Oregon Health Plan (OHP) Behavioral Health Coverage

Behavioral Health Services Do Not Need Prior Authorization

OHP covers behavioral health services. These are services to treat substance use, problem gambling and mental health disorders. You do not need a referral from your primary care provider to get treatment.

If you need help accessing behavioral health services, contact your CCO. Ask for care coordination.
If you are not in a CCO, contact OHP Care Coordination or your local Community Mental Health Program.
You can also use the Oregon Behavioral Health Directory to find providers that accept OHP or work with your CCO.

Mental Health Care

This includes:

Care coordination
Emergency services
Evaluations and consultations
Hospital stays
Medication management
Medication
Residential treatment
Therapy

Substance Use Disorder (Addiction) Treatment

You do not need a referral to get help for problems with alcohol or drugs.

Some of the covered outpatient and residential treatment services are:

Screening, assessment and physical examination including urine tests
Medication-assisted treatment
Acupuncture
Detoxification and
Individual, group and family or couple counseling.

A 24-hour care facility provides residential treatment for addiction. A residential facility can treat both adults and youth. Some facilities allow parents to bring their young children with them. Ask your CCO about treatment programs.

Covered medications include:

Methadone
Suboxone
Buprenorphine
Vivitrol and

Other medication services that help you cut down or stop using alcohol or drugs.

Other Behavioral Health Supports

Behavioral health in-home services to support independent living:

Personal care attendant services to help with or perform activities of daily living
Services to maintain, develop or improve skills needed to perform activities of daily living

Learn more about home- and community-based services.

These include applied behavior analysis, intensive in-home behavioral health treatment and family support services.

Wraparound services for children, youth and young adults under age 21 involved in two or more systems

Wraparound services are for children, youth and young adults and their families who are involved in two or more systems, such as:

Behavioral health
Special education
Juvenile justice
Intellectual/developmental disability services
Child welfare

Wrapround is a volunary care coordination model and planning process. It offers community-based services and supports for the youth and family's unique needs.

Young, young adults and their families will work with a team trained to support their needs. Together they will create a plan of care based on what the youth and family think will help most. This plan helps youth and family members move toward their goals and vision for the future and achieve postiive outcomes.

To get a referral for Wraparound, contact your child's CCO. You can also contact your county's Wraparound provider.

Peer-delivered services are services from a peer support specialist or peer wellness specialist. These are people who have lived through some of the same things you have. They can:

Show you how to get the right services for you and your family.
Go to meetings with you.
Support you in your recovery.
Support you in parenting children with special physical or behavioral health needs.