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Published byDella Palmer Modified over 9 years ago
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Fall 2013 Presented by the Self-Sufficiency Training Unit
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Oregon is ready to implement changes in the way we offer medical coverage to our customers This webinar will explain the immediate changes we will be supporting, including: Guidelines for daily work Interacting with our customers Collaboration with OHA and Cover Oregon
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Medical cases will be carried by the OHA Statewide Processing Center (5503), APD and AAA DHS will continue to determine REFM medical eligibility Cover Oregon will help customers compare and enroll into insurance that fits their budget
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Medical applications with a DOR prior to October 1 will be processed in the branch using current eligibility rules ◦ This includes cases that may be in pend status Once eligibility is established, and a separate P2 medical case is open, transfer the medical case to 5503
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Effective with a DOR of October 1, 2013 and later, DHS will do medical differently Eligibility for OCCS medical programs: BCCTP, CEC, CEM, CHIP, EXT, HKC, MAA, MAF, OPC, OP6, OPU and SAC will be determined by staff at 5503
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Renewals occurring October 2013 – March 2014 will be deferred out 6 months (excludes some populations) Original Renewal Month Deferred Renewal Month October 2013April 2014 November 2013May 2014 December 2013June 2014 January 2014July 2014 February 2014August 2014 March 2014September 2014 6
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SSP, OHA and APD will work together to complete all case transfers
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◦ All OCCS medical cases in SSP branches will be transferred to 5503 ◦ QMB/OCCS combination medical cases will be transferred to 5503 (example: a pregnant woman who also qualifies for QMB) No further action is required by the branch ◦ Any APD medical cases currently in an SSP office will need to be transferred to the local APD or AAA office A transfer notice needs to be sent
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All OCCS medical cases in APD branches will be transferred to 5503 This includes QMB/OCCS medical combination cases (example: a pregnant woman receiving QMB) No transfer notice will be required
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The Medical Chapter of the FSM will be removed on September 30, 2013 in preparation for the new MAGI medical eligibility processes that will begin October 1, 2013 The Medical Chapter will remain available on the FSM Archive site
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If a request for medical is received in an SSP office on, or after October 1, the branch will: ◦ Complete the Date of Request for OCCS Medical Request form ◦ Fax to: (503) 373-7493 ◦ Or email to: : 5503 Case Transfers
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Medical DOR form for OHA- 5503
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If a request for medical is received in an SSP office, the branch can: ◦ Provide the applicant with a date stamped 7210 application ◦ The application can be completed and mailed by the customer to 5503 or the branch can email or FAX the application to 5503 Fax: (503) 373-7493 Email: 5503 Case Transfers Direct the applicant to www.coveroregon.com
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Clients transitioning off of TANF due to an increase in income will remain eligible for EXT Indicate changes on the Date of Request for OCCS Medical Program Benefits form
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17 10/01/13 revision will exclude medical questions
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18 Paper ApplicationOnline Compatible with all browsers
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19 SNAP Based Medical Pended Presumptive Referrals Parents with Medically Eligible Children Standard Reservation List
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SNAP-Based Medical and Eligibility for Parents of Medically Eligible Children will be on a “fast-track” enrollment for the new January 2014 programs Your clients may receive a letter of consent Date stamp – fax or email to 5503
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OHP Standard Reservation List requesters will be mailed a letter in mid-October regarding new health care options for January 1, 2014
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When creating separate CM cases: ◦ Open two sessions of DHR ◦ Determine the type of combo case ◦ Verify there are no duplicate cases ◦ Follow the steps to separate and transfer the newly created case
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From Webm,Find ◦ Select the CM case, F22 for CASEM
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Place a “Y” in the Srce field Choose individuals to transfer F14
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DO NOT SAVE YET!
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Verify all information is correct on both cases First! ◦ Press F9 twice on your original combo case Second! ◦ Press F9 twice on your newly created medical stand alone case
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DO NOT SAVE YET!
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Verify all information is correct on both cases First! ◦ Press F9 twice on your original combo case Second! ◦ Press F9 twice on your newly created medical stand alone case
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DO NOT SAVE YET!
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Verify all information is correct on both cases First! ◦ Press F9 twice on your original combo case Second! ◦ Press F9 twice on your newly created medical stand alone case
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DO NOT SAVE YET!
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If you receive this error on the original combo case “Exempt reason code P requires DUE N/R or CH/NO under 2 years” Add the DUE date back onto the TANF only case.
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Verify all information is correct on both cases First! ◦ Press F9 twice on your original combo case Second! ◦ Press F9 twice on your newly created medical stand alone case
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Notice that recipient is only receiving QMB. If recipient was receiving QMB and OCCS medical, transfer whole case to 5503.
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DO NOT SAVE YET!
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Verify all information is correct on both cases First! ◦ Press F9 twice on your original combo case Second! ◦ Press F9 twice on your newly created medical stand alone case
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For policy questions: Medical.SSP-POLICY@dhsoha.state.or.us To refer applicants: Cover Oregon: 1-855-CoverOR (268-3767) www.coveroregon.com OHA Statewide Processing Center Phone: 1-800-699-9075 Fax: (503) 373-7493 Email: 5503sspcasetransfers@dhs.oregon.gov 52
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Additional Assistance ERDC: Childcare.Policy@state.or.us JPI, TA-DVS and TANF TANF.Policy@state.or.us Questions regarding impact on DHS Field Operations: Chere LeFore Phone: (503) 945-6473 Email: Chere.LEFORE@dhsoha.state.or.us 53
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