A newly launched program under the Oregon Health Plan (OHP/Medicaid) offers benefits to qualifying young adults aged 19 and 20 who have specific health care requirements.
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, 20% of children under the age of 18 have special health care needs, which include a variety of conditions such as physical, intellectual, and developmental disabilities, as well as intricate mental or medical issues. Unfortunately, when these Oregon Health Plan (OHP) members reach the age of 19, they lose their health insurance. As a result, over 80% of young adults with special health care needs do not have access to the necessary care.
To be eligible for YSHCN benefits, applicants need to be between the ages of 19 and 20 and meet the following criteria:
- 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 projects that approximately 4,000 young adults in Oregon will be eligible for YSHCN benefits due to new OHP enrollments, alongside 15,000 existing OHP members who will also 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].
