Coordinated care organizations (CCOs) are Oregon's way of delivering Oregon Health Plan (Medicaid) benefits. Each CCO serves set counties and brings physical, mental health and dental care together for its members. For people who have both Medicare and OHP, the CCO works alongside Medicare: Medicare pays first, and OHP fills in where it can.
What a CCO is
A CCO is a local network of health care providers that delivers OHP benefits to its members. Oregon started CCOs in 2012. The model emphasizes:
- Integrated care: physical, mental health and dental care under one plan
- Local accountability: each CCO serves specific counties and has a community advisory council that includes members
- Health-related social needs: OHA lists each CCO's contacts for health-related social needs benefits
CCOs administer OHP (Medicaid). They are not Medicare plans, even though some CCOs work with Medicare Advantage plans for members who have both.
CCOs and people with Medicare and OHP
If you have Medicare and OHP, you are often called a "dual eligible." Medicare is your primary insurance for hospital care, doctor visits and Part D drug coverage. OHP is secondary. Here is how OHA says CCOs work for you:
- Your CCO stays the same when you get Medicare.
- Medical care: people with Medicare can change or leave the CCO they use for medical care at any time.
- Dental and mental health care: people with Medicare must use a CCO for these.
- American Indian and Alaska Native members can join, change or leave a CCO at any time.
- If you don't choose, OHA chooses a CCO in your area that is open to new members.
To make a change, call OHP Client Services at 1-800-273-0557 (TTY 711) or use your dashboard at one.oregon.gov.
Which CCO serves your county
Your choice of CCO depends on where you live, and some counties have more than one. OHA keeps the current list, with each CCO's website, phone number and the counties it serves, on its CCO plans page, which you can filter by county and ZIP code. OHA also publishes a CCO directory and map. We don't list CCOs by name here because service areas change; OHA's pages are the current source.
How a CCO coordinates with Medicare
- Claims: Medicare pays first for Medicare-covered services. OHP pays Medicare cost sharing where you qualify (for example, QMB members owe no Part A or Part B deductibles, coinsurance or copays).
- Prescriptions: most OHP members with Medicare have OHP with Limited Drug. Medicare Part D covers their prescriptions; OHP doesn't pay Part D premiums or copays.
- Long-term care: Medicaid long-term services, such as in-home care, adult foster homes, residential care and nursing facility care, are approved through ODHS Aging and People with Disabilities, not by Medicare.
What Medicare and OHP each cover
| Service | Medicare | OHP (Medicaid) |
|---|---|---|
| Hospital and doctor care | Pays first | Pays Medicare cost sharing if you qualify |
| Prescription drugs | Part D plan | Only some drugs Part D excludes |
| Routine dental care | Generally not covered | Covered through your CCO |
| Rides to appointments | Generally not covered (ambulance only when medically necessary) | Covered |
| Long-term care at home or in a nursing facility | Not covered (only short-term skilled care) | Covered if you meet ODHS rules |
Your CCO's member handbook lists the exact benefits and any limits.
D-SNPs and CCOs
A dual eligible special needs plan (D-SNP) is a Medicare Advantage plan only for people who have both Medicare and Medicaid. OHA requires each CCO to work with one or more Medicare Advantage plans that serve dual eligibles throughout its service area, either directly or by contract, so the two sides can share information and coordinate care. OHA's page on CCO plans suggests asking your CCO which Medicare Advantage plans it works with.
Joining a D-SNP is optional. Your OHP benefits continue whichever Medicare option you choose. Medicare Advantage plans may offer extra benefits such as dental, vision, hearing or fitness. Extra benefits vary by plan and county, may have limits and costs, and not every plan offers them. Check a plan's Summary of Benefits or Evidence of Coverage. More in our dual eligible guide.
Getting help with CCOs and Medicare
- OHP Client Services: 1-800-273-0557 (TTY 711), 8 a.m. to 5 p.m. Pacific, Monday to Friday, for CCO changes, ID cards and handbooks.
- ONE Customer Service Center: 1-800-699-9075 (TTY 711), for OHP eligibility and applications.
- ODHS Aging and People with Disabilities: 1-855-673-2372, for long-term services and supports.
- 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048) and Medicare.gov, for Medicare coverage and plan choices.
- Licensed insurance agents: to compare Medicare plans from the companies they work with, including D-SNPs, you can request a call from a licensed insurance agent or see Oregon agents.
Related guides
Oregon Health Plan and Medicare
How OHP works alongside Medicare.
Dual eligible in Oregon
Medicare and OHP together.
Oregon Medicare resources
Federal and state contacts.
Sources
- Oregon Health Authority — Coordinated Care Organization (CCO) Plans
- Oregon Health Authority — Coordinated Care Organizations
- Oregon Health Authority — OHP and Medicare
- Oregon Health Authority — Affiliated Medicare Advantage Plan Guidance 2025 (PDF)
- Oregon Health Authority — Contact OHP
Frequently asked questions
What is a CCO in Oregon?
A coordinated care organization is a local network of health care providers that delivers Oregon Health Plan (Medicaid) benefits to members in the counties it serves. One CCO can cover a member's medical, dental and mental health care.
Do I need a CCO if I have Medicare?
Only if you also have OHP. Medicare by itself never puts you in a CCO. If you have OHP and Medicare, OHA enrolls you in a CCO, and you can leave the CCO for medical care at any time while still using a CCO for dental and mental health care.
Does my CCO replace my Medicare?
No. Medicare stays your primary insurance for hospital, medical and drug coverage. OHP, through your CCO, pays second and covers OHP services Medicare doesn't, such as dental care and rides to appointments.
How do I find out which CCO serves my county?
Use OHA's CCO plans page, which lists each CCO's service area by county, or call OHP Client Services at 1-800-273-0557 (TTY 711).
Medicare in your Oregon county
Plans, local agents and help, county by county: Multnomah · Washington · Clackamas · Lane · Marion · Jackson · Deschutes · Linn · Douglas · Yamhill · Benton · Polk · Josephine · Umatilla · Klamath · Coos · Columbia · Lincoln · Clatsop · Malheur · All 36 counties →
