Physical health

We want to help new Health Share/CareOregon members learn about their plan and benefits. The checklist below will help you make the most of your health plan. If you have questions, Customer Service is here to help.

• Call Customer Service and give us the name of your primary care provider (PCP). Don’t have a PCP? Find a doctor who’s open to new patients by using our Provider Search or by calling Customer Service.
• Note: If you’re choosing a new PCP because you’re a new member, please call your new PCP to start a relationship, even if you’re not sick. Don’t wait until you get sick to make the first call. It could cause delays if the PCP’s office doesn’t have you in their system.
• If you’re pregnant, search for a pregnancy provider who handles prenatal care before the baby arrives, like an obstetrician or midwife. Or, call Customer Service.
• Call your pregnancy provider to begin prenatal care as soon as possible.
• You’ll also want to begin or maintain a patient relationship with your PCP.
• Make sure all of your providers have your new insurance information. Show them your Member ID card.
• If you take medications, talk to your PCP about what your plan covers or view our drug list. You can also call Customer Service.
• As a new member, if you have trouble filling a prescription for a medication you’ve been taking, call us. We may be able to help you with a transitional supply.
• If you have diabetes supply needs, tell your PCP what they are.
• As a new member, if you have trouble getting diabetes supplies, call us. We may be able to help you get a transitional supply.
• If you need to know where you can get medical supplies or equipment, or want to set up mail order for your diabetes supplies, you can find a vendor by using our Provider Search. You can also call Customer Service.

Vision services are provided through Vision Service Plan (VSP). Routine eye exams and glasses are covered for members who are:

• Age 20 and younger
• Pregnant women of any age
• Over 20 with a qualifying medical need or have had eye surgery

Contact VSP directly for help with your eligibility, benefits and claims. Visit vsp.com or call VSP Member Services at 800-877-7195.

Members who have an eye infection or injury may call their primary (physical) care provider to help care for this.

Newborns are not automatically enrolled in the OHP. If you become pregnant, be sure to let OHP know right away so that your child will be covered. Call OHP toll-free at 800-699-9075 or email oregonhealthplan.changes@dhsoha.state.or.us.

We also have a program for new parents called CareBaby. It’s a special program designed to help guide our pregnant members through their pregnancy. We share info about extra benefits, give simple checklists for each trimester and offer ideas — from prenatal vitamins to dental appointments — to help you and your baby be healthy and happy.

Health needs can occur at any time. Your primary care provider/dentist is involved in your care even when the clinic is closed.

Here’s what to do in different situations:

• Evenings, weekends, holidays or for urgent care services: If you’re sick or injured and need after-hours advice, call your primary care clinic’s regular phone number or your dental plan’s phone number. The person who answers your call will either contact your doctor or a different doctor at the clinic, or advise you on what to do.
• Sick when away from home: Call your primary care provider/dentist if it isn’t urgent. If it is  urgent, find a local doctor/dentist who will see you right away. Ask that doctor/dentist to coordinate your care with your primary care provider/dentist.
• Use of the Emergency Department: If you believe your health is in serious danger, go to the nearest hospital or call 911 for help.
  A medical emergency is when you have severe symptoms, such as chest pain, head trauma, not breathing or mental distress.
  If you think it is an emergency, go to the ER right away. You don’t need to call your doctor, dentist or health plan first.
  Problems like common colds, constipation, diaper rash, back pain and toothaches are best cared for by your PCP or dentist, who knows you and your health history. Be sure to call them first when you are having problems like these. They will work hard to see you as soon as possible. If you need to be seen sooner than your provider can see you, go to an urgent care clinic instead of the ER. It’s usually faster and more convenient.