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Medical Benefits

Physical Health Services and Prescriptions

This care includes emergency care and ambulance services, diagnostic and preventive care, pregnancy care, prescriptions and the following services.

​​Hearing aids and related batteries, dispensing, fitting and repair 

Hearing services performed by a licensed physician, audiologist or hearing aid specialist

​​Care provided by a registered nurse or home health aide 

Physical, occupational or speech-language pathology services​​​​​

​​Home care

Inpatient care at a hospital, hospice or nursing facility

Respite care to relieve family members or caregivers​

​​Emergency treatment

Inpatient and outpatient care​

​​Medical care from a physician, nurse practitioner or physician assistant, such as a routine check-up or a general appointment

Acupuncture 

Chiropractic services

Surgery

Specialist care​​​

​​​Purchase, rental or repair of medical equipment, such as:

  • Canes or crutches
  • CPAP devices
  • Hospital beds
  • Oxygen equipment
  • Standing and positioning aids
  • Walkers
  • Wheelchairs

Medical supplies, such as:

  • Diabetes testing strips
  • Incontinent supplies​

​Home enteral/parenteral nutrition and IV therapy​

Oral nutritional supplements

Related goods, supplies and services​​​

​​Therapy to improve skills or function for daily living:

  • Up to 30 visits per year to restore skills following an illness, injury or disability, or
  • Up to 30 visits per year to teach age-appropriate skills (such as therapy for a child who is not walking or talking at the expected age).​

​This skilled nursing benefit is for people who need nursing facility care​ after a hospital stay. Learn more​ about this benefit.​

​​OHP pays for services and medications to help you stop smoking, such as:

  • Nicotine replacement therapy (such as nicotine gum or patch)
  • Tobacco cessation medications (such as Chantix and Zyban) and
  • Counseling.

To learn more, talk to your primary care provider. 

​​Oregon Quit Line 

​​OHP respects the health care needs of all members. This includes trans women, trans men, gender nonconforming, two-spirit and non-binary members. 

OHP covers gender-affirming services according to the World Professional Association for Transgender Health Standards of Care (Version 8). This includes hormone therapy, counseling, surgeries and non-surgical treatments to support gender identity. 

Learn more about gender-affirming care.​

To Get Medical Care:

If you are in an OHP coordinated care organization (CCO) that covers medical care:

  • Call your CCO to choose health providers. You can choose a primary care doctor, nurse practitioner and more.
  • If you don't want to choose a provider, your CCO may choose one for you to get started.

If you are not in a CCO, you need to see a provider that accepts fee-for-service OHP. This means the provider bills OHA for services they provide. 

Rules about Covered Services