Reporting private health insurance
- Anyone who gets medical benefits through the Oregon Health Plan (Medicaid) needs to report if they are covered by other health insurance.
- Providers and Coordinated Care Organizations (CCOs) need to report if a patient's insurance information is different from what the State has on record.
- This is so private insurance companies can be billed first for medical services and benefits are coordinated.
- Private health insurance coverage is also called "third party liability" or
TPL.
Add, update or remove TPL
OHP members, providers, application assisters and CCO representatives can all report and update TPL.
Report or update TPL
ODHS and OHA staff: Please use the ONE Worker Portal to update TPL information on a case.
Frequently asked questions
You are required to report:
- Insurance through a job (employer-sponsored health insurance)
- Insurance that was purchased from an insurance company (commercial health insurance), including Medicare Supplements
- Student insurance
- Insurance provided by someone who does not live in the same household as the OHP member
- If your insurance ends or there are changes to your policy
You don't have to report:
- Medicare A, B, C, D or Medicare Advantage (Replacement) policy information
- Car insurance
- Homeowner’s insurance
If you have OHP and meet the eligibility requirements, Oregon's Health Insurance Premium Payment Reimbursement program (HIPP) may be able to reimburse the policy holder for their private health insurance premiums.
Learn about the HIPP program
We will only use this information:
- To make sure your benefits are coordinated between the primary and secondary insurance coverage.
- To determine eligibility if you apply for the HIPP program.
Contact us