Sorry, you need to enable JavaScript to visit this website.
Skip to main content

Oregon’s Access to Primary Care law

Important details and what to expect 

Note: This law applies only to Oregon members who are covered by individual/family and fully insured group medical plans.

Oregon Senate Bill 1529 is now in effect. It states that health insurance companies must assign a primary care provider (PCP) for members who haven’t selected one by the 90th day of the plan year.

Please select a PCP as soon as possible. You can set the same PCP for yourself and other covered family members. Any member over age 15 may select their own PCP.

You have three options:

Frequently Asked Questions

Why do I need a PCP?
The intent of the law is to improve access to healthcare by connecting Oregonians to a primary care provider. Having a PCP can help you prevent disease through proactive screenings and help you manage any chronic conditions.

What happens if I don’t select a PCP?
If you don’t select a PCP within the first 90 days of enrollment, PacificSource Health Plans will assign one to you. When this happens, we will notify both the policyholder or parent and the assigned provider by mail.

How can I check to see if I already have a PCP?
You can see your current PCP in our secure member portal, InTouch. (If you don’t have an account, you can create one from this screen.) Once you’re logged in, go to Records in the top menu and select “Primary Care Providers.” Here you can view or update your PCP.

Can I select any provider to be my PCP?
Designated PCPs must be a general or family practice provider, internal medicine provider, or select naturopath. They also need to be in your plan’s network and accepting new patients.

How do you choose a PCP for me if I don’t select one?
To assign your PCP, we look at your PacificSource claims history, provider availability, and proximity to your home address. We do our best to find a good match for you.

What if I don’t like the doctor you’ve assigned to be my PCP?
You are not required to see the PCP we assign you, and you can switch to a different one at any time. You can change your PCP within InTouch or by calling Customer Service.

Can I just schedule an appointment with a PCP?
Scheduling an appointment with a PCP does not mean that you’ve selected that doctor as your PCP with PacificSource. To ensure we have your designated PCP in our records, please select one through our Provider Directory, InTouch, or by calling Customer Service as noted in the first question above.

Questions?

If you have any other questions, please contact us. Our Customer Service team is happy to help.