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OHP Standard Benefit Package
Note: This information is available in alternate formats for persons with special needs. Please call 1-800-757-5114 TTY 1-800-735-2900 to request this service.
Clients are assigned to OHP Standard if they do not meet the requirements for OHP Plus or other benefit packages. OHP Standard provides fewer services than OHP Plus and requires copayments for some of the services.
For a list of covered and non-covered services see the Client Handbook for the Oregon Health Plan.
Copayments
OHP Standard requires copayments for the following services. Be prepared to pay the following copayments at the time services are provided.
| Hospital |
| Inpatient Care (per admission) |
$250 |
| Outpatient Surgery and Ambulatory Surgical Centers |
$20 |
| Other Outpatient Hospital Services |
$5 |
| Emergency Services (waived if you are admitted to the hospital) |
$50 |
| Physicians, Physician Assistants, Nurse Practitioners, and other Health Professionals visits for: |
| Primary and Specialty Care, including urgent care |
$5 |
| Office, medical procedures |
$5 |
| Surgical procedures |
$5 |
| Occupational therapy, Physical Therapy, or Speech Therapy |
$5 |
| Home visits for: |
| Home Health, Private Duty Nursing, or Enteral/Parenteral Nutritional and IV services |
$5 |
| Other services and procedures |
| Emergency Ambulance Services |
$50 |
| Laboratory and Radiology Tests and Diagnostic Procedures |
$3 |
| Radiology treatments |
$5 |
| Prescription Drugs (Tier 1) |
| Generic prescription drugs and Enteral/Parenteral Nutritional products |
$2 |
| Brand drugs for Mental Health, Cancer, HIV |
$3 |
| All other brand name drugs |
$15 |
OHP Standard members do not have to pay copayments for the following services:
- Family Planning services and supplies, like birth control pills
- Pap Smears
- Mammograms (breast x-rays)
- Fecal occult blood test
- Diagnostic sigmoidoscopy (over age 50)
- Total blood cholesterol screenings
- for men ages 35-64
- for women ages 45-64
- Rubella serology or vaccinations for women of childbearing age
- Tetanus Diphtheria (Td) boosters
- Influenza Immunizations
- Hospice services
- Administrative Medical Exams - medical examinations required by DHS staff to assist in determining eligibility
- Venipuncture (blood draw)
- Women’s annual health exams
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