Are you enrolled in a CCO or are you an open card member? In this example: •John Doe is enrolled in a CCO named Pacific Trails CCO and a dental care organization named Happy Teeth DCO. This means he is CCO member for his mental and physical health care and he is enrolled in a DCO for his dental care. •Jane Doe is only enrolled in a dental care organization named Happy Teeth DCO. This means she is an open card member for all of her care except dental. The following chart lists coverage information for everyone who is eligible in your household. See the enclosed Benefit Package chart for information about what each benefit package covers. Letters in the Managed Care/ TPR enrollments section refer to the plans listed on the Managed Care/TPR Enrollment page. Name John Doe Jane Doe Date of birth 01/01/1968 02/01/1968 Client ID # XX1234XX XX1235XX Copays? No No Benefit Package OHP Plus OHP with Limited Drug Managed Care/ TPR enrollment A, B B These letters relate to the letters on page 3 Managed Care/TPR enrollment Plan Information Plan Information A CCOB-Mental and Physical Pacific Trails CCO 1-800-555-5555 B Dental Care Organizations - DC Happy Teeth DCO 1-866-555-5555 Are you an open card member? As an open card member, you can see any doctors or other health providers who accept OHP coverage. If you need help finding a provider who accepts OHP, please call OHP Client Services: 1-800-273-0557 (for TTY, dial 711). DMAP 1415 LP (3/14)
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