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Your Rights as an Oregon Health Plan (OHP) Member

OHP Rights and Responsibilities

These rules list the rights and responsibilities you have as an OHP member:

  • 410-120-1855 – For all OHP members.
  • 410-141-3590 – For all OHP members in coordinated care organization (CCO) or dental plan. 
  • 410-141-3810 – Explains when members can ask for disenrollment from a CCO/plan, and how to do this. 

Your Rights

Under the Americans with Disabilities Act, providers must give people with disabilities full and equal access to health care services and facilities. People with disabilities have a right to reasonable changes to gain equal access. ​

OHP must respect the dignity and the diversity of all members and their the communities. By law, OHA and all its providers and plans must treat everyone fairly. To learn more, visit OHA's Civil Rights page . ​

Everyone has a right to learn about Oregon Health Authority (OHA) programs and services. They have the right to learn in a way they can understand. 

​Tell OHA, your CCO, dental plan and health care providers about your language needs.
  • You can ask for an interpreter at health care appointments. Tell your provider about this at least two days before the appointment.
  • You can ask OHA, your CCO/plans, health care providers and pharmacies to give you written information in a different language.
  • When you call, you can also ask to speak with someone who speaks your language.
OHP providers must offer and give you these services free of charge. If they don't, you can file a complaint​.

To tell OHA your preferred written and spoken languages:

OHA can then share this information with your CCO/plans.

To tell your health care providers:

​In Oregon, providers are required to use qualified and certified interpreters listed in Oregon's Health Care Interpreter Registry.

To learn more, visit OHA's Language Access page. ​

Minor Rights and Access to Care (English) (Spanish). This guide tells you:

  • The types of services minors can get on their own, and
  • How their health information may be shared.​

​Learn what to do​ when you:

  • Do not agree with a decision to deny payment for your health care services.
  • Want to file a complaint about OHP services.
  • Want to file a complaint about an Emergency Medical Services provider, Trauma Systems provider, or health care facility​.

​There are three types of forms you can complete. They will help make sure providers know about the types of treatment you do and do not want:

Adva​nce directive

This form lets you decide what type of care you want before you need it. You can also name a person to direct your health care. This person is your "health care representative." Find this form in multiple languages on the Public Health Division website.

Physician Orders for Life-Sustaining Treatment (POLST)

This is a medical order completed by your doctor. It tells other providers the types of treatment you do and do not want in an emergency. Learn more on the Oregon POLST website.

Declaration for Mental Health Treatment

This form tells what kind of mental health treatment you do and do not want. Providers can use this form when you cannot make decisions during a mental health crisis. You can also name a person to make decisions about your treatment.

​You have the right to ask for copies of your health care records. 

  • You can ask your health care provider or CCO/plan for your records at any time.
  • You also have the right to make sure the information in your records is correct and know who has seen it. 


Your Responsibilities

Members must report all health coverage resources. This is to make sure OHP only pays after other resources have paid. 

  • Report personal injury or accidents: Report current personal injury claims or your intent to file a claim at www.reportinjury.org. Also report the injury to your CCO.
  • Report other health coverage: Report any other health coverage, such as private health insurance, at www.reportTPL.org .

If OHP pays for services that another resource should have covered, the Office of Accuracy and Payment Recovery will recover those payments. 

Report changes as soon as possible. Changes may be to your name, address, household, income or immigration status. Learn about the types of changes to report .​

If you think someone is misusing Medicaid programs and benefits, report it right away.

​After an OHP member dies, OHA will seek repayment for services that OHP covered after age 55 for people in long-term care. This applies only when OHP has paid some or all the cost of a member's long-term care using Medicaid funds. To learn more, read the Estate Recovery Program brochure.​