Oregon Health Plan (OHP) Benefits

What Does OHP Cover?

In general, OHP covers health care services only when they are in your benefit package and are:

Supplied in the United States by providers who accept the Oregon Health ID card and
Medically necessary. This means the service is important to keep you healthy or help you get better.

OHP covers services according to your benefit package and the Prioritized List of Health Services.

Do you want to know if OHP covers a specific service? If so, please ask your provider or coordinated care organization (CCO). Learn more about working with your CCO and finding OHP providers.
Do you want to know if OHP covers treatment for a specific health condition? Use the Searchable Prioritized List to find Guideline Notes about the health condition.

Learn about Your Benefits

To know what benefits you have, view your OHP coverage letter. It lists your benefit package.

Don't have your OHP coverage letter? Look in your dashboard at ONE.Oregon.gov (under "Current Benefits").

Learn more about your benefits in your OHP member handbook.

OHP Benefits: OHP Plus, OHP with Limited Drug and OHP Bridge

To learn what OHP covers, click each type of care for more details. You can also view the summary of OHP benefits and coverage.

Behavioral health care Care coordination Dental care Diagnostic and preventive care Emergency care and urgent care EPSDT (care from birth to age 21) Eye and vision care Gender-affirming care Medical care Pregnancy care Prescriptions Telehealth Travel help Limited or not covered services

Some OHP members may also qualify for health-related social needs benefits. These benefits are for members facing certain life changes. Learn more about these benefits:

Climate supports Housing benefits

OHP Dental

OHP Dental covers dental-only benefits for eligible Oregon Veterans and Compact of Free Association (COFA) citizens. Learn more about OHP's dental-only programs.

Qualified Medicare Beneficiary (QMB)

QMB does not cover health care. It only covers Medicare premiums and copayments (except for Medicare Part D) and deductibles.

Frequently Asked Questions

Visit the Apply for OHP page. You can find out more about the application process and where to find an application.

There are three steps to getting started using your OHP benefits:

Get to know your coordinated care organization (CCO). Your CCO can help you get the care you need.
Pick a provider.
Make an appointment.

Visit the New to OHP page. You can find more information about getting started with OHP.

You can report it as a change to OHP. Learn how to report changes to OHP.

Note: If you qualify for OHP Plus benefits but want to enroll in private health insurance coverage, known as a Qualified Health Plan (QHP), at HealthCare.gov:

Canceling your OHP does not mean that you no longer qualify for OHP Plus.
As long as you qualify for OHP Plus, you will not qualify for financial help to pay for the QHP's monthly premium. You would need to pay full cost.