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Premiums and premium debts for clients
Other client FAQs: Benefits • Enrollment • Rights • Premiums • Copayments
Do I have to pay premiums for the OHP Standard benefit package?
How much is my premium?
When do my OHP Standard premiums start?
Will my OHP Standard premium change?
What types of changes must I report to my worker?
When are my OHP Standard premiums due?
Where do I pay my OHP Standard premiums?
What if a friend or family member is paying the premium for me?
How are my OHP Standard premiums billed?
Who do I contact if I have questions about the amount on my premium bill?
How long do you keep track of past-due premiums?
Can my premium be waived or forgiven?
Q. Do I have to pay premiums for the OHP Standard benefit package?
A. Most people who receive the OHP Standard benefit package must pay a premium. You do not pay premiums if you are a Native American or Alaskan Native and are a member of a federally recognized Indian tribe or eligible for benefits through Indian Health Services. You do not have to pay premiums if your household income is 10 percent or less of the federal poverty level at the time of enrollment.
Some members of your household may be enrolled in the OHP Plus or OHP with Limited Drug benefit packages. They do not have premiums. Other members of your household may be enrolled in the OHP Standard benefit package. Check your OMAP Medical Care Identification to see which benefits each person receives.
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Q. How much is my premium?
A. Premiums will range from $9 to $20 per person per month. The amount is based on your income and the size of your family. You will receive a premium bill each month telling you the premium amount for your household. If you have questions about how your premium amount was calculated, talk to your worker.
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Q. When do my OHP Standard premiums start?
A. We will begin charging you premiums on the date your coverage begins.
Q. Will my OHP Standard premium change?
A. Usually, your premium will not change during the first six months of coverage, but it may change when someone gains or loses eligibility for the OHP Plus benefit package. For example, a woman on OHP Standard who reported and verified she was pregnant would no longer be charged OHP premiums. She would become eligible for OHP Plus benefit package in the month her pregnancy was verified. She would get OHP Plus benefits for the rest of her pregnancy and for two months after delivery.
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Q. What types of changes must I report to my worker?
A. Notify your worker right away if there is a change in your household situation. Talk to your worker if you have questions about what changes you need to report. Some examples of changes that you need to report include:
- Changes in your name
- Change of address
- Change of health care coverage
- When a member of your household becomes pregnant or gives birth or a pregnancy ends.
- When someone becomes disabled or eligible for SSI
- When you have access to employer-sponsored insurance
If your situation changes, your eligibility for medical assistance may change. As a result, you may no longer be eligible for medical assistance or may become eligible for a different program with a different benefit package. When this occurs, your worker will send you a notice telling you how your eligibility has changed.
Your eligibility may change from the program that provides the OHP Standard benefit package to a program that provides the OHP Plus benefit package. Medical programs that provide the OHP Plus do not require premiums. Unpaid premiums do not affect your eligibility for programs that provide OHP Plus.
If your eligibility for a program that provides the OHP Plus or OHP with Limited Drug benefit package ends because of a change, your worker will evaluate your eligibility for all medical programs. You may have to provide additional information to your worker to determine your eligibility for another program. If you have unpaid premiums, you may need to pay those before you can qualify for OHP Standard. Your worker will let you know.
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Q. When are my OHP Standard premiums due?
A. Your premiums are due on the 20th of each month. We consider a premium paid when the OHP Premium Billing Office gets it. A premium bill is mailed to you at the beginning of each month. The bill states the amount you must pay and when the payment needs to be received. If you do not get a premium bill, you may call the OHP Premium Billing Office at (541) 523-3602, or toll-free at (888) 647-2729, or TTY at (866) 203-8931. You may also email them at support@OHPBilling.com
You will not lose coverage during your current enrollment period just because you have a past-due premium. However, when your enrollment period is ending and you reapply, you will need to pay all billed premiums before you can qualify for another six months of coverage.
Coverage is not affected for clients in the household with OHP Plus or OHP with Limited Drug (such as children, pregnant women, or people with Medicare).
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Q: Where do I pay my OHP Standard premiums?
A: Do not send cash in the mail. You may pay by Visa, MasterCard or Discover credit or debit card by calling:
- 541-523-3602 (Baker City)
- Toll-free at 888-647-2729
Or you may send a check or money order for the OHP premium to:
OHP Premium Billing Office
P.O. Box 1120
Baker City, OR 97814-1120
Go to http://www.ohpbilling.com/ for more instructions, payment choices and contact numbers.
Do not take payments to branch offices. Branch offices cannot accept your payments.
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Q. What if a friend or family member is paying the premium for me?
A. You must make sure that the person who is paying your premium for you includes your name and client identification number with the payment. It is important to make sure that this person sends the payment coupon (attached to your premium bill) along with the payment. It is your responsibility to make sure that your premium payments are paid on time.
You will find your client identification number on your premium bill. It is also on your Medical Care Identification, next to your name.
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Q. How are my OHP Standard premiums billed?
A. The premiums are computed per person. But the household gets only one bill each month. The bill includes the premiums for all household members enrolled in the OHP Standard benefit package.
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Q. Who do I contact if I have questions about the amount on my premium bill?
A. You may contact the OHP Premium Billing Office at
The contact numbers are also listed on the OHP premium bill.
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Q. How long do you keep track of past-due premiums?
A. Past-due premium amounts are carried for three years.
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Q. Can my premium be waived or forgiven?
A. Past-due premiums cannot be waived.
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This page updated Oct. 16, 2007.
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