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To know what benefits you have, view your OHP welcome letter. It lists your benefit package.
Don't have your OHP welcome letter? Look in your dashboard at ONE.Oregon.gov (under "Current Benefits").
OHP covers services according to your benefit package and the Prioritized List of Health Services.
To see what OHP covers, view the lists below. Click each type of care for more details.
Behavioral health in-home services to support independent living:
Children, youth and family supports such as applied behavior analysis, intensive in-home behavioral health treatment and family support services
Mental health care such as therapy, medication management, residential treatment and peer delivered services
Substance use disorder treatment such as counseling, medication assisted treatment, acupuncture, residential treatment and peer delivered services
Learn more about behavioral health services in Oregon.
OHP covers all services needed for their health and development, such as:
To learn more, read OHA's fact sheet and web page about these benefits (also known as EPSDT).
Basic services including cleaning, fluoride varnish, fillings and extractions
Urgent or immediate treatment
Stainless steel crowns for molars (back teeth)
Other crowns for children under age 21 and pregnant adults.
Limited orthodontic benefits for members under age 21
Sealants, root canals on back teeth for children under age 21.
Learn more about OHP dental benefits.
Such as ambulance and emergency
OHP covers emergency care for true
emergencies. These are sudden illnesses or injuries
that need treatment right away. Not being treated
right away could cause severe problems or death.
Screening and treatment for medical conditions (such as cataracts, glaucoma, injury)
For children under age 21 and pregnant adults, services to correct vision (such as exams, glasses and fittings for glasses).
For other adults, routine vision exams are covered every 24 months. Glasses are covered only for certain medical conditions. These include aphakia, keratoconus, or after cataract surgery.
Hearing aids and related batteries, dispensing, fitting and repair
Hearing services performed by a licensed physician, audiologist or hearing aid specialist
Home health care:
Hospice services (end-of-life care):
Inpatient and outpatient care
Purchase, rental or repair of medical equipment, such as:
Medical supplies, such as:
Emergency services, such as an ambulance.
Non-emergency travel, such as:
Learn more about non-emergency travel.
Medical care from a physician, nurse practitioner or physician assistant, such as a routine check-up or a general appointment; acupuncture and chiropractic services; surgery
Therapy to improve skills or function for daily living:
Prenatal, labor, delivery and postpartum care, such as:
Labor and delivery outside a hospital is known as a planned community birth. Learn more about planned community births.
Postpartum care lasts 12 months for OHP Plus members.
Learn more about your options before, during and after pregnancy.
Such as medications and oral nutritional supplements
OHP with Limited Drug only includes drugs that are not covered by Medicare Part D. These include:
Learn more about prescription coverage.
Regular screenings and tests (such as pelvic exams and Pap tests)
You can set up appointments for covered services, talk to your providers, and get care without leaving your home. This is called “telehealth" and it's free for OHP members.
Laboratory tests and x-rays, such as blood screening and mammograms
Gender affirming services, such as
hormone therapy, counseling and some surgeries
Services to help you stop smoking, such as:
Dental-only benefits for eligible Oregon Veterans and Compact of Free Association (COFA) citizens. Learn more about OHP's dental-only programs.
Only covers Medicare premiums and copayments (except for Medicare Part D) and deductibles.
Visit the Apply for OHP page. You can find out more about the application process and where to find an application.
When you are approved for OHP, you get an approval letter, then a welcome letter. The welcome letter contains your Oregon Health ID card and lists your coordinated care organization (CCO).
If you don't know if you still have OHP, you can view your dashboard at ONE.Oregon.gov (look under "Current Benefits").
You can also call ONE Customer Service at 800-699-9075.
OHP may pay for services you get outside Oregon when:
OHP will not cover any health care services you get
outside the United States, including Canada and Mexico.
For all services you get outside Oregon, the provider
must accept OHP. If the provider does not accept OHP,
you must pay for the services.
If you need services outside Oregon:
You can report it as a change to OHP. Learn how to report changes to OHP.
Note: If you qualify for OHP Plus benefits but want to enroll in private health insurance coverage, known as a Qualified Health Plan (QHP), at HealthCare.gov:
OHP covers medication to prevent RSV in high-risk children up to two years of age
New OHP dental-only programs open Jan. 1, 2023
COVID-19 and OHP
Flexible services for CCO members
Rules about covered services
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