Member FAQ
Answers to questions about your health plan.
Call our Customer Service team with any questions or concerns, Monday through Friday, 8:00 a.m. to 5:00 p.m.
From October 1st to January 1st, our hours extend to seven days a week, 8:00 a.m. to 8:00 p.m.
800-431-4135, TTY: 711. We accept all relay calls.
You have the option to choose a different primary care provider that better meets your needs. Here are some ways you can change your PCP:
- Browse our provider directory and select a new PCP
- Sign in to your InTouch account
- Call our Customer Service team at 800-431-4135, TTY: 711
We don’t require a referral for you to see an in-network specialist for covered services. This includes services such as:
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Annual women’s exam
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Family planning services
You may find that there are some specialists who require a referral from your doctor before you can see them.
If you see a specialist who isn’t in your network, or for something that isn’t covered, your plan may not pay for your care.
Contact your dental plan (also known as your dental care organization or DCO) to change your dentist.
Learn if you have dental coverage, and how to reach your dental plan
To change your dental plan (also known as your dental care organization or DCO), call us at 800-431-4135, TTY: 711.
PacificSource has a list of covered prescription drugs called a formulary. Pharmacists and doctors decide which medications should be on the list. Some prescription drugs have additional requirements or limits on coverage.
Ask your doctor’s office when you make your appointment to have an interpreter (including sign language) at your healthcare appointments.
If you're having trouble scheduling an interpreter through your doctor, call our Customer Service team for help.
800-431-4135, TTY: 711.
Once you know you’re pregnant there are several things you can and should do to help ensure you and your child stay healthy:
- Notify Oregon Health Plan (OHP)
- Schedule a doctor appointment
- See a dentist
- See a birth doula
To get a ride you need to call your ride transportation provider. Where you live determines which ride transportation provider you should call. Before calling, you need to know the address where you'll be picked up and the time and location of your appointment.
Coverage varies depending on your plan. Benefits may include:
- No-cost office visits
- Prescription drugs
- Emergency and hospital care
- Behavioral and mental health
- Urgent and immediate care
- Dental care
- Rides to appointments
- Lab tests, MRIs, and x-rays
To see which benefits come with your plan, sign in to your member portal, InTouch. You can also view a complete list of benefits and exclusions in your Member Handbook.
There are no costs for services when you go to a doctor or other healthcare provider as long as they are within your network and covered by your plan.
Some exceptions apply, such as not letting your doctor know that you are enrolled in a Medicaid/OHP plan.
Search for an in-network provider or a pharmacy
For additional information about billing refer to your Member Handbook
You should receive two ID cards—an OHP Card and a PacificSource Member ID card. Take your PacificSource ID card with you to your doctor visits and the pharmacy. Keep your OHP ID card in a safe place at home.
Print your PacificSource Member ID card
To order a replacement OHP card, call them.
800-699-9076, TTY: 711
In most cases, you are not required to pay for medical services provided by your doctor. If you did receive a bill, it's important to contact our Customer Service team at 800-431-4135, TTY: 711.
For additional information about billing refer to your Member Handbook.
Log in to your ONE account and change your address.
Or, call the Oregon Health Plan Customer Service team at 800-699-9075.
- Medicare Prescription Drug program will pay for your prescription drugs, not OHP.
- Medicare may require copays for drug coverage.
- You might be able to have your copays covered by Medicaid.
- You are responsible for charges, such as deductibles and coinsurance, if you see an out-of-network provider for a nonemergency.
For more information on how and when you should enroll in a Medicare plan, please contact our Customer Service team at 800-431-4135, TTY: 711.
Medicaid is a national program that helps pay for some of the healthcare costs for low-income adults, children, older adults, and people with disabilities. The program is run by each state.
The Oregon Health Plan (OHP) is the state’s Medicaid program that pays for some of the healthcare costs for low-income adults, children, elderly adults, and people with disabilities. It is run by the Oregon Health Authority.
Contact the Oregon Health Plan Customer Service team to update your address, order a replacement OHP card, and more.
800-699-9075, TTY: 711
Learn about OHP, eligibility, and improving community health
You can call them, or visit their website for more information.
800-699-9075, TTY: 711
OHP website
PacificSource Community Solutions is a Coordinated Care Organization (CCO). We are a local health plan that coordinates care for people on the Oregon Health Plan in specific regions of the state. We work together with local Health Councils of doctors and other healthcare providers to improve the health of communities.
Learn where you can find our CCOs
Your renewal letter will say one of the following:
- Your OHP is renewed.
- More information is needed from you.
- You need to fill out a new application.
Follow up as soon as you can, if OHP is requesting more information.
For more ways to renew and to get help with the process, visit the OHP Renewal website.
Learn about where coverage is available, eligibility requirements, and more in our FAQ made specifically for potential members.
We’re here to help.
800-431-4135, TTY: 711
We accept all relay calls.
Our Customer Service team is here Monday through Friday, 8:00 a.m. to 5:00 p.m.
From October 1st to January 31st, hours extend to seven days a week, 8:00 a.m. to 8:00 p.m.