With Medicaid review underway, hundreds of callers a day give up on state’s helpline

Medicaid members have been calling the state’s helpline in recent weeks with questions about new eligibility requirements.

The state has started to verify whether each of the 1.5 million members still qualify now that the COVID emergency is over and extra federal benefits have ended.

This process started this month, and the state’s helpline is lacking, residents say. Callers always have to wait, sometimes for an average of 15 minutes, sometimes more than an average of 30 minutes, according to the Department of Human Service’s dashboard. It shows that hundreds of callers a day, and sometimes a few thousand, asking about Medicaid and other benefits hang up, apparently fed up with waiting. 

Members give the helpline a mediocre score, 3.16 out of 5 for the service in general and 3.39 out of 5 for the call takers’ ability to answer questions. That’s less than the department’s goal,  Jake Sunderland, the agency’s press secretary, told the Capital Chronicle in a statement.

“Our service goal is an average satisfaction survey score of four or higher,” Sunderland said.

Even worse: At least one member on the Oregon Health Plan, Oregon’s version of Medicaid, was given misinformation – twice. 

“They told me I can’t earn more than about $16,000,” the woman, who requested anonymity, told the Capital Chronicle. “One six months ago told me $18,000.”

Both figures are wrong. The income limits are based on federal poverty levels, which are updated by the federal government every year. Federal rules limit Medicaid to those earning up to 138% of the federal poverty level, now nearly $19,400 a year for one person, but under a temporary waiver Oregon has extended that to 200%, or about $29,000 a year, for one person.

Sunderland said eligibility status is based on many factors.

“There are many different financial considerations for Medicaid eligibility along with considerations of household composition as well as age and disability statuses and many other factors,” he said. “This makes it incredibly complicated to accurately give ‘salary limit’ information to callers who have general questions and are not seeking to apply or renew benefits.”

Nevertheless, income is a key benchmark, and the salary limits are clear.

Vivian Levy, interim deputy Medicaid director at the Oregon Health Authority, said the misinformation indicates that state officials need to continue training call takers to make sure they have the correct information.

“There’s a tremendous number of changes that are happening right now,” Levy told the Capital Chronicle. “And that requires a lot of training and a lot of communication in a lot of different ways with staff across the state.”

Status in April

The Medicaid verification process started this month. The Oregon Health Authority said Monday that it had renewed 140,000 members, requested more information for nearly 47,000 members and notified 6,000 that they will lose coverage.

To update your information, go to the One system

Medicaid members can call 800-699-9075 with questions.

Oregon Capital Chronicle is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Oregon Capital Chronicle maintains editorial independence. Contact Editor Lynne Terry for questions: [email protected]. Follow Oregon Capital Chronicle on Facebook and Twitter.

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