CONSUMER BULLETIN: Using your Jan. 1 benefits

Dec. 31, 2013



New health care benefits go into effect Jan. 1, 2014. Tens of thousands of people have enrolled into coverage in the past few weeks, meaning they will now have health insurance to protect them and their family.

With so many people starting new insurance coverage at the same time, it may take a little longer than usual to get everyone in the system. Here are some tips to help you use your insurance right away, if needed.

  • If you have enrolled in a plan through Cover Oregon and will be paying your first premium on time: You are covered.
    For Cover Oregon plans, payment must be received by your insurance company by Jan. 15. Your coverage will be back-dated, or retroactive, to Jan. 1. 
  • If you need health care services before you make your first premium payment: You may have to pay out of pocket now and be reimbursed later. Be sure to pay your first month's premium by Jan. 15, and your coverage will be back-dated, or retroactive, to Jan. 1. Check with your insurance company for details.
  • If you need health services before you receive your insurance card: Check with your insurance company. If you enrolled through Cover Oregon within the last week it is possible you may not yet be in the insurance company’s system. You can confirm your enrollment by calling 1-855-Cover-Or (1-855-268-3767)
  • If you need care before your policy has been added to the system: You have options. You can pay out of pocket for services or prescription drugs and be reimbursed by your new insurance company later. If you need urgent or emergency care, forward the bill to your new insurance company when you receive it. Just be sure to pay your first month's premium by Jan. 15, so that your coverage is back-dated, or retroactive, to Jan. 1.
  • If you have applied for the Oregon Health Plan and don’t have your welcome packet or insurance cards yet:
    Everyone who has applied and is eligible for Jan. 1, 2014, Oregon Health Plan coverage will have benefits that start on Jan. 1.  

    The Oregon Health Plan has more than 130,000 new enrollees starting on the same day. That means you may not get your member card right away. If you have not received your welcome packet and new member card yet, you are still covered for services starting Jan. 1, 2014. If you need to see a provider, call 1-800-273-0557 during normal business hours. For after-hours assistance, call
    1-800-562-4620. If you need to have a prescription filled before your see your doctor, you can visit your local pharmacy and they can access your OHP record.

    Here is a website with more information for new OHP enrollees: http://www.oregon.gov/oha/healthplan/Pages/New-to-OHP.aspx