How do I contact Oregon Health Plan (OHP)?
Contact Information Oregon Health Plan (OHP) OHP Fee-for-Service Providers - 800-336-6016 Press 2 for medication prior authorizations or pharmacy claims
What are the different Oregon Health Plan programs?
Oregon Health Plan Programs 1 OHP Plus for children ages 0-18 and adults ages 19-64 2 OHP Plus Supplemental for pregnant adults age 21 or older 3 OHP with Limited Drug for adults who qualify for both Medicaid and Medicare Part D
How do I access eligibility and enrollment information for Oregon Medicaid members?
OHA offers three ways for enrolled Oregon Medicaid providers to access eligibility and enrollment information for OHP members: After login, click "Eligibility" to get started. To learn more, see the Eligibility and Copayment Quick Reference. After login, press 1 for Recipient Eligibility. To learn more, see the AVR Quick Reference.
When can I apply for Oregon Health Plan?
OHP Policies and Rules Applying for Health Coverage You can apply for the Oregon Health Plan at any time of the year. Enrollment is always open for OHP. Medicare and private health insurance plans have open enrollment in the fall. When it is time to renew your OHP benefits, we will send you a letter.
Can I check my OHP status online?
Go to ONE.Oregon.gov to manage your OHP benefits, renew your OHP or apply. Registered users can log in here. Learn how to sign up, manage your Oregon Eligibility (ONE) account, and renew or apply online. You can also watch a 5-minute overview of the online OHP account.
Is the Oregon Health Plan the same as Medicaid?
The Oregon Health Plan (OHP) is Oregon's Medicaid program. There are several health care programs available for low-income Oregonians through OHP.
What is OHP portal?
The Oregon Medicaid Management Information System (MMIS) Provider Portal gives you free, real-time information about Oregon Health Plan (OHP) eligibility, claim status, prior authorization status, and more.
How do I update my Oregon Health Plan?
You can call OHP Customer Service at 800-699-9075 to report changes to OHP. You can call Monday-Friday, 7 a.m. to 6 p.m. Pacific Time.
What is the OHP income limit?
OHP is available to adults who earn up to 133 percent of the Federal Poverty Level. For a single person, income should be less than $1,507/month or household income of $3,076 for a family of four. OHP is available to kids and teens whose family earns up to 300 percent of the Federal Poverty Level.
What is the highest income to qualify for Medicaid?
Federal Poverty Level thresholds to qualify for Medicaid The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. For example, in 2022 it is $13,590 for a single adult person, $27,750 for a family of four and $46,630 for a family of eight.
Is CareOregon the same as OHP?
Oregon's Coordinated Care Organizations (CCOs) are networks of providers serving the Oregon Health Plan (OHP) on a local level. Providers work together to treat every aspect of your health. In the Portland area (Clackamas, Multnomah and Washington counties), CareOregon is part of the Health Share of Oregon CCO.
When should I download one health pass?
When to Register with One Health Pass. Passengers can complete the OHP registration process a few days before departure so that their pass is ready to use. The eHDC must be filled out no sooner than a day before departure. The QR code and BOQ certificate must have been issued in the last 24 hours to be valid for travel ...
Does OHP cover MRI scans?
OHP has coverage criteria for several studies defined throughout the Prioritized List (PL), including lumbar spine MRI defined in Diagnostic Guidelines D4. For all requests, ensure records include pertinent history, a current physical exam and the reason for the study.
Do you have to renew OHP every year?
We need updated information every year to make sure you still qualify for the Oregon Health Plan (OHP). We call this renewing your OHP. When it is time for you to renew, we will check to see if we have your updated information.
How long does Oregon Health Plan last?
one yearThe health insurance plans you buy through HealthCare.gov cover you for one year, as long as you continue paying the premium. The plan year, as it is called, is the same as the calendar year.
Can I use my Oregon Health Plan in another state?
A: No. Because each state has its own Medicaid eligibility requirements, you can't just transfer coverage from one state to another, nor can you use your coverage when you're temporarily visiting another state, unless you need emergency health care.
Is Oregon Health Plan the same as Medicare?
OHP covers your medical bills, hospital care, dental and other benefits. If you have Medicare, Medicare serves as your primary insurance and Medicaid / Oregon Health Plan becomes your secondary insurance, depending on the level of OHP eligibility you qualify for.
What type of insurance is Oregon Medicaid?
Oregon Health Plan (OHP) OHP is Oregon's Medicaid program. It provides free coverage for people in Oregon who meet eligibility criteria. Coverage includes doctor visits, hospital care, mental health services, dental, and some vision care.
What is covered by Oregon Medicaid?
It covers services such as:Regular check-ups.Prescriptions.Mental health care.Addiction treatment.Dental care.
Who administers Medicaid in Oregon?
Oregon Health Authority : Medicaid and CHIP State Plans : Medicaid Policy : State of Oregon.
If your office is new to the Provider Web Portal
Follow the steps in our Quick Setup Guide, then set up clerk accounts to give staff access to the features they need.
If your office already uses the Provider Web Portal
The Provider Web Portal administrator in your office can give you access to the features you need (such as Claims, Eligibility, Remittance Advice, Plan of Care, Prior Authorization, Benefits and Prioritized List Inquiry).
What are the Oregon health plans?
Oregon Health Plan Programs 1 OHP Plus for children ages 0-18 and adults ages 19-64 2 OHP Plus Supplemental for pregnant adults age 21 or older 3 OHP with Limited Drug for adults who qualify for both Medicaid and Medicare Part D
What is the OHP program in Oregon?
There are several health care programs available for low-income Oregonians through OHP. OHP Plus for children ages 0-18 and adults ages 19-64. OHP Plus Supplemental for pregnant adults age 21 or older. OHP with Limited Drug for adults who qualify for both Medicaid and Medicare Part D.
How to find out if you have OHP?
The best way to find out if you can have OHP is to apply. Go to ONE.Oregon.gov to login or create an account. You may qualify for OHP, even if you have been denied in the past. To qualify for OHP, individuals and families must meet income and residency requirements.
What are the requirements to qualify for OHP?
To qualify for OHP, individuals and families must meet income and residency requirements. Oregonians may also qualify based on age and disability status.
Register to use the Member Portal
CareOregon members can access the Member Portal after a brief online registration. Like other online services, the registration walks you through creating a username and password. You’ll also provide answers to some security questions.
How to use your Member Portal
Watch the following video to learn about features you’ll find in the Member Portal.
How to Verify OHP Eligibility and CCO Enrollment
OHA offers three ways for enrolled Oregon Medicaid providers to access eligibility and enrollment information for OHP members:
Tools and Resources
To learn more about verifying eligibility and enrollment for Health Share of Oregon members, visit the Health Share of Oregon website.
