The Oregon Health Plan (OHP) is for people of all ages who cannot afford to pay for health care on their own. The Oregon Health Authority (OHA) manages OHP. Learn how to know who covers your OHP and get help with your care.
At First, Everyone Is Enrolled in Fee-for-Service (Open Card) OHP.
When you are first approved for OHP, you will get a Notice of Eligibility. It says when your benefits start.
- You will have fee-for-service (FFS, or "open card") OHP starting on the date of this notice.
- You can view the notice in your Oregon Eligibility (ONE) account at ONE.Oregon.gov.
This does not mean you pay for the services. FFS means:
- You can see any provider who takes FFS OHP. Learn how to find providers who take FFS OHP.
- You manage your health care with providers who take FFS OHP.
- Providers who take FFS OHP agree to bill OHA (not a CCO) for your care.
Your
OHP coverage letter will come two or three weeks after your Notice of Eligibility.
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The letter lists your coordinated care organization (CCO).
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Your
Oregon Health ID comes with this letter. This is your OHP ID card. Show this at health care visits.
- To learn more about how to use your OHP benefits, read your OHP member handbook.
Most People Are Enrolled in a CCO.
Oregon law requires most people to be enrolled in a CCO for health care covered by OHP. Your CCO will send you a welcome packet. It will include your CCO member handbook and CCO member ID. When you get the welcome packet from your CCO, be sure to:
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Keep your Oregon Health ID safe. Show your CCO
member ID card at health care visits.
- Choose your providers and plans. You must use the CCO's providers and plans to get care covered by the CCO. Each CCO has dental plans for you to get dental care. The welcome packet will tell you how to choose providers and plans.
Some people are not in a CCO for their care. This means they will keep getting FFS OHP. This is because:
- They have major medical insurance. This is their primary health insurance. When this happens, OHP pays last. Learn more about OHP and private health insurance.
- They are American Indian or Alaska Native and choose not to enroll in a CCO for their care.
- They are in their last three months of pregnancy and want to stay with their current birthcare provider until the baby is born.
- OHP approved them for
temporary fee-for-service coverage for other serious health reasons.
People with FFS OHP need to show their Oregon Health ID card (and any other ID cards, such as for private health insurance) at health care visits.
How to Know if You Have a CCO or Fee-for-Service OHP:
- The “Managed Care/TPR enrollment” field on page 2 lists letters.
- Each letter is for a different type of health plan (your CCO or other coverage). CCOs are listed first.
- If the letter(s) next to your name are for a CCO, then a CCO covers part or all of your care.
- If the letters next to your name are not for a CCO, then you have fee-for-service OHP.