Diagnostic Services
The Oregon Health Plan (OHP) covers health care services to find out about your health. If you have a health problem, we will pay for services to find out what is wrong. Some examples of diagnostic services:
- Health care visits to find out if you have a health problem
- Blood tests, lab services, X-rays.
- Mammograms (breast X-rays)
OHP will pay for a second opinion if you want one. You can ask to see another OHP provider or specialist. Coordinated care organization (CCO) members must have the CCO's approval to see a provider outside of the CCO's network.
Preventive Services
We want to prevent health problems before they happen. You can make this an important part of your care. Please get regular checkups and tests to find out what is happening with your health. Then you can find and treat health problems right away.
OHP covers services to regularly check your child's health and development, such as:
- Head-to-toe physical exams
- Hearing and vision checks
- Mental and behavioral health checks
- Dental checks
- Lab tests
- Growth and development checks
- Nutrition checks (eating habits)
These checks happen during regular doctor visits. They can also happen at other times if a health problem occurs between visits. If your child needs follow-up visits or special appointments, OHP covers those too. Learn more about what OHP covers for children through age 20.
Vaccines according to recommended immunization schedules, including:
- Flu or COVID vaccine
- Childhood vaccines such as Measles, Mumps and Rubella (MMR)
- Non-routine and travel vaccines recommended by the Advisory Committee on Immunization Practices
View the list of covered vaccines
To Get Diagnostic or Preventive Care:
Ask your primary care provider (PCP).
Don't have a PCP? If you are in a CCO that covers your care:
- Call your CCO to choose health providers. You can choose a primary care doctor, nurse practitioner, primary care dentist 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 open card (fee-for-service) OHP. This means the provider bills Oregon Health Authority (not a CCO) for services they provide. Learn more about open card OHP and how to find open card providers.