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Oregon Health Plan FAQs

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If my phone number and address have changed, how do I update that information?

To update your contact information call the Oregon Health Authority, a customer service line for OHP members, at 1-800-699-9075. This is important so you can get notices about your coverage and other information about your healthcare.

I have OHP, but what does that have to do with Health Share and Tuality Health Alliance?

The Oregon Health Plan (OHP) and Health Share work together with Tuality Health Alliance (THA) on different parts of your healthcare needs. OHP provides health insurance. Health Share coordinates your services and issues your member ID cards. Tuality Health Alliance provides you with customer service, and helps with contracts and administrative work related to your care.

What is a PCP?

Your PCP (Primary Care Provider) provides most of your healthcare. Sometimes, on your Health Share ID card you will see a clinic listed under PCP. If that is on your card that means that there is a team of physicians that can serve as your PCP at that clinic. Every OHP member is assigned to a PCP or a clinic with a team of providers. If you have a concern that might require a specialist your PCP is the person that can write you a referral.

How do I select a primary care provider (PCP)?

To find a provider, visit our "Find a Provider" section.

Once you choose a provider, please call member services at 503-844-8104 and let us know. We work with Health Share to make sure you get an updated member ID card with your PCP (or Clinic) listed on it.

Can I change my primary care provider (PCP)?

Yes, you can change your PCP. To find a new provider, visit our "Find a Provider" section.

Once you choose a provider, please call member services at 503-844-8104 and let us know. We work with Health Share to make sure you get an updated member ID card with your PCP (or Clinic) listed on it.

Can I choose a different PCP for each member of my family?

Yes. Each covered family member can select his or her own PCP.

What is "urgent" care?

Any condition that is a non-emergency situation, but needs prompt healthcare service is an "urgent" care.

A few examples of urgent care needs include ear infections, sprains, high fevers, and vomiting. Call your clinic or PCP first to see if there are appointments available. If there are no appointments or you are experiencing a severe medical condition you can visit an urgent care clinic. It is a good idea to look for your nearest urgent care clinic ahead of time, so you know which urgent care clinics are easy for you to get to. For a list of urgent care locations visit our "Find a Provider" section under Oregon Health Plan Members. It is a good idea to keep the address of your PCP or the closest urgent care in your wallet in case you’re not home if an urgent healthcare need arises.

What do I do in an emergency?

Seek qualified help immediately. You and your family members are covered for emergency medical services anywhere, 24 hours a day.

An emergency is a sudden and unexpected onset of an injury or serious illness that, if not treated immediately, may result in serious medical complications, loss of life or permanent impairment of bodily functions. Some examples include (but are not limited to) chest pains, loss of consciousness, excessive bleeding, broken bones, loss of breathing or convulsions.

In an emergency, call for emergency assistance or go to the nearest hospital emergency room immediately.

What is the difference between family practice and pediatrics?

Family practice is qualified to care for the entire family (all age groups). Pediatrics specializes in children. Most pediatricians can treat children from birth to adolescences.

What if I need transportation to attend my medical appointments?

As an OHP member you can get free transportation to medical appointments. To get a ride to an appointment call "Ride to Care", a non-emergency medical transportation service. When you call for services they will ask you the following information: your name, your OHP number, the time and date of your appointment, your complete address and phone number, your medical provider information (address or general information). To make arrangements call Ride to Care at 503-416-3955 or 855-321-4899 or TTY/TDD 503-802-8058.

How can I get help with my OHP application?

You can get free help from a certified insurance agent, community partner, or customer service representative by visiting www.oregonhealthcare.gov. Or you can call the Oregon Health Authority (OHP Customer Service) at 1-800-699-9075 to get a list of agents who can assist you with the Oregon Health Plan application process. Assistance is available in multiple languages.

If I submitted an application to renew or receive OHP benefits, but I have not received a letter or a call, who can I contact to see if I have been approved?

If your application was submitted online, an e-mail confirmation should have been sent to you confirming that the application was received. If your application was mailed, or if you have not received a response regarding coverage, contact the Oregon Health Authority (OHP customer service) at 1-800-699-9075 to verify the status of your application.

How do I cancel my OHP benefits?

Please call the Oregon Health Authority (OHP customer service) at 1-800-699-9075, and they can assist you with canceling your OHP plan.

How do I know when I am supposed to renew my OHP plan?

You should receive a letter from OHP letting you know when it is time to reapply. You can always call the Oregon Health Authority (OHP customer service) at 1-800-699-9075, and they will let you know when you need to reapply. If you move, remember to change your address with them so that they will send notices about coverage to the correct address.

Do I have to pay for services?

If you are an OHP member you do not pay for services. Health Share Tuality member benefits are paid by the Oregon Health Plan insurance.

Where can I get my prescriptions filled?

For OHP members, THA contracts with many local pharmacies where you can get your prescriptions filled.
Download list of contracted pharmacies »

How do I contact member services, and when are they available?

Member Service is available Monday through Friday, from 8am to 5pm, at 503-844-8104. You can email us anytime at THA.Customerservice@tuality.org