New Oregon Health Plan (OHP) Benefit
As of Jan. 1, 2025, OHP will offer benefits to certain young adults who qualify for a new eligibility category: Young Adults with Special Health Care Needs (YSHCN).
What Are the Benefits?
Extra vision and dental services
All medically necessary and medically appropriate care (also known as EPSDT)
Special help managing care
OHP also offers some members health-related social needs benefits. Heath-related social needs (HRSN) are basic needs that affect a person’s health. They include things like:
- Housing,
- Nutrition and
- Equipment to stay healthy during extreme weather.
Learn more about the HRSN benefits and eligibility requirements.
Who Qualifies?
To qualify, young adults ages 19 and 20 must have:
- At least one qualifying health care need that began before age 19, and
- Individual or family income up to 205 percent of the
Federal Poverty Level.
Current OHP members who qualify will automatically receive these benefits starting January 1. Young adults will also be able to complete a short set of questions in the OHP application to qualify. More information about eligibility coming soon.
Resources
YSHCN Provider Guide
YSHCN Provider Memo (12/19/2024)
Fact sheet for coordinated care organizations and other partners:
Behavioral health diagnosis codes:
Screening questions:
Member frequently asked questions (FAQs):