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OHP Renewal PART 1 - oregon form

welcome to health share care organ we'd like to introduce ourselves and answer some questions members often ask for starters who are we we're part of the Oregon Health Plan OHP for short the Oregon Health Plan is the state's Medicaid program and you're a client we're a health plan serving OHP clients and we're glad you're with us as a health plan we have a provider network our network includes primary care providers specialists behavioral health workers pharmacies urgent care centers hospitals and more everybody in the plan works with you together for your health and wellness what can you count on from us it's our job to make all the parts of your health care fit together well to be clear and how we explain your benefits to help you be as healthy as you can be to listen and to make sure you get the covered care you need when you need it the big picture so how does all this work the Oregon Health Plan includes several types of care starting with physical health your physical health plan is care organ physical health is basically doctor visits and hospital care medications can be an important part of your wellness and we cover many prescription medicines the Oregon Health Plan also covers mental health care this is often called behavioral health your mental and physical health are connected in many ways next we offer services to help you quit tobacco or to deal with dependence on alcohol or other substances we're here for those who want to take that step because good oral health is really important to good overall health OHP includes dental benefits that begin at birth and continue through the adult years so you see top to bottom will be your partner and wellness your member ID card you should have received a letter from the Oregon Health Plan including an Oregon Health ID card however when our health plan member ID card comes in the mail start using that instead it tells your providers who your health plan is and gives information about your other care you'll also get a member handbook in the mail the handbook has a lot of helpful information about your benefits and how to use them by the way if you lose your ID card we'll send you a new one just ask customer service your primary care provider when you receive your member ID card it's easy to get started check the ID card you'll see we assigned you to a primary care office if you need a primary care provider clinic staff will match you with one your primary care provider could be a nurse practitioner physician assistant or doctor do you already have a primary care provider you like if your provider is part of our network we're happy to assign you provider just ask customer service and you might like this you can search for providers using the provider directory on our website go to four members and look for the provider directory section a wellness visit now that you're a member of our plan we'd like you to schedule a wellness visit with your primary care provider if you haven't already done that a wellness visit is a nice way to talk over your health concerns and goals and it makes it easier to get an appointment if you do become sick just call your clinic as soon as you can tell them you're part of our health plan and that you'd like to schedule a wellness visit just so you know it's typical to wait several weeks for a wellness appointment oh and if you have to miss an appointment be sure to call ahead of time and let the clinic know more about dental health the Oregon Health Plan also provides dental care dental includes exams cleanings fluoride treatments fillings and more maybe you've already picked a dental care organization if not call the number at the end of this video the next step contact your dental care organization to find a dentist in your area more about prescription medicines we put together a list of the prescription drugs we cover this list is called a formulary you and your providers can find this drug list on our website under four members then drug search or drug lists some of these medications require prior authorization that means we need to okay the medicine has had when you're ready to fill a prescription where should you go you may use any pharmacy in our network our network includes independent pharmacies and chain drugstores like Friday Fred Meijer and Safeway you can also use the provider directory on our website to search for drugstores as your health plan we do not require a co-payment when you feel an approved prescription however mental health drugs are handled a little differently the state covers them in the state may charge a copay other services we want to make it easier for you to take care of yourself do you have transportation for health appointments if not let customer service know we'll connect you with a company that arranges freud's to non-emergency appointments do you want a language interpreter no problem let the clinic know before your appointment another thing anytime you call customer service you may ask for an interpreter to be on the call about payments you will not owe any money for covered physical dental or behavioral health services if your provider asks for a co-payment or sends you a bill please do not pay it if you are at the clinic ask the staff to call us if you get a bill in the mail don't ignore it call customer service right away we're here to help so now onto some questions common questions I'd like to change to a different dental plan how do I do that call the customer service number at the end of this video we'll let you know your options I think I need to see a specialist how do I find one start by talking with your primary care provider you may also go to our website and use the provider directory to search for specialists or call customer service how do you decide what services to cover or not actually it's the state that determines which benefits to cover federal and state tax dollars then pay for those benefits how long does my coverage last unless your eligibility changes your OHP coverage is active for one year the state will let you know when it's time to renew I moved do I need to let you know let the state know the state keeps track of your name address and phone number also let the state know if you become pregnant you may be eligible for extra benefits it's really important to keep your information accurate and up to date here's how to do that tell your state caseworker or call the Oregon Health Authority at one 800 695 or send an email to the Oregon Health Plan do you cover acupuncture physical therapy or chiropractic care depending on your condition these benefits may be covered however they may require a prior authorization as we've mentioned prior authorization means we need to okay your treatment ahead of time what do I do if I get sick when my primary care providers office is closed if it's an emergency call 911 s hospital or er otherwise call your providers number even after hours someone will always answer also be sure to call your provider before going to an urgent care clinic do you pay for glasses sometimes this benefit is for members under age 21 and members who are pregnant ask us those are the questions we hear the most we invite you to call customer service anytime you have a question we're always happy to help you can also check our website we'll keep in touch during the year - mailing you important information we care about your health and your well-being thanks for joining us