Medicaid members get information, ask questions about transition to Trillium

Medicaid members who will be shifting insurance providers from PacificSource to Trillium gathered Saturday, Dec. 6 in Cottage Grove to ask questions and get more details about the transition.

About 20 people attended the meeting at the Cottage Grove Community Center, organized by the Oregon Health Authority, and shared concerns, ranging from access to behavioral services to language barriers. 

PacificSource and Trillium are insurers that serve as coordinated care organizations, or CCOs, which manage care for people enrolled in the Oregon Health Plan, the state’s Medicaid program. The health authority in September ended contract negotiations with PacificSource as a Lane County CCO.

As a result, state officials plan for PacificSource Community Solutions to exit the county Jan. 31, with Trillium Health Plans taking over its members’ coverage Feb. 1. About 92,000 Medicaid members in Lane County will be switched from PacificSource Community Solutions to Trillium Community Health Plan.

Representatives of the state health authority said one goal of Saturday’s meeting — one of three that will be held with Medicaid members in Lane County — was to hear directly from people who will be affected by the switch.

“We talk about rules, but we don’t know how that interprets and works out to somebody’s daily life, until you just get out in front of us and say this has happened, this is happening,” said Jerry Riener, a health system analyst with the state health authority. “This is how we can adjust our information and communication to try and address these issues.”

Palmira Rosario came to the meeting seeking information on how she could continue her son’s therapy treatment. At the moment, she said, her son’s therapist is not in Trillium’s network and is unlikely to make the transition. The therapist has told Rosario that Trillium has barriers inhibiting providers from working with its network.

Brandie Thielman, a Trillium executive, said the insurer is working on fixing those network issues, adding that 84% of behavioral health providers under PacificSource are in Trillium’s network and that Trillium is working to increase that percentage.

More than 90% of primary care providers and 100% of dental and pharmacy providers in PacificSource’s network are also in Trillium’s network, Trillium said.

Rosario, who only speaks Spanish, also advocated for more translation services to help the residents like herself who could not read the English pamphlets and graphics presented during the meeting. 

Details of the switch 

Presenters at Saturday’s meeting provided additional details about the switch:

After Jan. 31, 2026, PacificSource members will be automatically moved to Trillium. If a current provider isn’t part of Trillium’s provider network, Trillium will send advance notice and help find a new provider. In some cases, members with out-of-network providers can still request authorization for specific covered services. 

Regardless of whether the provider is in Trillium’s network, most members under the Oregon Health Plan will continue to receive physical health and dental care for another 30 days, as well as behavioral health for another 60 days.

Those with Medicare and Medicaid will continue to receive physical, dental, and behavioral health care for another 90 days. 

Members with high-risk conditions can finish the treatment they started as a PacificSource member.

More information can be found at Oregon Health Authority’s website. For general questions, comments, or concerns, email CCOSpecialprojects@oha.oregon.gov

Here are details about the remaining two meetings intended for Medicaid members who will be switching to Trillium, both have virtual options: 

• Tuesday, Dec. 9, 6 p.m. to 7:30 p.m.,Siuslaw Public Library, 1460 Ninth St., Florence.
• Thursday, Dec. 11, 6 p.m. to 7:30 p.m., Graduate by Hilton Eugene, 66 E. Sixth Ave., Eugene.

This story has been updated to reflect the correct spelling of Jerry Riener’s name.