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Pick Your Plan

CCO Plan
Comparison
Guide
2020
New health plan choices are coming
to the Oregon Health Plan (OHP) in 2020.
OHP has local health plans that help you use your benefits.
These plans are called coordinated care organizations or CCOs.

This guide will help you Consider,


Compare and Choose your plan.

Why is OHP asking members


to pick a plan?
You count on the Oregon Health Plan for your health care. Your benefits
are not changing, but the health plans or CCOs that help you use your
benefits are changing. In some areas of the state, there will be new CCO
plans. In other areas, CCO plans are closing. You get to compare the
plans in your area and decide what works best for you and your family.
New plans will start January 1, 2020.

This guide is for OHP members who live in areas


where choices of CCO plans have changed. If you are
looking for information about a CCO and don’t see it in
this guide, go to OHP.Oregon.gov.

2 CCO Plan Comparison Guide: Introduction


How did I get matched with a plan?
OHP matched you with a CCO plan based on the mental health and
primary care providers you have seen in the past 24 months. We heard
from members and health care providers that OHP’s main goals during
this transition should be:
• Keeping members with providers they see now and
• Not disrupting their care.
OHP values your choice. You do not need to keep the CCO plan OHP
matched you with. You can compare that plan with other plans in your area.
You have two chances to pick a different plan:
1. Between October 16 and November 17, 2019, you can choose
another plan. If you don’t choose another CCO plan by November 17,
your matched plan will start January 1, 2020.
2. Between January 1 and March 31, 2020, you can try out your CCO
plan and change it for any reason.
If you’re happy with your matched plan, you don’t have to do anything.

Help is available
Call: OHP has a special phone number to answer your questions and
help you make your choice. The number is 877-647-0027 (TTY 711).
Regular business hours: 7 a.m.­–5 p.m. Monday-Friday
October 16-November 17, 2019: 7 a.m.–8 p.m. Monday-Friday
If you need an interpreter, ask for one when you call.

Ask a trusted community partner: Find a person trained to help


guide you through this process at OHP.Oregon.gov.

Go online: Compare plans and find links to more CCO information at


OHP.Oregon.gov.

CCO Plan Comparison Guide: Introduction 3


Your OHP letter
Important information you will need to pick your plan is in your letter from OHP.

Statewide Processing Center


PO Box 14015
Salem, OR 97309

10/16/2019 What you need to know:


• Your OHP benefits are
Letter ID: XXX123
not changing.
• More CCO plans are coming
in January.
Letter ID John A. Doe
• You can choose a CCO plan.
123 First Ave. • If you don’t choose, you will
Somewhere, Oregon 90000 be enrolled in a plan based
on the care you get now.
• New plans will start
There are more health plan January 1, 2020.
choices coming to your area
Dear John,

Thank you for being a part of the Oregon Health Plan. There are new health plan choices coming to OHP
in January. OHP has local health plans that help you use your benefits. These plans are called coordinated
care organizations or CCOs.

Starting in January, you will have more CCO plan choices in your area. You get to compare the plans and
decide what works best for you and your family.

We started by matching you with a CCO plan based on your doctors and the care you get now:
John Doe: CCO Example Name 1
Mary: CCO Example Name 1
Amy: CCO Example Name 2

Your matched
plan(s) How to get help:
Call 877-647-0027 Ask a local community partner. Learn more at:
(TTY 711) Find one at: ohp.oregon.gov ohp.oregon.gov

You can get this letter in another language, large print, or another way that is
best for you. Call 877-647-0027 (TTY 711) 19-129 073019

If you are happy with the CCO plan(s) listed, you don’t have to do anything.
Your CCO plan will start January 1, 2020. You will get a welcome letter and ID card close to January 1.
You can choose a different CCO plan.
If you don’t like the CCO plan(s) listed, that’s okay. You can choose any of these plans: CCO Example
Name 2, CCO Example Name 3

Your other Compare the CCO plans, consider what each plan offers, and then choose.
You can learn more about the plans in the guide sent with this letter or at OHP.Oregon.gov. Look at each

plan choice(s) plan’s health care providers, pharmacies, hospitals, and services.
Tell us if you want a different CCO plan by November 17.
If the plan(s) listed will not work for you, go to http://bit.ly/CCOchoice and tell us your choice. Please use
your Letter ID to login: XXX123. You can also call us at 877-647-0027. This special phone number is set
up to help you with your 2020 CCO plan choice. You can also get help in person. Find a trusted community
partner near you at OHP.Oregon.gov.
Don’t worry. You can also change your CCO plan after January 1.
Try out your CCO plan. If you are happy with your plan, you won’t have to do anything. If you want a
different CCO plan after January 1, you can tell us at that time. You can change plans for any reason until
March 31, 2020.

About the OHP benefits and services you get now


Your OHP benefits are not changing.
You still have the same OHP physical, dental, and mental health benefits. Some CCO plans have extra
services, like health classes. Check with your CCO plan about what extra services it offers.
4 CCO Plan Comparison Guide: Instructions
If you need to renew your OHP before January 1, your eligibility may change.
Choosing a new plan? You can still use the CCO plan you have now until January 1.
Many doctors or providers work with all the CCO plans in your area. But if you need a different
provider, your new CCO plan will help you pick one. Your new plan will help you get the prescriptions and
Follow these steps to pick your plan
1. Consider:
• In your letter, find the CCO plan that we matched you with as well as any
other options.
• In this guide, find the CCOs in the alphabetical list, which starts on page 10.

2. Compare:
• Read about other CCO plans in your area. Make sure you check which ZIP
Codes are served. Some CCOs serve only part of a county. Look at each
CCO plan’s health care providers, pharmacies, hospitals and extra services.
• Except for the extra services and pharmacy options, all CCOs offer you
the same benefits.
• Each CCO has a provider directory on its website. Look for a list of
doctors and providers that work with that CCO plan.
• Learn more about other services offered by the CCO.
• You may want to use the Pick Your Plan Worksheet on the next two
pages to help you compare.

3. Choose: To pick your plan online:


• After comparing your options,
choose a plan. If you’re Use the CCO plan choice form
happy with your matched online. It’s the fastest way to pick
plan, you don’t have to a plan.
do anything! If you want to 1. Go to http://bit.ly/CCOchoice.
choose a different CCO plan,
2. Use your unique Letter ID
tell OHP your choice:
to login. You’ll also need your
• Online at OHP ID number from your OHP
http://bit.ly/CCOchoice or CCO card.
• By phone at 3. Choose a plan for yourself
877-647-0027 and other members of your
• Through a trusted household.
community partner.
4. Save your plan choice and get
You can find one at
a confirmation email.
OHP.Oregon.gov.

CCO Plan Comparison Guide: Instructions 5


Pick Your Plan Worksheet
Picking your health plan can be easy.
Use this worksheet to help you choose the best CCO plan for you and your
family. Each CCO plan has different doctors, hospitals and pharmacies. In
three simple steps, you will have all the information you need to make the
best health plan choice and enroll.

Step 1 Consider
Review your letter, or this guide or go online to OHP.Oregon.gov to find the
CCO plans in your area, including the one you’ve been matched with. List the
plans you can choose from.

Your plan choices

Option 1

Option 2

Option 3

Important due dates:


If you don’t choose another CCO plan by November
Nov 17, your matched plan will start January 1, 2020.
17

Between January 1 and March 31, 2020, you can try


Mar out your CCO plan and change it for any reason.
31

6 CCO Plan Comparison Guide: Pick Your Plan Worksheet


Step 2 Compare
List the doctors, hospitals and pharmacies that are most important to you.
For each CCO plan, find out whether the doctor or facility is in the plan’s
network. You can do this by calling your doctor’s office or the CCO plan,
or by visiting the plan’s website. Go to OHP.Oregon.gov or look in this guide
to find the health plan’s contact information.

Doctors, hospitals and pharmacies


Which CCO they participate in
that are important to you

To narrow your choice, you may want to consider extra services listed in this
guide or at OHP.Oregon.gov.

Step 3 Choose
Name of the plan that is best for you:
If you agree with the plan OHP matched you with, you don’t need to do
anything. If you want to choose another option, do ONE of the following:
Fastest option: Change your health plan ONLINE.
1. Go to http://bit.ly/CCOchoice.
2. Use your unique Letter ID to login. You’ll also need your OHP ID number
from your OHP or CCO card.
3. Choose a plan for yourself and other members of your household.
4. Save your plan choice and get a confirmation email.
PHONE: Call 877-647-0027
TRUSTED COMMUNITY PARTNER: You can find one at OHP.Oregon.gov.
Do not fax or mail this form. It is a tool to help you, not an
enrollment form.
CCO Plan Comparison Guide: Pick Your Plan Worksheet 7
CCO plan choices
Please note: Information in this guide is current as of August
30, 2019. Many CCOs expanding to new areas are setting up
their network of doctors, hospitals and other providers. The
information in this guide was provided by the CCOs and is
subject to change.
For the most complete and up-to-date information on a CCO plan,
go to the plan’s website or call its customer service number.

The following list only includes CCOs in areas where the choice of CCO plans
has changed for 2020. If you are looking for information about other CCO
plans, please go to OHP.Oregon.gov.

Clackamas Multnomah
Health Share of Oregon Health Share of Oregon
Trillium Community Health Plan Inc. Trillium Community Health Plan Inc.

Douglas Polk
Umpqua Health Alliance LLC PacificSource Community Solutions
(97441, 97467 and 97473 excluded) — Marion Polk
AllCare CCO Inc. (97410, 97442 only) Yamhill Community Care
Trillium Community Health Plan Inc. Organization (97101, 97304, 97347,
(97424, 97436, 97441, 97467, 97371, 97378, 97396 only)
97473, 97493 only)
Washington
Jackson Health Share of Oregon
AllCare CCO Inc. Trillium Community Health Plan Inc.
Jackson Care Connect Yamhill Community Care
Organization (97119, 97123, 97132,
Lane 97140 only)
PacificSource Community
Solutions — Lane
Trillium Community Health Plan Inc.

8 CCO Plan Comparison Guide: CCO plan choices


Extra services
All CCO plans are required to provide the same OHP-covered mental, physical
and dental care services. These are your core benefits.
Some CCOs provide extra services. These are items or services to support
your health or manage a condition. This guide provides examples of each CCO
plan’s extra services. Some extra services are available to all members. Others
are provided on a case-by-case basis or by special request. You can contact
each CCO to learn about a full list of services and how to access them.
Extra services may include:
• Child and family: Parenting classes, childbirth classes and other
supports for children, new parents and pregnant women
• Wellness: Supports for healthy living, such as gym memberships,
cooking classes, other training and education; rides to access wellness
resources, or incentives to complete appropriate preventive care
• Chronic condition support: Classes, programs and resources to
support people living with diabetes, chronic obstructive pulmonary
disease, and other conditions
• Housing support: Temporary housing, shelter, home repair and other
services to help members stay housed or live in a healthy environment

Did you know?


CCO benefits include physical, dental and mental health care.
Behavioral health care means treatment for mental health
conditions or substance use disorders.

CCO Plan Comparison Guide: CCO plan choices 9


You have 24-hour He
See membership card f

AllCare CCO Inc. allcare cco


Non-Emer
ReadyRid
Call to sch
Name: <FN> <MI> <LN> Monday th
ID: <MEMBERID> or (800) 4
Dental Plan: <DCO>
Curry, Jackson, Josephine, and
24 hours a
Dental Plan Phone: <(XXX) XXX-XXXX>
PCP: <PCP NAME> Pharmacy

partial Douglas (97410, 97442 only) PCP Phone: <(XXX) XXX-XXXX> Must be a
Member Services (541) 471-4106 PCN # 00
TTY (800) 735-2900 Toll free (888) 460-0185
counties
OHP-ALL-17-114

541-471-4106 or 888-460-0185 or TTY 800-735-2900,


language access line: 888-260-4297
www.allcarehealth.com

Contracted hospitals
• Ashland: Asante Ashland Community Hospital
• Crescent City: Sutter Coast Hospital
• Gold Beach: Curry General Hospital
• Grants Pass: Asante Three Rivers Medical Center
• Medford: Providence Medford Medical Center; Asante Rogue Regional
Medical Center

Primary care provider locations


• Curry County: Brookings, Coos Bay, Crescent City, Gold Beach, Port Orford
• Douglas County: Coos Bay, Eagle Point, Grants Pass, Medford, Rogue
River, Shady Cove
• Jackson County: Ashland, Butte Falls, Central Point, Eagle Point, Gold Hill,
Jacksonville, Medford, Prospect, Rogue River, Shady Cove, Talent, White City
• Josephine County: Cave Junction, Grants Pass, Selma
• United Indian Health Services in Del Norte County: Crescent City,
Arcata, Klamath, Smith River

Dental care networks


• Curry County: Advantage Dental Services
• Douglas County: Advantage Dental Services, Willamette Dental Group
• Jackson County: Advantage Dental Services, Capitol Dental Care,
La Clinica, ODS Dental Plan, Willamette Dental Group
10 CCO Plan Comparison Guide: CCO plan choices
• Josephine County: Advantage Dental Services, Capitol Dental Care, ODS
Dental Plan, Willamette Dental Group

Behavioral health networks


For a full list of behavioral providers, call Member Services or visit:
www.AllCareHealth.com/CCO/Behavioral-Health
• Curry County: Curry Community Health
• Douglas County: Options for Southern Oregon, Adapt, Choices
Counseling, Grants Pass Treatment Center, OnTrack Rogue Valley
• Jackson County: Options for Southern Oregon, Addictions Recovery
Center, Allied Health Services, OnTrack Rogue Valley, Phoenix Counseling
For Mental Health Crisis – Jackson County Mental Health
• Josephine County: Options for Southern Oregon, Adapt, Choices
Counseling, Grants Pass Treatment Center, OnTrack Rogue Valley

Pharmacies
Many area pharmacies. Find a pharmacy online at
www.AllCareHealth.com/CCO/Find-Pharmacy.

Medicare plan
AllCare Advantage www.AllCareHealth.com/Medicare

Provider directory
www.AllCareHealth.com/CCO/Find-Doctor

Member handbook
www.AllCareHealth.com/CCO/Member-Handbook

Extra services
Gym memberships, tobacco-cessation programs, rides to health-related
services, weight-loss programs for adults and children, and wellness
programs such as managing chronic pain. Also offers a “Babe Store” (items
for pregnant women, babies, and new parents), meal delivery, help applying
for Social Security Disability, programs to manage chronic health conditions,
help finding housing, and home repair
More information: Call the Care Coordination team or go to
www.AllCareHealth.com/CCO/Coordination.

CCO Plan Comparison Guide: CCO plan choices 11


Health Share of Oregon
Clackamas, Multnomah
and Washington counties

503-416-8090 or 888-519-3845, TTY 711


www.HealthShareOregon.org

Contracted hospitals
• Clackamas: Kaiser Sunnyside Medical Center
• Gresham: Legacy Mt. Hood Medical Center
• Hillsboro: Kaiser Westside Medical Center, Tuality Community Hospital
• Milwaukie: Providence Milwaukie Hospital
• Oregon City: Providence Willamette Falls Medical Center
• Portland: Adventist Medical Center, Doernbecher/OHSU, Legacy Emanuel,
Legacy Good Samaritan, Providence Portland Medical Center, Providence
St. Vincent Medical Center, Unity Center for Behavioral Health
• Tualatin: Legacy Meridian Park Medical Center

Primary care provider locations


• Clackamas County: Canby, Clackamas, Damascus, Estacada, Gladstone,
Gresham, Happy Valley, Keizer, Lake Oswego, Milwaukie, Molalla,
Mt Angel, Oregon City, Portland, Sandy, Silverton, Tualatin, Welches,
West Linn, Wilsonville, Woodburn
• Multnomah County: Beaverton, Clackamas, Gresham, Happy Valley,
Hillsboro, Milwaukie, Portland, Tualatin
• Washington County: Aloha, Beaverton, Forest Grove, Hillsboro,
North Plains, Sherwood, Tigard, Tualatin

12 CCO Plan Comparison Guide: CCO plan choices


Dental care networks
Advantage Dental Services, CareOregon Dental, Kaiser Permanente Dental,
ODS Community Dental Plan, Willamette Dental Group

Behavioral health networks


CareOregon, Kaiser Permanente, OHSU Health, Legacy Health PacificSource,
Providence Health & Services

Pharmacies
Many area pharmacies. See a complete list on the CCO’s website.

Medicare plans
CareOregon Advantage, Kaiser Senior Advantage, PacificSource Medicare,
Providence Medicare Dual Plus (HMO SNP)

Provider directory
www.healthshareoregon.org/members/my-health-plan

Member handbook
www.healthshareoregon.org/members/my-health-plan/member-handbook

Extra services
Dental programs for young children and pregnant women; infant and
toddler programs (Baby Day); summer camps and classes; cooking classes;
cleaning services; clothing and shoes; food delivery; gym and community
center memberships; meal service; personal care kits; prepaid cell phones
or minutes; self-help support services; sensory items; weight management;
chronic disease management and prevention classes; eviction prevention;
home equipment and repairs; hotel/motel (short-term); household furniture
and furnishings; identification documentation replacements; legal help to
address housing barriers; recovery housing programs (Clean and Sober);
recuperative care; rental assistance; shelter; supportive moving and
hauling; utility assistance.
More information: 503-416-8090 or www.HealthShareOregon.org.

CCO Plan Comparison Guide: CCO plan choices 13


Jackson Care Connect
Jackson county

855-722-8208,
TTY 800-735-2900
www.jacksoncareconnect.org

Contracted hospitals
• Ashland: Asante Ashland Community Hospital
• Grants Pass: Asante Three Rivers Medical Center
• Medford: Providence Medford Medical Center,
Asante Rogue Regional Medical Center
• Portland: Adventist Medical Center, Doernbecher/OHSU, Legacy Emanuel,
Legacy Good Samaritan, Providence Portland Medical Center, Providence
St. Vincent Medical Center, Providence Willamette Falls Medical Center,
Providence Milwaukie Hospital

Primary care provider locations


Ashland, Butte Falls, Central Point, Eagle Point, Jacksonville, Medford,
Phoenix, Rogue River, Shady Cove, Talent, White City

Behavioral health networks


Jackson County Mental Health, ColumbiaCare Services, Kairos, OnTrack
Rogue Valley, Addictions Recovery Center, Albertina Kerr, Family Solutions,
Hearts with a Mission, Integrated Health Services, Juniper Ridge, Redemption
Ridge, Trillium Family Services, Compass House, Options for Southern
Oregon, Kolpia, Phoenix Counseling, Allied CRC, multiple private therapists

Dental care networks


Advantage Dental Services, Capitol Dental, ODS Dental Plan,
Willamette Dental Group

14 CCO Plan Comparison Guide: CCO plan choices


Pharmacies
Many area pharmacies. See a complete list on the CCO’s website.

Medicare plans
CareOregon Advantage

Provider directory
www.jacksoncareconnect.org/for-members/provider-search

Member handbook
www.jacksoncareconnect.org/for-members/member-handbook

Extra services
Diapers, car seats and other gear, care coordination, social support, and
lactation support for caregivers of children under 4 years; childcare and
enrichment programs for eligible members; local gym memberships; weight
management and cooking classes for adults and children; rides to wellness
and prevention programs (including 12-step and other recovery support
communities), WIC appointments, Starting Strong, YMCA, mental health peer
support, and other activities; oral hygiene supplies; other supports depending
on member needs, such as sensory items, clothing and shoes; support
and incentives to complete appropriate preventive care; chronic disease
management and prevention classes; housing supports for qualified members.
More information:
www.jacksoncareconnect.org/for-members/wellness-benefits/strong-families

CCO Plan Comparison Guide: CCO plan choices 15


PacificSource Community
Solutions: Lane Member Name: [Member Name]
OHP ID #: [OHP ID #]
Member ID #: [Member ID #]
Primary Care Provider: [Provider Name]
Dental Plan: [Dental Plan Name]
If you have a medical emergency, call 911 or go to the
nearest emergency room. If you are not sure if you have a true

Lane county dental emergency, please call your dentist.

Customer Service: [(800) 431-4135]


TTY Line: (800) 735-2900
503-210-2515 or 800-431-4135 or TTY 800-735-2900
Hours: 8 a.m. to 5 p.m., Monday - Friday
Online:
Electronic Claims Payor ID#: [ insert number]

www.communitysolutions.pacificsource.com
Pharmacists: (541) 330-4999 or (888) 437-7728
RxBin [012114] RxGroup [RX6156] RxPCN [COBSEGADV]

Keep your ID card with you at all times. Please show your ID
card to your provider at each visit.

Contracted hospitals
• Crook County: St. Charles Prineville
• Deschutes County: St. Charles Medical Center Bend, St. Charles Medical
Center Redmond
• Grant County: Blue Mountain Hospital
• Harney County: Harney District Hospital
• Hood River County: Providence Hood River Memorial Hospital
• Jefferson County: St. Charles Madras
• Lane County: McKenzie-Willamette Medical Center, PeaceHealth Cottage
Grove Community Medical Center, PeaceHealth Sacred Heart Medical
Center University District, PeaceHealth Peace Harbor Medical Center,
PeaceHealth Sacred Heart Medical Center at RiverBend
• Marion County: Legacy Silverton Medical Center
• Multnomah County: Legacy Emanuel Medical Center, Legacy Good
Samaritan Medical Center, Legacy Mount Hood Medical Center, Oregon
Health & Science University, Shriners Hospitals for Children
• Wasco County: Mid-Columbia Medical Center
• Washington County: Legacy Meridian Park, Providence St. Vincent
Medical Center
• California: Stanford Children’s Health — Lucile Packard Children’s
Hospital Stanford
• Washington state: Skyline Hospital

16 CCO Plan Comparison Guide: CCO plan choices


Primary care provider locations
Cottage Grove, Creswell, Eugene, Florence, Junction City, Oakridge,
Springfield, Veneta

Dental care networks


Advantage Dental Services, Capitol Dental Care, Oregon Dental Service

Pharmacies
Many area pharmacies. See a complete list on the CCO’s website.

Medicare plans
Multiple Medicare Advantage plans.

Behavioral health networks


Review the provider directory to find behavioral health providers in the
network. If you have questions about any particular provider’s participation in
PacificSource’s network, contact customer service at 800-431-4135.

Provider directory
www.communitysolutions.pacificsource.com/Tools/ProviderDirectory

Member handbook
www.communitysolutions.pacificsource.com/Member

Extra services
Training and education for health improvement or management, home
and living environment items or improvements, and transportation needs.
Examples include, but are not limited to, gym passes, swim passes, exercise
equipment, temporary transitional housing, air purifiers, and water filters
More information: Contact customer service at 800-431-4135.

CCO Plan Comparison Guide: CCO plan choices 17


PacificSource Community
Solutions: Marion Polk Member Name: [Member Name]
OHP ID #: [OHP ID #]
Member ID #: [Member ID #]
Primary Care Provider: [Provider Name]
Dental Plan: [Dental Plan Name]
If you have a medical emergency, call 911 or go to the
nearest emergency room. If you are not sure if you have a true

Marion and Polk counties dental emergency, please call your dentist.

Customer Service: [(800) 431-4135]


TTY Line: (800) 735-2900
503-210-2515 or 800-431-4135 or TTY 800-735-2900
Hours: 8 a.m. to 5 p.m., Monday - Friday
Online:
Electronic Claims Payor ID#: [ insert number]

www.communitysolutions.pacificsource.com
Pharmacists: (541) 330-4999 or (888) 437-7728
RxBin [012114] RxGroup [RX6156] RxPCN [COBSEGADV]

Keep your ID card with you at all times. Please show your ID
card to your provider at each visit.

Contracted hospitals
• Crook County: St. Charles Prineville
• Deschutes County: St. Charles Medical Center Bend, St. Charles Medical
Center Redmond
• Grant County: Blue Mountain Hospital
• Harney County: Harney District Hospital
• Hood River County: Providence Hood River Memorial Hospital
• Jefferson County: St. Charles Madras
• Lane County: McKenzie-Willamette Medical Center, PeaceHealth Cottage
Grove Community Medical Center, PeaceHealth Sacred Heart Medical
Center University District, PeaceHealth Peace Harbor Medical Center,
PeaceHealth Sacred Heart Medical Center at RiverBend
• Marion County: Legacy Silverton Medical Center
• Multnomah County: Legacy Emanuel Medical Center, Legacy Good
Samaritan Medical Center, Legacy Mount Hood Medical Center, Oregon
Health & Science University, Shriners Hospitals for Children
• Wasco County: Mid-Columbia Medical Center
• Washington County: Legacy Meridian Park, Providence St. Vincent
Medical Center
• California: Stanford Children’s Health — Lucile Packard Children’s
Hospital Stanford
• Washington state: Skyline Hospital

18 CCO Plan Comparison Guide: CCO plan choices


Primary care provider locations
Marion: Salem, Keizer, Aumsville, Mount Angel, Monmouth, Silverton,
Stayton, Sublimity, Woodburn
Polk: Dallas, Salem, Monmouth, Grand Ronde

Dental care networks


Advantage Dental Services, Capitol Dental Care, Oregon Dental Service

Pharmacies
Many area pharmacies. See a complete list on the CCO’s website.

Medicare plans
PacificSource is in the process of affiliating with other plans to serve
Marion County and Polk County.

Behavioral health networks


Review the provider directory to find behavioral health providers in the
network. If you have questions about any particular provider’s participation in
PacificSource’s network, contact customer service at 800-431-4135.

Provider directory
www.communitysolutions.pacificsource.com/Tools/ProviderDirectory

Member handbook
www.communitysolutions.pacificsource.com/Member

Extra services
Training and education for health improvement or management, home
and living environment items or improvements, and transportation needs.
Examples include, but are not limited to, gym passes, swim passes, exercise
equipment, temporary transitional housing, air purifiers, and water filters
More information: Contact customer service at 800-431-4135.

CCO Plan Comparison Guide: CCO plan choices 19


Trillium Community Medical
Dental

Health Plan Inc.


Behavioral Health
Name: <JOHN SMITH>
Oregon Health Plan#: <123456789101112>
PHARMACY
PROVIDER INFORMATION INFORMATION
PCP Start Date: <12/05/2016> RX: Envolve Rx
Doctor (PCP): <Dr. Jane Doe> RXBIN: 004336
DCO: <DCO Name> RXPCN: MCAIDADV

Clackamas, Multnomah and


DCO Phone: <(555) 555-1234> RXGRP: RX5461

Washington and Lane, partial Douglas


(97424, 97436, 97441, 97467, 97473, 97493 only) and partial
Linn (97446 only) counties

541-485-2155 or 877-600-5472 or TTY 877-600-5473


www.TrilliumCHP.com

Contracted hospitals
Cedar Hills Hospital (psychiatric), ColumbiaCare Services (psychiatric), Legacy
Emanuel Hospital, Looking Glass Youth and Family Services (psychiatric),
Lower Umpqua Hospital, McKenzie Willamette Hospital, Oregon Health &
Science University, Peace Harbor Hospital, Sacred Heart Medical Center
University District, Sacred Heart Medical Center Riverbend

Primary care provider locations


• Clackamas, Multnomah and Washington: Beaverton, Canby, Estacada,
Gresham, Hillsboro, Milwaukie, Oregon City, Portland, Tigard, Wilsonville
• Lane, Douglas and Linn: Albany, Blue River, Coburg, Cottage Grove,
Creswell, Curtin, Dexter, Eugene, Florence, Glide, Junction City, Lebanon,
Myrtle Creek, Oakridge, Pleasant Hill, Reedsport, Roseburg, Springfield,
Sutherlin, Veneta, Winston

Dental care networks


Advantage Dental, Capitol Dental, Oregon Dental Service, Willamette Dental

Behavioral health networks


Go to providersearch.trilliumhealthplan.com or call 541-485-2155 or
877-600-5472 or TTY 877-600-5473 to learn about options for mental
health and substance use disorder treatment.
20 CCO Plan Comparison Guide: CCO plan choices
Pharmacies
Many area pharmacies. See a complete list on the CCO’s website.

Medicare plans
Trillium Medicare Advantage www.trilliumadvantage.com

Provider directory
www.trilliumohp.com/members/oregon-health-plan/for-members/benefit-
information.html

Member handbook
www.trilliumohp.com/members/oregon-health-plan/for-members/
handbooks-forms.html

Extra services
• Clackamas, Multnomah and Washington: Start Smart for Your Baby
(extra benefits and support during and after pregnancy); caregiver support;
24/7 nurse advice line; online search for free or low-cost assistance
programs; digital scale, air conditioner, medical bracelets, aquatic classes;
help applying for Supplemental Security Income (SSI) benefits; online health
and life coaching programs for conditions including asthma, diabetes, back
pain, congestive heart failure, heart disease, hyperlipidemia, hypertension,
weight management and others; flexible funds to attend specific wellness
programs (such as the Diabetes Prevention Program)
• Lane, Douglas and Linn: Start Smart for Your Baby (extra benefits and
support during and after pregnancy); caregiver support; tobacco prevention
programs for children and pregnant women; parenting support services
and education; 24/7 nurse advice line; online search for free or low-
cost assistance programs; digital scale, air condition, medical bracelets,
aquatic classes; wellness incentives (gift cards) for Medicare members
and adolescents; help applying for Supplemental Security Income (SSI)
benefits; Intensive Community Care Management clinics; diabetic care
program; online health and life coaching programs for various conditions;
flexible funds to attend specific wellness programs (such as the Diabetes
Prevention Program); Sheltercare Medical Recuperation; Trillium Produce
Plus (access to no cost fresh fruit and vegetables in some clinics and
public settings)

CCO Plan Comparison Guide: CCO plan choices 21


Umpqua Health Member Name:
«first_name» «last_name»

Alliance LLC
Member ID: «member_number»

Member Services:
541-229-4UHA or 541-229-4842
TTY Users: 541-440-6304
Partial Douglas (excludes 97441, Website: www.UmpquaHealth.com

97467 and 97473) county

541-229-4842 or 866-672-1551 or TTY 888-877-6304


or 541-440-6304
www.umpquahealth.com/ohp

Contracted hospitals
Roseburg: Mercy Medical Center

Primary care provider locations


Canyonville, Glide, Myrtle Creek, Roseburg, Sutherlin, Winston, Drain

Dental care networks


Advantage Dental Services

Behavioral health networks


Adapt, Compass, Serenity Lane, Umpqua Health- Newton Creek, UCHC,
Douglas CARES, Valley View, Second Wind Mental Health, Cow Creek, Jessica
Blake LLC, Evergreen Family Medicine, other independent providers.

Pharmacies
Most Douglas County pharmacies

Medicare plans
ATRIO plans

22 CCO Plan Comparison Guide: CCO plan choices


Provider directory
www.umpquahealth.com/ohp

Member handbook
www.umpquahealth.com/ohp

Extra services
Support for pregnant women (New Day) and families with young children
(New Beginnings) who are experiencing barriers to health, training and
education; Quit for Life tobacco cessation program, some non-medical rides,
diabetes education classes, intensive case management.
More information: www.umpquahealth.com/ohp/programs

CCO Plan Comparison Guide: CCO plan choices 23


Yamhill Community Care Organization
Yamhill county, partial
Polk (97101, 97304, 97347, 97371, 97378, 97396) and
partial Washington (97119, 97123, 97132, 97140) counties

503-488-2800 or 855-722-8205 or TTY 800-735-2900


www.yamhillcco.org

Contracted hospitals
• McMinnville: Willamette Valley Medical Center
• Newberg: Providence Newberg Medical Center
• Portland: OHSU including Tuality, Legacy, Providence
• Salem: Salem Health

Primary care provider locations


• Yamhill County: McMinnville, Newberg, Sherwood, Tualatin
• Polk County: Falls City, Monmouth, Salem
• Washington County: Aloha, Beaverton, Forest Grove, Hillsboro,
Sherwood, Tigard, Tualatin

Dental care networks


Capitol Dental Care

Behavioral health networks


Yamhill County Health and Human Services

Pharmacies
Many area pharmacies. See a complete list on the CCO’s website.

24 CCO Plan Comparison Guide: CCO plan choices


Medicare plans
Contact the CCO for details.

Provider directory
yamhillcco.org/for-members/find-a-provider

Member handbook
yamhillcco.org/for-members/member-handbooks

Extra services
Childbirth classes; Quit for Life tobacco cessation program; some non-
medical rides; other services to help with housing, accessing healthy foods
and non-medical transportation services; diabetes prevention program; other
services to help with housing

CCO Plan Comparison Guide: CCO plan choices 25


Key terms
Use this list to help you understand some of the words in OHP letters and
documents.
Benefits: The services that your health care plan pays for. CCO benefits
include physical, dental and mental health care.
Behavioral health care: Treatment for mental health conditions or substance
use disorders.
Community partner: A person or organization that helps people apply for
health coverage. Community partners are local. Help is free.
Coordinated care organization (CCO): A CCO is a health care plan that
has a local group of providers: doctors, counselors, nurses, dentists and
others who work together in your community. CCOs help make sure OHP
members stay healthy.
Health plan or plan: A company that arranges and pays for health care services.
Medicaid: A state-run program that helps with health care costs for people
with low incomes. In Oregon, it’s part of the Oregon Health Plan.
Medicare: A federal health care program for people 65 or older. It also helps
people with disabilities of any age.
Primary care provider or primary care physician (PCP): The medical
professional who takes care of your health. This is usually the first person you
call when you have health issues or need care. Your PCP can be a doctor, nurse
practitioner, physician’s assistant, osteopath or sometimes a naturopath.
Provider: A licensed person, group or facility that offers a health care service.
Examples are a doctor, dentist, therapist, or a hospital.

26 CCO Plan Comparison Guide: Key terms


Rights and responsibilities
You have the right to:
• Be treated with dignity and respect, the same as other patients.
• Choose your health care providers.
• Tell your provider about all your health concerns.
• Have a friend or helper come to your appointments.
• Get an interpreter if you want one.
• Get information on all your covered and noncovered treatment options.
• Help make decisions about your health care, including refusing treatment.
• Not have people hold you down or keep you away from others as a way to:
• Make you do something you don’t want to do.
• Make caring for you easier for your providers.
• Punish you for something you said or did.
• A referral or second opinion, if you need it.
• Get care when you need it, any time of day or night.
• Mental health care and family planning services without a referral.
• Help with addiction to cigarettes, alcohol and drugs without a referral.
• Get handbooks and letters you can understand.
• See and get a copy of your health records, unless your doctor thinks it
would be bad for you.
• Limit who can see your health records.
• A Notice of Action letter if you are denied a service or your service
level changes.
• Information and help to appeal CCO denials and/or ask for a hearing.
• Make complaints and get a response without bad treatment from your
plan or provider.
• Get free help from the OHA ombudsperson.
You have the right to understand information from OHP.
You can ask for:
• An interpreter.
• Information in other languages.
• Information in Braille, large print and other formats.
Tell your CCO if you need help. (continued on next page)

CCO Plan Comparison Guide: Rights and responsibilities 27


(continued from previous page)

You have a right to be treated fairly.


OHP, its providers and its CCOs must follow state and federal civil rights
laws. It cannot treat people unfairly in any of its programs or activities
because of a person’s:
• Age • Marital status • Sex
• Color • National origin • Sexual orientation
• Disability • Race
• Gender identity • Religion
Tell us if you are not treated fairly.
If you feel you were treated unfairly for any of the above reasons, tell us.
Contact the civil rights manager in one of these ways:
• Web: www.oregon.gov/OHA/OEI
• Email: OHA.PublicCivilRights@dhsoha.state.or.us
• Phone: 844-882-7889, TTY 711
• Mail: OHA Office of Equity and Inclusion
421 SW Oak St., Suite 750, Portland, OR 97204

Call: OHP has a special phone number to answer your questions and
help you make your choice. The number is 877-647-0027 (TTY 711).
Regular business hours: 7 a.m.–5 p.m. Monday-Friday
October 16-November 17, 2019: 7 a.m.–8 p.m. Monday-Friday
If you need an interpreter, ask for one when you call.

Ask a trusted community partner: Find a person trained to help


guide you through this process at OHP.Oregon.gov.

Go online: Compare plans and find links to more CCO information at


OHP.Oregon.gov.

You can get this document in other languages, large print,


braille or a format you prefer. Contact the Oregon Health Plan
at 877-647-0027. We accept all relay calls or you can dial 711.
OHA 2832C (09/2019)

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