Medical Health Benefits

Medical Health Benefits

Be well with Health Share

As a Health Share member, you are eligible for all benefits covered by the Oregon Health Plan (OHP), at no cost.

Your benefits include:

  • Primary care services
  • Doctor visits
  • Prescription drugs
  • Pregnancy Care
  • Some vision services
  • And more

Download a Member Handbook to see all the benefits available to you.

Member Handbook

How to get care

Watch this short video to learn more about Health Share’s medical health benefits and how to get care.

Your Medical Health Plan

You can change your primary care provider—that's your main doctor or clinic—if you want. Just call the contact number for your medical health plan listed on your Member ID Card.

Find Pharmacies and Prescriptions

Learn more about the pharmacies and prescriptions available to you on our Pharmacies + Prescriptions page.

Advance Directives

An Advance Directive is a written statement of a person's wishes regarding medical treatment. It is made to ensure those wishes are carried out should the person be unable to communicate them to a doctor.

Advance Directives Information

Find more information about OHSU Advance Directives here.

For more information about Kaiser Advance Directives, click here.

End of life decisions and Advance Directives (living wills) Adults 18 years and older can make decisions about their own care, including refusing treatment. It’s possible that someday you could become so sick or injured that you can’t tell your providers whether you want a certain treatment or not. If you have written an Advance Directive, also called a living will, your providers may follow your instructions.

If you don’t have an Advance Directive, your providers may ask your family what to do. If your family can’t or won’t decide, your providers will take the usual steps in treating your conditions. If you don’t want certain kinds of treatment, like a breathing machine or feeding tube, you can write that down in an Advance Directive. It lets you decide your care before you need that kind of care - in case you are unable to direct it yourself, such as if you are in a coma. If you are awake and alert your providers will always listen to what you want.

You can get an Advance Directive form at no cost by calling CareOregon Customer Service at 800-224-4840, TTY 711. You can also get it from Oregon Health Decisions by calling toll-free 800-422-4805 or online at oregon.gov/oha/PH/ABOUT/Documents/Advance-Directive.pdf. If you write an Advance Directive, be sure to talk to your providers and your family about it and give them copies. They can only follow your instructions if they have them. Some providers and hospitals will not follow Advance Directives for religious or moral reasons. You should ask them about this. If you change your mind, you can cancel your Advance Directive anytime. To cancel your Advance Directive, ask for the copies back and tear them up, or write CANCELED in large letters, sign and date them.

If you think CareOregon did not follow Advance Directive requirements, or if your provider does not follow your wishes in your Advance Directive, you can complain. A form for this is at healthoregon.org/hcrqi Send your complaint to: Health Care Regulation and Quality Improvement Mail: 800 NE Oregon St, #305 Portland, OR 97232 Email: Mailbox.hcls@state.or.us Fax: 971-673-0556 Phone: 971-673-0540 TTY: 971-673-0372 For questions or more information contact Oregon Health Decisions at 800-422-4805 or 503-241-0744, TTY 711.

For more information about Legacy Health Advance Directives click here.

Click here for more information on Advance Care Planning. 

Early and Periodic Screening, Diagnosis, and Treatment of Members Under 21

Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program, also known as "well-child" visits, are medical exams (visits) for children. They give care to all children. This means from birth until 21. At these visits, kids are screen and diagnosed for physical or mental issues. Children also get care to help treat any issues found. 

These visits are vital. They can help treat and stop medical problems. They are also free to members under 21. If you need help getting to these visits, you can learn more about how to set up a ride on our Ride to Care page.

Early and Periodic Screening, Diagnosis, and Treatment of Members Under 21 Information

Call your primary care provider to ask for a screening. You can have as many screenings as you need.

You can get a screening from a doctor. You can also get one from a nurse practitioner. Licensed physician assistants and continuing care providers can also give screenings.

If you (or your child) have a primary care provider, you can get screened and diagnosed. You can also get treated and referred for a follow-up. The only care you can't get is required dental care. But, your provider can refer (send) you to a dentist. The dentist can give dental care. They will give the care according to OHA's OHP Dental Periodicity Schedule. 

You can view the schedule at: https://www.oregon.gov/oha/HSD/OHP/Tools/OHP-Recommended-Dental-Periodicity-Schedule.pdf

Health Share can also help you get dental care. 

At your visit, your provider can maintain (keep up) your consolidated (shortened) health history. This can be made up of information from other providers.

You can also get physicians' services (care) for acute, episodic, or chronic (life-long) illnesses.  

Yes, you or your representative will need to sign an agreement. The agreement will have your obligations (duties). It will also say that your provider will give care for a certain amount of time.

Your (or your child's) screening will have:

  • A comprehensive (whole) health and developmental history. This involves an assessment (review) of physical and mental health development. 
  • A review of nutritional (food) health status

  • A comprehensive (whole) physical exam without clothes. This involves looking at teeth and gums. Dental care will be supplied if needed. You may be referred to a dental provider to get care.

  • Recommended Immunizations (shots). If you need one at the screening they can give it to you. These are recommended by the Advisory Committee on Immunization Practices (ACIP). 

  •  Adult Immunization Schedule (19+): https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html

  • Lead testing. Children must have blood lead screening tests at 1 and 2 years. Children between 24 and 72 months with no record of the test must get one. This cannot be met through a completed (finished) risk assessment questionnare. All kids with lead poisoning will get a follow up. This will be from case management services.

  • Other lab tests based on age and risk. These could include anemia and sickle cell tests.

  • Health education. Your provider will talk to you about what you can expect for your future health. 

  • Hearing and vision tests. You can get glasses and hearing aids if needed. View the schedules for these below.

  • Periodicity Schedules for Screening Services: Periodicity schedules specify screening services for eligible EPSDT members at each stage of the member’s life, beginning with a neonatal exam, up to the age of 21

  • AAP Periodicity Schedule available here: https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf

  • EPSDT Fact Sheet: https://www.oregon.gov/oha/HSD/BH-Child-Family/SOCAC/EPSDT%20fact%20sheet-OR%20Final.pdf

If you have any questions, contact Health Share Customer Service.

You may be referred (sent) to another provider. This may happen if a medical, mental health, substance use, or dental issue is found. The provider screening you will explain why. The other provider can help treat the issue. If you agree to the referral, they will help you make an appointment. If you need care coordination, Health Share and OHA will make sure you have it. Health Share can help you if need a referral for social services, education programs, and nutritional assistance programs.

After your screening, you can get your recommended services. These will take no longer than six months to get after a request is filed.

Yes, some services are not covered. These include the Supplemental Nutrition Assistance Program (SNAP), and other social service programs. To learn more about how to access services not covered, call Health Share Customer Service at 503-416-8090.

Discover the best birth control for you. Your insurance through the Oregon Health Plan covers all options that are available, all at no cost. Learn more about birth control options here.