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Updated: 12-month eligibility for Oregon Health Plan post-partum benefits

Oregon Health Plan·OR · OB-GYN, Family Medicine, Pediatrics +2 more·Plan
Effective date
Apr 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

Oregon Health Plan extended post-partum benefits from 2 months to 12 months for members whose pregnancies ended on or after April 1, 2021. This affects OHP Plus (BMH) benefits for members under 21 and OHP Plus Supplemental (BMP) benefits for members 21 and over, including enhanced dental and vision coverage.

Action Required

Action needed
Immediately: Update billing systems to recognize 12-month post-partum eligibility for Oregon Health Plan members instead of 2-month period. Verify member eligibility using pregnancy due dates in 834 enrollment files and PERC codes. Train billing staff on extended coverage period for post-partum services including enhanced dental and vision benefits. Monitor for upcoming member reimbursement guidance expected June 2022.