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Oregon's Health CO-OP certified as Qualified Health Plan for Cover Oregon

September 6, 2013

September 6, 2013 -- Cover Oregon this week certified Oregon’s Health CO-OP as a “Qualified Health Plan,” or “QHP.” The certification is an important next step for the CO-OP, which will be offered on Cover Oregon’s health insurance marketplace in October, and will begin covering health care needs of members beginning January 1, 2014.

“We’re very glad to have achieved this milestone,” said Bob Dickes, the CO-OP’s marketing director. “It means we’re that much closer to providing for Oregonians the kind of health plan they’ve been asking for.”

Both Oregon’s Health CO-OP—a Consumer Operated and Oriented Plan—and Cover Oregon were launched under provisions of the federal Patient Protection and Affordable Care Act (ACA). To be offered on the Cover Oregon marketplace, a health plan must be certified as a QHP, an attestation that it meets all the requirements of the Affordable Care Act, as well as any requirements the state has added.

Among these requirements are accreditation standards, a network of providers adequate for the expected member population, quality improvement standards and coverage of 10 categories of Essential Health Benefits: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance-abuse disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management.

Oregon’s Health CO-OP has plans that meet all these standards and more. It has also traveled throughout the state talking to Oregonians about their desires for health care. With this input, the CO-OP developed its “SiMPLE” plans with features important to Oregonians, such as accrediting naturopaths as primary care providers, flat copayments for most services, coverage for telephone or e-mail follow-up care and deductibles only for big-ticket care, such as hospitalization.

Beginning October 1 Oregon’s Health CO-OP plans will be offered through www.ohcoop.org or through independent health insurance brokers or community partners certified by Cover Oregon. Later in October, application may be submitted directly through CoverOregon.com for those individuals not needing the assistance of community partners or brokers. Coverage begins January 1, 2014.

For information, contact Jeanie Lunsford.

 

 

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