FAQs

Medicaid is a federal and state program that provides health care coverage to those who meet eligibility requirements. In Oregon, Medicaid is called Oregon Health Plan (OHP). On January 1, 2014, Oregon expanded Medicaid to a larger and more diverse group of people, including adults and children below certain income levels.

To qualify for Medicaid or Medicaid Bridge, you must meet certain requirements and have a certain income based on the Federal Poverty Level Guidelines.

See if you may qualify for Medicaid.

You must qualify for Medicaid or Medicaid Bridge and get assigned to a CCO where Kaiser Permanente has a contract to provide Medicaid medical services. Kaiser Permanente may or may not be accepting new members depending on our contract with Health Share of Oregon or PacificSource Community Solutions. If Kaiser Permanente is not accepting new members, an exception may be available if you:

Were a Kaiser Permanente member in the past 12 months
OR
Have a current Kaiser Permanente member in your household

An immediate family member is a family member who lives in the home of a current Kaiser Permanente member and is a:

• Spouse (including Domestic Partners)
• An unmarried dependent child under age 21
• A disabled dependent over the age of 21
• A married/unmarried stepparent of children under age 21
• A foster child or stepchild
• A Legal guardian
• A grandparent, parent, guardian, or other relative who applied for Medicaid on behalf of a current Kaiser Permanente member that is under 21

If you think you qualify for Medicaid or Medicaid Bridge, visit https://one.oregon.gov/ to start your application process online.

Trained community partners across the state can help you fill out an application. Visit https://one.oregon.gov/ to find community partners in your area.

You can apply at any time during the year – there is no deadline. When you’re declared eligible for Medicaid or Medicaid Bridge, in most cases, you may be able to get Medicaid coverage right away.

Learn more about the Medicaid enrollment process.

To check on the status of your application, contact the Oregon Health Plan Processing Center at 1-800-699-9075 (toll free).

If you are not approved for Medicaid or Medicaid Bridge, you might still be eligible for federal financial assistance. Visit buykp.org to choose a Kaiser Permanente plan that meets your needs.

Yes, families with higher incomes may find that only their children qualify for Medicaid coverage.

Please visit https://one.oregon.gov/ or call the Oregon Health Plan Customer Service at 1-800-699-9075 (toll-free) for more information.

Most individuals who qualify for Medicaid or Medicaid Bridge will have no monthly premium, no copay, and no out-of-pocket cost for most covered services. Depending on your income and the eligibility rules, you may have to pay a share of the cost of your care.

Medicaid and the Health Care Exchange both offer health coverage. Whether you get health coverage through Medicaid, Medicaid Bridge, or the Exchange depends on your household income. If you qualify for Medicaid or Medicaid Bridge, your health care will be free or at a lower cost to you and your eligible family members. If you do not qualify for Medicaid or Medicaid Bridge, you may be able to get financial assistance through the Health Care Exchange at https://healthcare.gov/.

Yes, you can choose your own doctor from our network of doctors. You can also switch to a new Kaiser Permanente doctor at any time.

All of our available doctors take Medicaid and Medicaid Bridge health plan members. Simply visit kp.org/chooseyourdoctor.

You can find information on medical facility locations, departments, and care at kp.org. You can also call Member Services:

Portland
503-813-2000 or TTY 711

Outside Portland
1-800-813-2000 (toll free) or TTY 711

Hours
Open Monday through Friday from 8 a.m. to 6 p.m.

Your Member Handbook will give you complete benefit information.

If you are eligible for Medicaid or Medicaid Bridge and choose to receive your care from Kaiser Permanente, medication is included. To check if your medication is covered, please contact Member Services:

Portland

503-813-2000 or TTY 711

Outside Portland
1-800-813-2000 (toll free) or TTY 711

Hours
Open Monday through Friday from 8 a.m. to 6 p.m.

To speak with a pharmacy representative who can help you transfer your prescription(s), call Member Services:

Portland
503-813-2000 or TTY 711

Outside Portland
1-800-813-2000 (toll free) or TTY 711

Hours
Open Monday through Friday from 8 a.m. to 6 p.m.

When you call, please have your prescription number(s) and the name and phone number of the pharmacy where you wish to transfer them from ready. We’ll handle the rest.

You can also visit New Member Prescription Transfer for information on how to transfer your prescriptions.

Yes – if you are a Health Share of Oregon member, be sure to bring both your Health Share of Oregon ID card and your Kaiser Permanente ID card any time you receive services. Providers use the information on the card(s) to check your eligibility.

Your Medicaid benefits will stay active for 1 year, if you have no change in circumstances. Every year, the state will check whether you meet the Medicaid requirements before your Medicaid benefits can be renewed.

Find out more about the annual renewal process.

Yes, if you no longer qualify for Medicaid or Medicaid Bridge, you’ll have a limited amount of time to act to get other coverage before your Special Enrollment Period ends. You should quickly see if you are eligible for financial assistance from the government by visiting https://one.oregon.gov.

Or visit continuecoverage.kaiserpermanente.org to find a Kaiser Permanente plan for you and your family.

Losing health coverage such as Medicaid is considered a qualifying event that would trigger a Special Enrollment Period. You are eligible to enroll within 60 days of that event.