Frequently Asked Questions

FAQ

Please click on a bulleted item to expand.

• What is Jackson Care Connect?

  Jackson Care Connect is a coordinated care organization (CCO) that serves Oregon Health Plan (OHP) members in Jackson County. A CCO is a network of health care providers who agree to work together in their community for people who have health care coverage from OHP. In each Oregon community, one or more CCOs serve as the umbrella for various provider groups, hospitals, health plans and social agencies. All of these work together to serve OHP members. Each CCO strives to improve patient care and make access to care easier.

• How can members contact Jackson Care Connect?

   

  Call Jackson Care Connect Customer Service at the following numbers:

  • Physical/mental health: 855-722-8208
  • Dental health: Numbers vary depending on your dental provider. See the Dental Health Resources page for customer service information.
  • TTY: 711

• How can I be sure I’ll be able to see who I want under OHP and Jackson Care Connect?

  We have a large provider network of providers and pharmacies, and we contract with every hospital in the county. We work with you to build a team that includes your providers, mental health specialists, dentists, pharmacists and everyone at Jackson Care Connect. Together, we get you quality care to meet your needs.

• Why was I assigned to a provider when I already have a doctor?

  We match new members with PCPs based on where they live. If you already see a PCP in our network, give us a call. We’re happy to update our records.

• How do I change my primary care provider (PCP), my dentist or my mental health provider?

  To change your PCP or mental health provider, call Jackson Care Connect Customer Service at 855-722-8208. We’re happy to help you find a new one. To change your dentist, call your dental health plan’s customer service phone number. The number is located on the back of your Jackson Care Connect Member ID card.

• I want to see a specialist. What should I do?

  If you and your PCP decide you should see a specialist, your PCP will give you a referral. Refer to your Member Handbook for more information.

• I want to see a mental health specialist. What should I do?

  You don’t need a referral from your PCP. Contact a mental health provider listed in our provider directory or call Customer Service for assistance.

• If I, or someone I care about, is considering suicide, who can help?

  Talk to someone right away. Call the Jackson County Mental Health Crisis Line at 541-774-8201. Or, see “Mental health crisis/Suicide prevention” in the “Mental Health Services” section of your Member Handbook. It has appropriate phone numbers to call if you or someone you know are in crisis or considering suicide.

• I’m pregnant and would like to begin prenatal care right away. How can I find an pregnancy provider who will deliver my baby at the hospital I want?

  Contracted providers can be found using our provider search. Call and ask which hospitals your pregnancy provider works with. If you prefer to call us for the information, we’re glad to help you.

• I’m a new member. I need to refill a prescription for medication from my last insurance and get diabetes supplies. What should I do?

  Call Customer Service. You may be eligible for a transitional supply. Talk to your primary care provider as soon as possible about medical supplies and/or drugs we cover.

• I’m a new member and would like to know if my medications are covered.

  Jackson Care Connect maintains a list of covered drugs called a formulary. You’ll find it on the Member Resources page. Talk with your PCP about the medications you need. Your PCP may need to submit a prior authorization or make a change to a covered drug. (Jackson Care Connect does not cover mental health drugs. Mental health drugs are covered by OHP. Your pharmacy will bill these medications to OHP.) If you’re a new member and are unable to fill a prescription, you may qualify for a transitional supply. Call us to find out.

• Does my plan cover vision services?

  OHP does cover some vision services for members ages 20 and under and pregnant members. Please see the “Vision care” section on page 24 of your Member Handbook.

• I was in the hospital, and OHP paid for that. But now I’m getting bills from other providers. What can I do?

  When you go to the hospital or the ER, you may be treated by a provider who doesn’t work for the hospital. For example, emergency room doctors may have their own practice and provide services in the ER. If you receive a bill, please call Customer Service at 855-722-8208 (TTY 711).

• What if I get a bill from my doctor?

  If your health care provider sends you a bill, don’t pay it. Instead, call Customer Service right away at 855‐722‐8208 (TTY 711).

• Will Jackson Care Connect ever send me a bill?

  No. We will never charge you for any covered Medicaid/OHP service.

• I need to see a doctor, but I don’t have my Jackson Care Connect Member ID card yet. What should I do?

  Call Jackson Care Connect Customer Service at 855-722-8208. We’re happy to help.

• I lost my Member ID card. How do I get a new one?

  Call Customer Service at 855-722-8208 and we can help you.

• I just moved, have a new baby or changed my name. Who do I call?

  There are three ways to contact OHP for questions or to make updates to your current information:

  1. By telephone (toll-free): 800-699-9075

  Members can call OHP to do any of the following:

  • Change your address, phone number, family status, CCO or other information
  • Replace a lost OHP Card
  • Check the status of your application
  • See if you or your children are still covered by OHP
  • Change plans
  • Solve a problem or make a complaint
  • Get an OHP Handbook

  2. By email: oregonhealthplan.changes@state.or.us. Your email must include your full name, date of birth, Member ID number and phone number.

  Existing members can email OHP to change your address, phone number, family status, CCO or other information. Note: The email address is for changes only. 

  3. Online: Most OHP members can report changes online at ONE.Oregon.gov. The online site supports the following browsers. (If you don't know your browser version, click your browser's Help menu, then click About.)

  • Windows (PC): Internet Explorer 11, Internet Explorer 10, Internet Explorer 9, Internet Explorer 8, Firefox 39.0 and 43.0 and Chrome 43.0 and 44.0.
  • Macintosh: Firefox 39.0 and 43.0 and Chrome 43.0 and 44.0. Safari is not supported.
  • Smartphone browsers are not supported.

  Need help?

  • Learn how to set up your online account. English | Español
  • Learn to use your online account dashboard. English | Español
  • Watch a five-minute overview of the Applicant Portal.

• Where does the money come from to pay for my OHP benefits?

  OHP is paid for by federal and state taxes. The amount is decided by Oregon lawmakers. Funding is passed on to Jackson Care Connect by OHP, so we can provide you with the care you need to stay healthy.

• Who is enrolled in Jackson Care Connect?

  OHP members who live in Jackson County.

• What if I want to leave my CCO or change to a different one?

   

  If you want to change to a different CCO, there must be another CCO available that services the same area. If you want to make a switch to another CCO from Jackson Care Connect, call OHP Customer Service at 800-699-9075. Or, email them at oregonhealthplan.changes@state.or.us with your request.

  Note: The email address above is for changes only. (Your email must include your full name, date of birth, medical ID number and phone number.)

  You can ask OHP to be placed on fee-for-service OHP (or open card OHP, as it is sometimes called). This lets you see any providers that accept Oregon Health Plan patients. Any OHP member who has a good reason to have an open card can ask to leave their CCO. Talk to your DHS caseworker about the best way to receive your medical care. If you don't have a caseworker, contact OHP Customer Service at the toll-free number listed above.

• How is Jackson Care Connect different from a traditional health plan?

   

  Jackson Care Connect provides a different way of delivering care to OHP members. By working within the community, Jackson Care Connect:

  • Integrates physical, dental and mental health care services.
  • Brings new models of care that are patient-centered and team-focused.
  • Is local enough to be relevant and large enough to be financially sustainable.
  • Is governed by a partnership among local health care providers and community members.
  • Has a Community Advisory Council (CAC) that looks at local health care needs and recommends changes.

• Who are Jackson Care Connect’s partners?

  Jackson Care Connect works closely with many clinical and community partners. Visit the Find a Provider page to find health care providers throughout Jackson County.

• How do I contact my local DHS office?

  Please visit this page to find specific DHS resources.

• How do I report suspected fraud, waste and abuse?

  Jackson Care Connect takes fraud, waste and abuse very seriously. We comply with all applicable laws, including the State and Federal False Claims Act. Examples of fraud, waste and abuse include:

  Provider fraud:

  • Billing for services not rendered
  • Altering medical records
  • Use of unlicensed staff
  • Drug diversion (for example, dispensing controlled substances with no legitimate medical purpose)
  • Kickbacks and bribery
  • Providing unnecessary services to members

  Member fraud:

  • Falsifying information
  • Forging or selling prescription drugs
  • Using transportation benefits for non-medical business
  • Adding an ineligible dependent to the plan
  • Lending or using another person’s insurance card
  • Identity theft

  If you suspect your benefits aren't being used correctly or want to report a case of fraud, waste or abuse, contact Ethics Point at 888-331-6524. You can also file a report online at ethicspoint.com.