Losing Medicaid (OHP/Oregon Health Plan) at 65+

Losing Oregon Health Plan (Medicaid)?

You have options.

Stack of mail with an OHP, Oregon Health Plan redetermination letter at the top
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FOR DETAILS, READ ON:

Medicaid redeterminations are constantly happening across Oregon. As those happen, thousands of people - especially those over 65 - get letters saying their Oregon Health Plan coverage is ending.

Medicaid redeterminations can be due to any number of things, like:

  • Income changes

  • Internal delays at OHP

  • You missing a notice in the mail

  • Something else entirely

If this is happening to you or someone you care about, first know that you’re not alone in this, and second, that while this can be stressful, you absolutely have options.

THIS PAGE APPLIES TO YOU IF:

  • You received a notice that your Medicaid (OHP) is ending

  • You or your spouse are turning 65 soon

  • You’re over 65 and haven’t signed up for Medicare yet

  • You don’t qualify for Medicaid anymore but still need affordable insurance

WHAT HAPPENS WHEN YOU LOSE MEDICAID?

Medicaid often supports more than just basic coverage—especially for people over 65. When it ends, it can affect:

  • Part B Premiums: You may start paying the monthly Part B premium ($185/month in 2025) unless you qualify for another Medicare Savings Program.

  • Prescription Help: If Medicaid paid for prescriptions through Extra Help (LIS), those savings may stop unless you requalify.

  • D-SNP Plans: Dual Special Needs Plans are only available to people on both Medicare and Medicaid. Losing Medicaid can trigger disenrollment.

  • Home or Long-Term Care: If Medicaid covered caregiving, in-home support, or assisted living, those services may be impacted.

  • Enrollment Windows: You may qualify for a time-limited Special Enrollment Period to change or update your Medicare plan.

HERE’S HOW WE CAN HELP:

1. Understand What You Qualify For - We’ll ask questions to see if you are eligible for:

  • Medicare (and when you can enroll)

  • Medicare Savings programs like QI-1 or SLMB

  • Extra help for prescription costs

  • If you are under 65, we have someone to refer you to that can help you with Marketplace plans.

2. Review Your Coverage and Make A Recommendation

If you were in a D-SNP or using Medicaid to supplement Medicare, your plan may need to change. We’ll walk through your medications, providers, and budget to find the right fit.

COMMON QUESTIONS

What if I missed a notice or didn’t renew in time?
You may still be eligible for a special enrollment window. The key is acting quickly.

I’m 64. Do I need Medicare now, or something else?
We’ll help you figure out what to do based on your situation and income.

Can I keep my doctor?
That depends on your plan. We’ll check for you.

You Don’t Have to Figure This Out Alone

Losing OHP/Medicaid is hard, and what to do next is overwhelming. You don’t have to take this on yourself. Whether you’re sorting through a stack of confusing mail, worried about rising costs, or just unsure what’s next, we’re here to help.

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