Financial Services

Insurance Accepted

Affordable Care

Navigating health care plans, Medicaid, and even private or traditional insurance options can feel very overwhelming and confusing. At One Community Health, we specialize in simplifying this process and making it as stress-free as possible for you.  If you need assistance signing up for Medicaid, our Sliding Scale Discount, or other help to afford your healthcare, our Patient Care Advocates can help.

Insurances We Accept

One Community Health accepts most major insurances!  Please remember to bring your insurance card and a photo ID with you at every visit. If you have any questions about insurance-specific pricing and coverage, please contact your plan directly. The following are larger health insurance plans that we work with frequently:

  • Medicaid Washington (Apple Health) includes Amerigroup WA, Molina, and Community Health Plan of Washington (CHPW), Coordinated Care Organization (CCO)

  • Medicaid Oregon (Oregon Health Plan) includes PacificSource, Eastern Oregon CCO, and Open Card

  • Medicare, Railroad Medicare, and Medicare Advantage plans listed below

  • Tricare

  • Commercial plans include United HealthCare, Regence Blue Cross Blue Shield, Cigna, First Choice, Health Net, Moda, PacificSource, Providence, Aetna, and LifeWise, Premera Blue Cross Blue Shield

Medical Services

For medical care, we accept Oregon Medicaid (Oregon Health Plan) and Washington Medicaid (Apple Health), commercial insurance, and Medicare. We also accept patients who do not have insurance and encourage you to apply for our sliding scale discount program.

Below is a list of the Exchange and Medicare Advantage plans that we will accept in 2025

If you don’t see your insurance, but you have an “extended” network or similar open network, contact your plan to find out if you are still able to see a provider at One Community Health.

Medicare Advantage Plans by County

  • Humana Choice

    Providence Medicare Bridge

    Providnce Medicare Timber

    Providence Medicare Choice

    Providence Medicare Extra

    AARP Medicare Advantage

  • Out-of-Network for a Medicare Advantage Plan.

  • Out-of-Network for a Medicare Advantage Plan.

  • PacificSource -

    PacificSource Medicare Essentials Choice POS

    PacificSource Medicare Essentials HMO

    PacificSource Medicare Essentials POS-HMO

Exchange Plans by County

  • Moda

    PacificSource

    Providence

    Regence

  • LifeWise Cascade

    LifeWise WA Essential

    Molina Cascade

    Molina Constant Care

  • LifeWise Cascade

    LifeWise WA Essential

    Molina Cascade

    Molina Constant Care

  • Moda

    PacificSource

    Providence

    Regence

Dental Services

We accept several insurances, including:

  • Delta Dental Medicaid

    Advantage Dental

    Capitol Dental Care, Inc.

    Oregon Health Plan Open Card

    Washington Apple Health (Medicaid)

  • Metlife

    Guardian Dental

    Regence Blue Cross Blue Shield

Health Insurance Glossary

Allowed Amount

Maximum amount on which payment is based for covered health care services. This may be called “eligible expense,” “payment allowance” or “negotiated rate.” If your provider charges more than the allowed amount, you may have to pay the difference. (See Balance Billing.)

Appeal

A request for your health insurer or plan to review a decision or a grievance again.

Balance Billing

When a provider bills you for the difference between the provider’s charge and the allowed amount. For example, if the provider’s charge is $100 and the allowed amount is $70, the provider may bill you for the remaining $30. A preferred provider may not balance bill you for covered services, and OCH does not balance bill.

Co-insurance

Your share of the costs of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service. You pay co-insurance plus any deductibles you owe. For example, if the health insurance or plan’s allowed amount for an office visit is $100 and you’ve met your deductible, your co-insurance payment of 20% would be $20. The health insurance or plan pays the rest of the allowed amount

​​Co-payment or Co-pay

A fixed amount (for example, $15) you pay for a covered health care service, usually when you receive the service. The amount can vary by the type of covered health care service.

Deductible

The amount you owe for health care services your health insurance or plan covers before your health insurance or plan begins to pay. For example, if your deductible is $1000, your plan won’t pay anything until you’ve met your $1000 deductible for covered health care services subject to the deductible. The deductible may not apply to all services.

Excluded Services

Health care services that your health insurance or plan doesn’t pay for or cover.

In-network Co-insurance

The percent (for example, 20%) you pay of the allowed amount for covered health care services to providers who contract with your health insurance or plan. In-network co-insurance usually costs you less than out-of-network co-insurance.

In-network Co-payment

A fixed amount (for example, $15) you pay for covered health care services to providers who contract with your health insurance or plan. In-network co-payments usually are less than out-of-network co-payments.

Non-Preferred Provider

A provider who doesn’t have a contract with your health insurer or plan to provide services to you. You’ll pay more to see a non-preferred provider. Check your policy to see if you can go to all providers who have contracted with your health insurance or plan, or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers.

Out-of-network Co-insurance

The percent (for example, 40%) you pay of the allowed amount for covered health care services to providers who do not contract with your health insurance or plan. Out-of-network co-insurance usually costs you more than in-network co-insurance.

Out-of-network Co-payment

A fixed amount (for example, $30) you pay for covered health care services from providers who do not contract with your health insurance or plan. Out-of-network copayments usually are more than in-network co-payments.

Out-of-Pocket Limit

The most you pay during a policy period (usually a year) before your health insurance or plan begins to pay 100% of the allowed amount. This limit never includes your premium, balance-billed charges, or health care your health insurance or plan doesn’t cover. Some health insurance plans don’t count all of your co-payments, deductibles, co-insurance payments, out-of-network payments, or other expenses toward this limit.

Preauthorization

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug, or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval, or precertification. Your health insurance or plan may require preauthorization for certain services before you receive them, except in an emergency. Preauthorization isn’t a promise your health insurance or plan will cover the cost.

Preferred Provider

A provider who has a contract with your health insurer or plan to provide services to you at a discount. Check your policy to see if you can see all preferred providers or if your health insurance or plan has a “tiered” network and you must pay extra to see some providers. Your health insurance or plan may have preferred providers who are also “participating” providers. Participating providers also contract with your health insurer or plan, but the discount may not be as great, and you may have to pay more.

Premium

The amount that must be paid for your health insurance or plan. You and/or your employer usually pay it monthly, quarterly, or yearly.

Primary Care Provider
A physician (M.D. – Medical Doctor or D.O. – Doctor of Osteopathic Medicine), nurse practitioner, clinical nurse specialist, or physician assistant, as allowed under state law, who provides, coordinates, or helps a patient access a range of health care services.

Adapted from Healthcare.Gov