Oregon Health Plan Benefits

Novel coronavirus (COVID-19): Oregon Health Plan members are covered.
Have OHP and need to be tested for COVID-19? It’s covered. Need to stay in the hospital because of COVID-19? That’s covered, too. We have answers to your top questions about testing and more on the COVID-19 Updates page.

The Oregon Health Plan provides Oregonians access to coordinated health care. It covers services such as regular check-ups, prescriptions, mental health care, addiction treatment and dental care.

Benefits covered under OHP Plus, OHP with Limited Drug and CAWEM Plus

To see what OHP covers, view the benefit chart below or the page 2 of OHP's guide to understanding your welcome letter. OHP benefits are covered according to your benefit package and the Prioritized List of Health Services.

To find out if a specific service is covered, please ask your provider or coordinated care organization (CCO).
More information about your coverage and your CCO was in your OHP welcome letter.

Benefits chart

Chemical dependency care
Dental	Basic services including cleaning, fluoride varnish, fillings and extractions Urgent or immediate treatment Dentures Stainless steel crowns for molars (back teeth) Other crowns for pregnant women and children under age 21. Sealants, root canals on back teeth for children under age 21.
Hearing	Hearing aids and hearing aid exams
Home health	Private duty nursing
Hospice care	End-of-life care
Hospital care	Emergency treatment Inpatient and outpatient care
Immunizations and vaccines	Such as the flu shot or measles-mumps-rubella (MMR) vaccine
Labor, delivery and post-partum care
Laboratory tests and X-rays
Medical care from a physician, nurse practitioner or physician assistant	Such as a routine check-up or a general appointment
Medical equipment and supplies	Such as diabetes testing strips or crutches
Medical transportation	Such as an ambulance or non-emergency transportation to an appointment
Mental health care	Such as therapy or medical treatment
Physical, occupational and speech therapy
Prescription drugs	OHP with Limited Drug only includes drugs that are not covered by Medicare Part D
Vision	Medical services Services to correct vision for pregnant women and children under age 21 Glasses are covered for pregnant adults and adults who have a qualifying medical condition such as aphakia or keratoconus, or after cataract surgery.

Other benefit packages

CAWEM

Covers emergency medical, emergency dental and emergency transport services.

Qualified Medicare Beneficiary (QMB)

Only covers Medicare premiums and copayments (except for Medicare Part D) and deductibles.

OHP Frequently Asked Questions

How do I apply for OHP benefits?

Visit the How to Apply page to find out more about the application process and where to find an application.

What do I need to know if I’m new to OHP?

Visit the New to OHP page to find more information about getting started with OHP.

How do I find out if a specific service is covered under OHP?

Ask your provider or coordinated care organization (CCO) if a specific service is covered. You can also call OHP Client Services at 800-273-0557 for more information.