Quick Reference Guide to OHP Plus and Standard Covered Services

*Standard Population Limited Hospital Benefit Code List
**Standard Benefit Package Limitations ( OAR 410-122-0055 )
1Specific criteria must be met
Covered Service OHP Plus OHP Standard
Acupuncture X Chemical Dependency Only
Ambulatory Surgical Center X X
Audiology X Diagnostic Exams Only
Bariatric Surgery1 X  
Chemical Dependency X Outpatient Only
Chiropractic & Osteopathic Manipulation X  
Dental X Limited Emergency Only
Emergent/Urgent Care X X
Hearing Aids & Exams X  
Home Health X  
Hospice X X
Hospital Care X Limited*
Immunizations X X
Laboratory Services X X
Medical Equipment & Supplies X Limited**
Medical Transportation X Emergency Only
Occupational Therapy X  
Physical Therapy X  
Physician Services X X
Prescription Drugs X X
Private Duty Nursing X  
Speech Therapy X  
Vision Care X Eye Disease Treatment Only
X-rays X X