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Learn about Medicaid with Kaiser Permanente in Oregon

Medicaid provides free or low-cost health coverage to low-income individuals and their families. In Oregon, Medicaid is called the Oregon Health Plan (OHP). On January 1, 2014, Oregon expanded Medicaid to a larger and more diverse group of people, including adults and children below certain income levels.

Most individuals who qualify for Medicaid or Medicaid Bridge will have no monthly premium, no copay, and no out-of-pocket cost for most covered services. Depending on your income, a small monthly premium may apply.

Kaiser Permanente participates in the Oregon Health Plan in several counties. To choose Medicaid or Medicaid Bridge with Kaiser Permanente, you must qualify and be assigned to one of the Coordinated Care Organizations (CCOs) in our service area. At Kaiser Permanente, you have a wide network of doctors and specialists to choose from. All of our doctors accept Kaiser Permanente members with OHP coverage.

Benefits

Medicaid and Medicaid Bridge in Oregon provide a core set of health benefits, including doctor visits, hospital care, immunization, and pregnancy-related services. The Affordable Care Act ensures all Medicaid and Medicaid Bridge health plans offer what are known as Essential Health Benefits (EHB). These comprehensive services include the following categories:

Primary and Specialty care

Get care from a healthcare provider such as a nurse, doctor or specialist – including appointments, exams, and treatment.

Pediatric services

Your child can get regular check-ups, dental care, vision care and immunizations.

Medication

Get prescriptions that are covered by your plan.

Hospital care

If you have to go to a hospital, you can get the services you need, including x-rays and lab tests.

Emergency care

If you need to make an emergency room visit, you can get emergency services.

Laboratory services

Lab tests are covered.

Maternity and Newborn care

Regular maternity care appointments, newborn screenings, immunizations, and more are covered.

Rehabilitative & Habilitative Services

Services and devices to help you recover from an injury, disability or chronic condition. Examples may include physical and occupational therapy.

Preventive and wellness services

Care you need to stay healthy, such as physical exams, counseling, screening, vaccines and chronic disease management.

Health Related Social Needs

Some Kaiser Permanente Medicaid members may be eligible for benefits designed to help with needs that go beyond healthcare. These benefits provide climate, housing, and nutrition support to eligible members. Visit Health Share of Oregon to learn more and see if you qualify.

Please note: Some services may require preauthorization. All services must be provided by a Kaiser Permanente doctor or medical staff.

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Questions about Medicaid or Medicaid Bridge with Kaiser Permanente?

Call the Kaiser Permanente Medicaid Assistance Center at

1-800-518-3731 (toll free) or 711 (TTY),

8 a.m. to 5 p.m., Monday through Friday.

Español: 1-800-518-3785