What stays the same
- Your CCO. OHA: "If you get Medicare while you have OHP, your CCO will not change."
- Your OHP benefits. Most OHP members with Medicare have "OHP with Limited Drug": OHP Plus benefits except drugs Part D covers.
- Services Medicare doesn't cover. Your CCO still covers OHP services such as non-emergency medical transportation and dental care.
What changes
- Medicare pays first. Medicare is your primary coverage; your CCO and OHP pay after Medicare.
- Drugs move to Part D. OHP no longer covers drugs Part D covers, and it doesn't pay Part D premiums or copays. You get Extra Help automatically.
- You choose how to get Medicare. Original Medicare, a Medicare Advantage plan, or a dual special needs plan (D-SNP) that works with OHP. OHA says Medicare Advantage plans work with your CCO to align your OHP and Medicare benefits.
How your CCO works with Medicare
OHA's guidance for CCOs requires each one to work with Medicare Advantage plans that serve full-benefit dual eligible members across its service area, through an affiliation or contract. Under that guidance, the CCO:
- Provides rides to Medicare appointments as well as OHP appointments. OHA tells CCOs that rides aren't limited to Medicaid-covered services.
- Covers OHP services Medicare never covers, such as community health workers, peer services and some behavioral health, vision and dental services.
- Coordinates care with your Medicare plan and Medicare providers.
Find your CCO and its contact information on OHA's CCO page, or read our guide to coordinated care organizations.
Choosing Medicare coverage with a CCO
Ask your CCO which Medicare plans it works with in your county, and check that your doctors take the plan you're considering. Plan choices vary a lot across Oregon: for 2027 CMS lists no Medicare Advantage plan open to everyone in Grant, Harney, Lake, Umatilla and Union counties. See Medicare by Oregon county. To compare options from the companies they work with, you can request a call from a licensed insurance agent.
Related questions
What is a dual special needs plan?
D-SNPs and OHP.
What happens to my OHP at 65?
OHP Plus vs. OHP Bridge.
Can I have Medicare and OHP?
How the two work together.
Sources
- Oregon Health Authority — OHP and Medicare
- Oregon Health Authority — Guidance on Medicare plan to CCO affiliation (2025)
- Oregon Health Authority — Coordinated care organizations
- Oregon Health Authority — Contact OHP
- CMS — Medicare Advantage and Part D contract and enrollment data (CY2027 Landscape file)
More questions in this guide
- Can I have Medicare and the Oregon Health Plan?
- Does OHP pay my Medicare Part B premium?
- How do I qualify for Medicaid long-term care in Oregon?
- What's the difference between Medicare and Medicaid in Oregon?
- What happens to my OHP when I turn 65?
- What is a dual special needs plan (D-SNP) in Oregon?
- What is Oregon Project Independence and who qualifies?
Part of the guide: Oregon Health Plan and Medicare: combined coverage · All questions
Frequently asked questions
Can I see Medicare doctors who aren't in my CCO's network?
OHA says you don't have to get your medical care through your CCO. With Original Medicare you can see providers who accept Medicare; with a Medicare Advantage plan, check that plan's network.
Do I have a CCO if I only have QMB?
Usually not. OHA says some QMB members don't qualify for OHP and get an Oregon Health ID card only so the state can pay Medicare cost sharing.
Who do I call about my CCO?
Call OHP Client Services at 1-800-273-0557 (TTY 711), weekdays 8 a.m. to 5 p.m. Pacific, for CCO questions, ID cards and handbooks.
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 →
