In addition to the general requirements applicable to OHP Bridge – Basic Health Program set forth in this Division 200, this rule describes specific eligibility requirements for OHP Bridge – Basic Health Program.

1. (1) OHP Bridge – Basic Health Program is effective on July 1, 2024.

2. (2) To be eligible for OHP Bridge – Basic Health Program an individual must:

   1. (a) Be age 19 or older and under age 65;
   2. (b) Have, as required under OAR 410-200-0315, monthly MAGI-based income which exceeds 133 percent of the federal poverty level (FPL) for the applicable family size; have annual household income for the applicable family size between 133 percent and up to and including 200 percent FPL for the coverage year being requested; and
   3. (c) Meet citizenship status requirements outlined in OAR 410-200-0215(1), or non-citizen status requirements outlined in OAR 410-200-0215(5).

3. (3) Even if an individual meets the requirements in section (2) of this rule, the individual shall not be eligible for OHP Bridge – Basic Health Program if they:

   1. (a) Are enrolled in Medicare benefits under part A or B of Title XVIII of the Act; or
   2. (b) Are receiving other healthcare coverage that qualifies as Minimum Essential Coverage as defined in OAR 410-200-0015(55), unless that coverage is an Insurance Affordability Program as defined in OAR 410-200-0015(50); or
   3. (c) Are able to access affordable coverage as described in section 36B(c)(2)(C)(i)(II) of the IRS Code and 26 CFR section 1.36B–2(c)(3)(v)(A)(1). The required contribution percentage is indexed annually under section 26 U.S.C. 36B(c)(2)(C)(iv); or
   4. (d) Are receiving Supplemental Security Income (SSI) benefits.
4. (4) OHP Bridge – Basic Health Program eligibility is re-evaluated every twelve (12) months.
5. (5) An individual who is approved for OHP Bridge – Basic Health Program coverage is entitled to twelve (12) months of coverage provided they continue to meet non-financial eligibility criteria. Once approved, an individual’s OHP Bridge – Basic Health Program coverage shall not be terminated during a twelve (12) month eligibility period due to an increase of countable income.

Statutory/Other Authority

ORS 411.402, 411.404, 413.042, 414.241, 414.534, 42 CFR 433.138, 433.145-433.148, 435.3-435.4, 435.110, 435.115-435.119, 435.190, 435.222, 435.403, 435.406-435.407, 435.608, 435.610, 435.916-435.917, 435.940, 435.952, 435.956, 435.1008, 435.1200, 435.1205, 447.56, 457.80, 457.320, 457.340, 457.350, 457.360, 457.380, 457.805, 458.350, 435.112, 435.170 & 42 CFR 600

Statutes/Other Implemented

ORS 411.402, 411.404, 414.241, ORS 411.060, 411.406, 411.439, 411.443, 413.032, 413.038, 414.025, 414.231, 414.440, 414.534, 414.536, 414.706, 411.095 & 411.400

History

DMAP 85-2025, amend filed 12/02/2025, effective 12/02/2025
DMAP 49-2025, temporary amend filed 06/10/2025, effective 06/10/2025 through 12/06/2025
DMAP 94-2024, adopt filed 05/29/2024, effective 06/01/2024