Oregon Health Plan and Coordinated Care Organizations
Who we are
The Oregon Health Plan (OHP) is the social insurance/Medicaid program administered by the state of Oregon. OHP is designed to cover the basic health care needs and health care costs of lower income families. Most OHP members are enrolled in a Coordinated Care Organization (CCO). The CCO works with providers like doctors, counselors, nurses and dentists to ensure youth and families get the care they need.
In the Tri-County region there are two CCOs: Health Share of Oregon and Trillium Community Health Plan. Assigned CCO can be found on the person’s OHP card. If a person is unsure if they enrolled in OHP or which CCO they are enrolled in they can call the CCOs or OHP.
Benefits covered
CCOs offer a wide range of health related benefits including:
Primary care services - Your PCP is the doctor members see for routine checkups and care. The PCP will help find other types of healthcare providers when needed.
Prescription drugs
Pregnancy Care
Chemical dependency care
Mental health care
Dental care
Hearing
Hospital care
Some vision services
Transportation - If plan members do not have a way to get to the doctor, dentist, or counselor, they can get help paying for rides to medical appointments. To schedule a ride call the ride service used by Health Share of Oregon or Trillium Community Health Plan.
Health related services flexible funding - Health-related services are non-covered services that are offered as a supplement to covered benefits.
Medical equipment and supplies
Physical, occupational and speech therapy
How to apply
A youth is eligible for OHP based on the Oregon Health Plan income criteria.
Information about eligibility and how to apply can be found online at ONE.Oregon.gov or request a paper application by calling OHP Customer Service at 1-800-699-9075 or 711 (TTY).
How to coordinate with us
Search for a healthcare provider on the CCO plan website: Health Share of Oregon / Trillium Community Health Plan.
The best first point of contact with the health system is to contact the treating healthcare provider. If you have spoken to the treating provider and still have questions about benefits, contact the Customer Service team on the back of the medical ID card. You will need to confirm the members identity using the member ID number that can be found on the front of the card, along with the member’s date of birth.
If you are calling on behalf of the member, the member needs to be present or have a signed Authorization for Disclosure of Protected Health Information (PHI) form. The form can be accessed directly from the websites of each health plan.