Oregon Health Plan Members
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Welcome to OHSU Health Services
Member information and resources
Your medical benefits from the Oregon Health Plan (OHP) are coordinated through Health Share of Oregon. OHSU Health Services works with Health Share to deliver the medical care you deserve and to give you information about healthy living.
- Download this booklet to see some of the services for you.
- Visit Health Share of Oregon's member page to download a member handbook.
Getting care
- In an emergency, call 911 and go to the closest hospital.
- Click here for same-day care in person or virtually.
- Use this list of urgent and immediate care clinic locations for other issues or ongoing care.
- Should you go to the ER? Use this page to help you decide where you need care.
Care coordination and management
You can ask us for a care coordinator. The purpose of this free service is to make your overall health better. We will help find out your health care needs. We will help you take charge of your health and wellness. Your care coordinator team will work closely with you and your provider to manage and organize your services. The care coordinator team will connect you with community and social support resources that may help you. Email ohsuhscareteam@ohsu.edu or call 844-827-6572 if you have any questions or would like to know more about the Care Management Program.
Language access
You have the right to free language services. You can get help from a certified and qualified health care interpreter. We can also provide information in a way that works for you. You can get information in other languages, large print, Braille or a format you prefer. Call OHSU Customer Service at 844-827-6572 or TTY 711. We accept relay calls. You can also get your medication labels printed in English and another language. Tell your pharmacist to print your labels in two languages.
Suicide prevention
- Call or text 988 for Suicide and Crisis Lifeline. The service is available 24/7 for people having a behavioral health crisis. You can also dial 988 if you are worried about a loved one who may need crisis support.
- Chat online at 988lifeline.org.
- Resources for local and national hotlines, walk-in centers and a list of common symptoms
COVID-19 tests and vaccines
Information can change frequently about availability and coverage. Please check these resources for the most current information:
- Centers for Disease Control
- Oregon Health Plan and COVID-19
- OHSU coronavirus resources
Children in foster care
Children must have these health exams in the first 60 days (2 months) of entering foster care:
- Physical exam
- Mental health screening — for ages 3+
- Dental exam — for ages 1+.
A care coordinator can help you schedule these visits. Contact ohsuhscareteam@ohsu.edu or 844-827-6572.
Do you have someone to speak for you when you can’t?
- Learn how to make an official document to let your wishes be known for end-of-life care. Instructions for Advance Directives.
Schedule a ride
Ride to Care gets a lot of Health Share members to their Oregon Health Plan appointments. You can plan a trip as far ahead as 90 days. When possible, call two business days ahead of your trip or ride. At this site, you can:
- Plan a trip
- Cancel a trip
- File a grievance
For details, visit this page for a rider's guide, how to check on a ride and more.
Contact information for Ride to Care
- Regular business hours: 8 a.m.-5 p.m., Monday through Friday, except holidays.
- Portland metro area: 503-416-3955, (TTY/TDD 711)
Health-Related Social Needs Benefits
Some Oregon Health Plan members may be eligible for a new group of benefits designed to help with needs that go beyond health care. Health Related Social Needs (HRSN) benefits provide climate, housing and nutrition support to members experiencing certain life transitions and who have physical or behavioral health needs.
You may qualify if you fit in one of these groups:
- If you're an adult or a young person released from custody or a residential behavioral health setting
- If you are in or were in Oregon's child welfare system
- If you're changing from only having Medicaid to having both Medicaid and Medicare
- If you're homeless or might become homeless.
Housing Supports Benefit
Housed eligible members can get help staying in their homes, such as adding a wheelchair ramp or getting rent assistance. This benefit does not provide housing.
Climate Devices Benefit
Eligible members can get helpful things like air conditioners, heaters, air purifiers, mini fridges for medicines, or portable power supplies for medical equipment.
To apply for HRSN benefits:
- Send a request online to 211info: Social Needs Request Form
- Call the 211info Coordination Center: 503-468-5375
- Email: hrsn@211info.org
- Fax: 503-594-4602
Learn about Health Share of Oregon and Oregon Health Plan insurance
The Oregon Health Plan (OHP) and Health Share of Oregon work together with OHSU Health Services on different parts of your health care needs.
- OHP provides insurance.
- Health Share of Oregon coordinates your services.
- OHSU Health Services works with providers to deliver your medical care needs.
What is the Oregon Health Plan?
The Oregon Health Plan (OHP) is the Medicaid program for the state of Oregon. This program provides health care coverage for low-income residents of Oregon. The plan serves:
- Families
- Children
- Pregnant women
- Single adults
For more information, visit the Oregon Health Plan website. If you already have OHP, visit Health Share of Oregon's member page to download a member handbook.
What is Health Share of Oregon?
Your medical, mental and dental benefits from the Oregon Health Plan (OHP) are coordinated through Health Share of Oregon. OHSU Health Services works with Health Share to deliver the medical care you deserve and to give you information about healthy living. Health Share organizes your care into three categories to help with all your health needs: Physical, Mental and Dental. View the back or inside of your Health Share ID card to locate the plan you have been assigned to. To contact Health Share for more information, call 503-416-8090 or visit www.healthshareoregon.org.
You can use OHSU Health Services if your Health Share ID card lists OHSU Health Services as your physical health plan. Your physical health plan is listed on the back or inside of your Health Share ID card.
What is OHSU Health Services?
OHSU Health Services provides access to a system of health care resources, including three adult hospitals - OHSU Hospital, Adventist Health Portland and Hillsboro Medical Center - and OHSU Doernbecher Children’s Hospital. There are also dozens of patient care locations throughout the Portland metro area. Our goal is to serve OHP members with outstanding patient care informed by cutting-edge research.
What is a Traditional Health Worker?
Traditional Health Workers
A Traditional Health Worker is trained to walk alongside you in your health care journey. They may share similar life experiences, language and/or ethnicity with you. They can help you with questions, connect you with services and find a provider.
Working with a Traditional Health Worker is free to you as an OHP member. To begin,
- Talk with your primary care provider team or your behavioral health provider.
- Email ohsuhscareteam@ohsu.edu or call 844-827-6572.
There are five types of licensed traditional health workers in Oregon:
- Birth doula (see below): A birth companion who provides personal, nonmedical support during pregnancy and childbirth.
- Peer support specialist: A person who gives support services to people who are or have been in mental health or substance use treatment.
- Peer wellness specialist: A trained person who also has lived experience with psychiatric conditions. They support you as part of a health team that combines mental health with primary care.
- Personal health navigator: A person who provides tools and information to help you make the best health care choices.
- Community health worker: A trusted member of a community working in public health to connect people with social and medical resources.
Traditional Health Workers are often based in primary care and behavioral health clinics as well as community organizations.
Birth doula services
Birth doulas are trained birth companions. You may choose to use services from a certified doula, along with your prenatal provider. Doulas offer personal support to pregnant members and families during pregnancy, delivery and beyond. Doulas aren’t medical providers but can be a great addition to your health care team. Research shows that doulas improve the likelihood of a healthier birth for both baby and mother.
OHSU Health Service OHP members can use:
Redetermination of eligibility
Oregon Health Authority is contacting Oregon Health Plan members to review eligibility for Medicaid coverage. The Oregon Health Plan is Oregon’s Medicaid program. This income review is called redetermination.
If you are an Oregon Health Plan member:
- Make sure the state has your mailing address. To check or update your address, you can:
- Go to one.oregon.gov and click on Manage Account.
- Call the Oregon Health Authority’s Customer Service Center at 800-699-9075 weekdays between 7 a.m. and 6 p.m. Interpreters are available.
- If you are an OHSU patient: Call OHSU Health Services Customer Service at 844-827-6572 (for TTY users, 711) weekdays between 7:30 a.m. and 5:30 p.m.
- When you receive your notice, follow the steps within 90 days to keep Medicaid coverage. If you don’t respond within 90 days, you will have coverage for 60 more days.
Learn more:
- Redetermination FAQ, Health Share of Oregon
See something wrong? Tell someone.
Fraud, waste and abuse in health care hurt everyone. When money is misused, it can't help those who need it.
- Fraud is when someone tricks others on purpose for their own benefit.
- Waste is spending money on health care that isn't needed or used well.
- Abuse is when someone accidentally gives wrong information causing unneeded cost.
Some examples of fraud, waste and abuse by a provider are:
- Faking reports of services that didn't happen or products that weren't given.
- Reporting more services than were provided.
- Charging too much to people who don't have Medicaid or other insurance.
- Not giving the right services that are supposed to be given.
- Charging people more than they should pay.
- Doing things that cost too much, aren't needed or don't follow good healthcare practices.
Some examples of fraud waste and abuse by a member are:
- Cheating in the process of enrolling or disenrolling people.
- Going to multiple doctors for prescriptions for a drug already prescribed.
- Using another person’s ID to get benefits.
You can report fraud, waste or abuse if you think you've seen it. You don't have to give your name, and you're protected by law. OHSU Health IDS tells the authorities about any fraud they find.
Here is how you can report:
- Call the OHSU Anonymous Compliance Hotline at 1-877-733-8313.
- Fill out a form online at www.ohsu.edu/hotline.
- Call or write to:
DHS Fraud Investigation Unit
P.O. Box 14150
Salem, OR 97309
Hotline: 1-888-FRAUD01 (888-372-8301) (TTY/OREGON RELAY users, please call 711)
Fax: 503-373-1525 Attn: Hotline
Website: www.oregon.gov/oha/FOD/PIAU/Pages/Report-Fraud.aspx
Filing a complaint or appeal
For assistance, call 844-827-6572.
Oregon Health Authority Request to Review a Health Plan Decision
Oregon Health Plan Complaint Form