eligibility for financial assistance.
- You are no longer eligible for financial assistance through the Marketplace if you are eligible for OHP benefits, even if you choose to not keep your OHP coverage.
- If you do not report your new OHP benefits to the Marketplace and continue receiving financial assistance, you may have to pay back the assistance you receive on your taxes at the end of the year.
- If you involuntarily lose OHP benefits in the future, you can update your application through the Marketplace and may get financial help again.
Transitioning between Marketplace coverage and OHP benefits can be confusing, but it is easier to understand with the help of an expert. Insurance agents and health coverage application assisters are available throughout Oregon to provide free one-on-one assistance. Find local help at OregonHealthCare.gov/GetHelp.