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223 (07/2026) Chapter 2:Eligibility • Section 5: Financial eligibility Since the individual is does not meet the financial or non-financial eligibility criteria for another OHP Plus benefit, they will transition to CEPACA for the remainder of their CE period. When an individual is potentially eligible for an additional or better benefit and an RFI is generated, their existing benefits will not close and they will retain their existing CE period even if they do not respond. For example, A QMBP recipient reports a change that makes them potentially eligible for OSIPMAD, an RFI for AVS and interview will be sent because OSIPMAD is an additional benefit. If the individual does not respond, they will keep QMBP coverage throughout the remainder of their CE period. The following RFIs will still be generated during a CE period and medical benefits will be closed if the RFI is not responded to. • Citizenship – including U.S. citizenship and identity • Immigration status • Social Security Number Coverage may be terminated during the CE period only in the following circumstances: • The individual is no longer an Oregon resident; • The individual is deceased; • The individual or someone authorized to act on their behalf requests voluntary termination of eligibility; • The agency determines that eligibility was erroneously granted at the most recent determination or renewal of eligibility because of agency error, fraud, abuse, or perjury attributed to the individual or someone authorized to act on their behalf; • For Medicare Savings Programs, if the person becomes disenrolled from Medicare Part A, or • Non-response to a citizenship, immigration, or SSN RFI. • For recipients of the YSHCN program, turning 26 is an allowable closure for YSHCN. However, an individual turning 26 will transition to OHP Plus/Healthier Oregon-level coverage for any time remaining in their CE period. Note: Benefits will still be suspended for individuals who become incarcerated; the CE period will continue during the incarceration.