A new Oregon Health Plan (OHP/Medicaid) program provides benefits to eligible young adults with special health care needs ages 19 and 20.
The Young Adults with Special Health Care Needs (YSHCN) benefits launched Jan. 1 and are the first of their kind in the nation. These benefits extend OHP coverage, enhanced vision and dental services and the new health-related social needs (HRSN) climate and housing benefits to this young population.
In Oregon, one in five children under 18 has a special health care need—ranging from physical, intellectual and developmental disabilities to complex mental or medical conditions. However, when these OHP members turn 19 they lose their health coverage. More than 80% of young adults with special health care needs lack access to the care they need.
To qualify for YSHCN benefits, applicants must be age 19 or 20 and have:
- At least one qualifying health care need that began before turning 19; and
- An individual or household income up to 205% of the Federal Poverty Level (FPL). Based on current FPLs, that means a single individual with an annual income of $30,873 or less would qualify. For a family of three, that figure is $52,931.
OHA estimates 4,000 young adults in Oregon will qualify for YSHCN benefits through new OHP memberships, and 15,000 current OHP members will qualify.
Current OHP members who qualify for YSHCN benefits will receive a letter asking if they want to apply, or they can contact their coordinated care organization (CCO). Non-OHP members interested in YSHCN benefits can apply for OHP online, or call or visit a local community partner or Oregon Department of Human Services office.
NOTE: People must apply for YSHCN benefits before they turn 21. Once enrolled, OHP members with YSHCN benefits remain in the program until their 26th birthday.
If you have questions, call 1-800-273-0557 or email [email protected].
