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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'ABOUT THE PATIENT/SUBSCRIBER' section. Enter the patient's name, sex, birthdate, and address. Ensure all details are accurate to avoid delays.
Next, provide the subscriber's information including their name, relationship to the patient, and contact details. If the subscriber's address differs from the patient's, include that as well.
In the 'ABOUT THE NON-PLAN CARE' section, detail where the illness or injury occurred and include incident dates. Indicate if you notified Kaiser at that time and provide any relevant emergency care details.
Complete any follow-up care information if applicable. Describe in detail why treatment was not received at a Kaiser facility.
Finally, certify that all information is correct by signing and dating the form before submission.

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What is Oregon Medicaid called?

The program has different names in different states. For example, in California, Medicaid is called Medi-Cal while in Kansas, its called KanCare.

Is CareOregon the same as Medicaid?

DMAP pays health care costs for eligible low-income Oregonians, funded jointly through state and federal resources. DMAP is currently implementing a federal waiver demonstration project to expand the Medicaid program under the Oregon Health Plan, monitored by the Center for Medicare and Medicaid Services.

What is Medicaid now called?

AllCare CCO provides Medicaid enrollees in Southern Oregon with great care thats less complicated.

What is the new health care law in Oregon?

In 2021, the Oregon Legislature passed HB 2362 to oversee health care consolidation, creating the Health Care Market Oversight (HCMO) program. This law directs the Oregon Health Authority (OHA) to review business deals involving health care entities, such as hospitals, health insurance companies, and provider groups.

Is CareOregon a Medicaid plan?

Our health care plan combines the benefits of Medicaid and Medicare and adds extra benefits for anyone who qualifies for both plans. Click here to learn more about our plan, our benefits, prescription drug coverage, and to find out if you qualify.

NON-PLAN CARE INFORMATION - oregon 2026

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