OHP??

I was planning on having an open RNY (only kind Kaiser would do) when I HAD kaiser insurance. I've recently been fired from my job, and between false accusations/pending investigations and my own health problems whi*****lude severe back and knee pain, and bad asthma I have been having trouble finding another job; especially a job that offers health insurance that covers wls. Until I find another job I am on unemployment and my daughter is on OHP. I was told that even though my income is low enough (duh) I am not eligable for OHP. Does anyone know how that works? or if they even allow/offer wls while on the plan? I have visited the insurance message boards, and it seems that people from every other state medicare program have been approved or had wls. I was just wondering if anyone knows where Oregon stands on that? Thanks!

Adults aren't able to get on the Oregon Health Plan/Medicaid unless they are considered disabled. If you feel you have a claim to disability, contact your local senior and disabled office and see if they can assist you with applying. I THINK you may have to apply for OHP, get your denial, and then appeal with a claim of disability. However, my understanding is that OHP/Medicaid in Oregon does not pay for weight loss surgery. I've read that some people have gotten exceptions to this, but only after significant legal efforts. If you feel you are disabled, you can apply for Medicare/Social Security benefits. This is generally a very lengthy process. Most people, unless they are VERY clearly disabled, are initially denied for Social Security. After that denial, you then have to appeal. It's very helpful to have a lawyer at this point. They can help you navigate and advocate for yourself. Medicare does pay for weight loss surgery. Sorry this is long winded! I hope this is helpful. Tammy

I do not belive that adults cannot get on the plan unless they are disabled. I know many people that are on the plan as adults with no children. you just have to be in there income level which is incredable low. like 150 a month. My oldest daughter is on ohp not disabled at least not labeled that way. I have heard that it can be covered but its not easy to get it covered.

Do you know how she managed to get on ohp?? Cause I've applied twice recently, the first time when I lost my job and had NO income whatsoever and was still denied, and the second time after I finally got approved for my unemployment and are getting $260/mth to support myself and my three year old daughter and all my stacks of bills. Still denied. Which sucks not only because of my need/desire for wls, but also because I've had several health issuse surface recently, which may or may not be related to my weight but need medical attention anyway. *sigh* If you know how your daughter managed to get covered, let me know! I'd welcome any tips, even if it's just try try again. Thanks!! -Heather

I've been told by OHP that they will not approve new non-disabled adult applications. I work in a medical office and have tried to help a couple of patients navigate this. People who were on OHP before the new rule was put in place continue to qualify but if they let their coverage slip for even a brief period of time, they will not be eligible to reapply.

I work for the state of Oregon and they do not take adults and have not since 2003. The only adults they take are disabled and pregnant women. The adults that were already on OHP in 2003 are able to stay on it because they were already on it when the state quit excepting adults. If they ever let theirs lapse or loose it because they are over income, they will not be able to get back on. Also, the income level guidelines are much higher that $150.00.