Oregon Health Plan (OHP) Benefits for Health-Related Social Needs

Supports for OHP Members in Certain Living Situations

Health-related social needs are needs for climate, housing or nutrition support. For people in certain living situations, these supports are important to support their health.

Release from incarceration in the past 12 months
Discharge from Institutions for Mental Disease (IMDs) in the past 12 months. IMDs are residential mental health facilities with 16 or more beds.
Current or past involvement in the Oregon child welfare system
Changing from Medicaid-only to dual (Medicaid and Medicare) coverage. This change can be within the next three months or past nine months
Being homeless or at-risk of becoming homeless

Climate support benefits start March 1, 2024. Learn more about climate supports.

Other supports will come in 2024 and 2025:

Housing supports (November 2024): Help getting housed or staying housed
Nutrition supports (January 2025): Help with food benefits and keeping a healthy diet

How to Get Started

If you think you may qualify, you can:

Your CCO will tell what to do.

Don't know if you are in a CCO? Call OHP Client Services (800-273-0557).

Not in a CCO? Call 888-834-4304.

Not an OHP member? Apply for OHP.

Complete the form. Send it to your CCO.

Not in a CCO? Email it to ORHRSN@kepro.com or fax it to 1-833-551-2607.

Download the form in your language:

English Español / Spanish Русский / Russian Tiếng Việt / Vietnamese اللغة العربية / Arabic 简体中文 / Simplified Chinese 繁體中文 / Traditional Chinese 한국어 / Korean Af Soomaali / Somali Lus Hmoob / Hmong Português / Portuguese

These people can work with you to complete and send your request:

Your primary care provider
A local OHP community partner
Someone you trust

Your CCO or OHA may contact you in different ways. They will do this if they need more information. They will always send you letters by mail if they deny your services. Be sure to check and update your mailing address, phone number, email, or other information.

What Happens Next?

Someone from your CCO or OHA (Acentra Health) will ask questions to find out which HRSN services you qualify for.

They will also ask you about any other needs you have.
You may need to provide more documents or information to help people decide if you qualify. If you do this, it can help your CCO or OHA decide more quickly.
They will help create a plan to meet your health needs. This person can also help connect you to other services.

You can fill out an authorization form. The form lets your CCO or OHA share needed information with your provider to make sure you get services.

Download the form in your language:

You will learn whether you qualify and what to do next. Someone from your CCO or OHA will contact you within 14 days of your screening for HRSN services.

If you qualify, they will refer you to an HRSN provider to help get what you need.
If you qualify for a climate device, let them know as soon as possible if you need help installing the device.
If you don't qualify, your CCO or OHA will send you a letter by mail.

You can ask your CCO for an appeal. If you are not in a CCO, you can ask OHA for a hearing. Learn more about appeals and hearings.

Your service provider or an OHP ombudsperson can help with this.

You can also ask your CCO or OHA to see if you qualify for the same or similar services through other programs.

What to Do If You Qualify for HRSN Services:

An HRSN provider will contact you when your services or equipment is available.

Confirm your address to get the services or equipment where you live.

It may take up to 30 days to get your services or equipment.

Someone will contact you by phone or the best way to reach you. They want to make sure you got your services or equipment, and everything works.

Contact your health plan to fix or replace equipment or see if you qualify for more services.

Your CCO or OHA will check in at least every six months to understand if the services meet your needs or if you need other services.

If you haven't already, you can work with someone from your CCO or OHA to make a plan for your care. Do this when it is convenient for you.

You can meet with someone from your CCO or OHA in person, by phone, or by videoconference to review and update your plan every 12 months.

Making this plan can help you keep services you already qualify for. It can also help you find other services you may qualify for. You can do make this plan as soon as you learn that you qualify for HRSN services.