Fall 2013
Presented by the Self-Sufficiency Training Unit
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:

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
Guidelines for daily work
Interacting with our customers
Collaboration with OHA and Cover Oregon
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
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
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
Renewals occurring October 2013 – March
2014 will be deferred out 6 months
(excludes some populations)
Original Renewal
Month
Deferred Renewal
Month
October 2013
April 2014
November 2013
May 2014
December 2013
June 2014
January 2014
July 2014
February 2014
August 2014
March 2014
September 2014
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SSP, OHA and APD will work together to
complete all case transfers
◦ 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
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
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
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
Medical
DOR form
for OHA5503
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
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
10/01/13 revision will
exclude medical
questions
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Compatible with all browsers
Paper Application
Online
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• 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
OHP Standard Reservation List requesters will
be mailed a letter in mid-October regarding
new health care options for January 1, 2014

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

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
DO NOT SAVE YET!
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
DO NOT SAVE YET!
DO NOT SAVE YET!


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
DO NOT SAVE YET!
DO NOT SAVE YET!


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
DO NOT SAVE YET!
DO NOT SAVE YET!

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.


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
Notice that recipient is only receiving QMB.
If recipient was receiving QMB and OCCS
medical, transfer whole case to 5503.
DO NOT SAVE YET!
DO NOT
SAVE YET!


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
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
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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
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