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Oregon Health Authority

Oregon Health Plan (OHP) Medical Benefits

Physical Health Services and Prescriptions

This care includes emergency care and ambulance services, diagnostic and preventive care, pregnancy care, prescriptions, COVID-19 services and the following services.

This is a 20-day skilled nursing benefit. It is for people who need nursing facility care​ after a hospital stay. Learn more about this benefit.​

​Hearing aids and related batteries, dispensing, fitting and repair 

Hearing services performed by a licensed physician, audiologist or hearing aid specialist​

​Care provided by a registered nurse or home health aide

Physical, occupational or speech-language pathology services

​Home care

Inpatient care at a hospital, hospice or nursing facility

Respite care to relieve family members or caregivers

​Emergency treatment

Inpatient and outpatient care

​Medical care from a physician, nurse practitioner or physician assistant, such as a routine check-up or a general appointment; acupuncture and chiropractic services; surgery; specialist care​

​​Purchase, rental or repair of medical equipment, such as:

  • Canes or crutches
  • CPAP devices
  • Hospital beds
  • Oxygen equipment
  • Standing and positioning aids
  • Walkers
  • Wheelchairs

Medical supplies, such as:

  • Diabetes testing strips
  • Incontinent supplies

Home enteral/parenteral nutrition and IV therapy​

Oral nutritional supplements

Related goods, supplies and services​​

​Therapy to improve skills or function for daily living:

  • Up to 30 visits per year to restore skills following an illness, injury or disability, or
  • Up to 30 visits per year to teach age-appropriate skills (such as therapy for a child who is not walking or talking at the expected age).

​The following services are available for adults and teens:

  • Family planning visits (physical exam and birth control education)
  • Birth control, including condoms, birth control pills, immediate post-partum IUD and implants
  • Sterilization services, including vasectomies, getting tubes tied, immediate post-partum IUD and implants

Other services include: `

  • Annual exam
  • Regular screenings and tests (such as pelvic exams and Pap tests)
  • Pregnancy testing
  • Screenings for sexually transmitted diseases (STDs)
  • Abortion, and
  • Testing and counseling for AIDS and HIV.

You can go to any of the following places for family planning services: (If you are in a CCO, you may need a doctor's referral for family planning services provided outside of the CCO's network.)

  • A county health department
  • A family planning clinic or
  • Any provider that will take your Oregon Health ID.

​OHP pays for services and medications to help you stop smoking, such as:

  • Nicotine replacement therapy (such as nicotine gum or patch)
  • Tobacco cessation medications (such as Chantix and Zyban) and
  • Counseling.

To learn more, talk to your primary care provider. 

​​Oregon Quit Line 

​OHP respects the health care needs of all members. This includes trans women, trans men, gender nonconforming, two-spirit and non-binary members. 

OHP covers gender affirming services according to the World Professional Association for Transgender Health Standards of Care (Version 8). This includes hormone therapy, counseling, surgeries and non-surgical treatments to support gender identity. 

Learn more about gender-affirming care.​

To Get Medical Care:

If you are in an OHP coordinated care organization (CCO) that covers medical care:

  • Call your CCO to choose health providers. You can choose a primary care doctor, nurse practitioner and more.
  • If you don't want to choose a provider, your CCO may choose one for you to get started.

If you are not in a CCO, you need to see a provider that accepts fee-for-service OHP. This means the provider bills OHA for services they provide.