What is FamilyCare, Inc.?
FamilyCare is a managed care health plan that contracts with the State to provide benefits to people who have the OHP Plus or Standard benefit packages. FamilyCare is one of your choices for a managed care plan.
How do I get an Oregon Health Plan application or re-application?
All applications or re-applications come from the State. If you need an application, please call 1-800-359-9517 or visit the Department of Health and Human Services website to fill out the on-line application. Remember, it is the State that approves applications or re-applications, not FamilyCare.
How do I contact my Oregon Health Plan caseworker?
You should receive a Coverage Letter from the state. The number to your Oregon Health Plan caseworker should be listed on the first page of the coverage letter.
Who do I contact if my address or phone number changes?
Please call your caseworker as soon as possible so that you can continue to receive your DHS Medical Care ID Card.
Who do I call if I have other insurance coverage (for example, Worker’s Compensation, health insurance)?
You need to call your caseworker and the Navigations Services Department at FamilyCare at 503-222-2880 or 1-800-458-9518.
Does FamilyCare cover drug and alcohol treatment?
Outpatient treatment is covered. You do not need a referral for services when you go to a contracted provider.
Who is eligible for routine vision benefits?
OHP Plus and OHP with Limited Drug clients who are younger than 21 or clients who are pregnant women are eligible for routine vision services.
Where can I be seen for an eye exam and glasses?
If you qualify for routine vision benefits, and live in Multnomah, Clackamas, Washington, Josephine or Jackson Counties, please call Vision Service Plan (VSP) at 1-800-877-7195. Give them your DHS Medical Care ID Card. They will tell you what your benefits are and where you can go for an eye exam. For member residing in Umatilla and Morrow County please call Navigation Services at 503-222-2880 or 1-800-458-9518.
Do I have mental health coverage?
To find out if you have mental health coverage, first look in the Managed Care/TPR enrollment section of your Coverage Letter from the state. If a Mental Health Organization (MHO) is not listed, please call your caseworker.
Do I have dental coverage?
You can find your dental information by looking first in the Managed Care/TPR enrollment section of your Coverage Letter from the state. If a dental service is not listed, please call your caseworker.
Are interpretation services available if I do not speak English?
Yes. If you need an interpreter for provider visits or to help you with questions, please call Navigation Services at 503-222-2880 or 1-800-458-9518 and they will help you. For TTY, please call 1-800-735-2900.
Is medical transportation available?
In some cases, transportation to doctor’s appointments is covered by FamilyCare. Please call Navigation Services at 503-222-2880 or 1-800-458-9518 for more information. You can also call your caseworker in advance for transportation.
What do I do if I get a bill for healthcare services?
Call your healthcare provider’s office to make sure they know you are on the Oregon Health Plan. Let them know they are to send the bill to FamilyCare. If you still need help, please call Navigation Services at 503-222-2880 or 1-800-458-9518.
Remember to take your DHS Medical Care ID Card with you to all of your appointments and show it to the office staff.
What about prescriptions?
If your provider gives you a new prescription, ask the provider or their staff if your diagnosis is covered by the Oregon Health Plan. If your diagnosis is not covered, you may still get your prescription but you may need to pay for it yourself.
If your prescription needs prior approval that means your provider needs to fax paperwork to FamilyCare for approval. Without prior approval, FamilyCare will not pay for certain medications. If your prescription is denied by the pharmacy, it may be because the medication needs a prior approval. Please call your provider's office as soon as possible or ask the pharmacy to call your provider.
It can take up to 72 hours to process a prescription request. In most cases, the review is done within 24 hours of receiving your provider's paperwork. Call your pharmacy directly to see if your medication was approved. Your provider's office may take more time in processing your medication approval request. Do not wait until your medication is gone to request a refill.