What are Flexible Services?
Flexible services are items or services that are not processed through usual medical billing, but they will help improve or support your health. They are a benefit to you that falls under health-related services in the Oregon Health Plan.
Another way to look at it is, have you ever been told by your doctor or other care provider that if you just had or did something that it would help your condition or improve your quality of life? But that something was not medical and then you had the barrier of how to get it or pay for it?
Examples of this might be:
- Access to a warm pool to swim to help with your arthritis and improve your movement.
- An air conditioner to help you when the air gets too warm and makes you feel like you cannot breathe.
- A place to stay for a while to heal and get stronger after surgery when you do not have a home to return to.
- A tablet to use to virtually join groups that your counselor or provider has recommended.
How can I apply Flexible Services?
If you have a need that is like the examples that will improve your health, talk with your doctor, a member of your care team or someone that you work with at a community agency. They can complete a Flexible Services Request Form for you and send it to us to review.
You can also call Trillium at 1-877-600-5472 and ask to talk with a care manager. They can complete a Flexible Services Request Form for you and get it reviewed.
You, or someone that helps you, can fill out the Flexible Services Request Form as well.
What are the criteria?
- You must be eligible as a member with Trillium at the time of request.
- The item/service must:
a. Improve your health quality
b. Increase the chance that you will meet health goals in a way that can be verified.
c. Be for you
- Be proven by:
a. Evidenced based medicine, or
b. Widely accepted best practice, or
c. Criteria issued from medical, quality, or government groups
- Help you with at least one of the following;
a. Improve health outcomes, or
b. Prevent hospital readmissions, or
c, Improve your safety, or
d. Increase your wellness and health activities
It is important to be sure that the item or service will support you in a health positive way and is not part of another benefit available to you. This benefit cannot replace a benefit that you have with another agency or in the community.
What happens after the form is submitted?
If it is urgent, it can take up to 3 days, and 14 days for others to process the request. Once the request is reviewed, it will be approved or declined.
If it is approved, the service or item will be ordered or arranged for by Trillium staff who will work with you on the plan. If it is an item that is ordered, additional time may be incurred due to delivery.
If the item does not meet requirements and is declined, you have the right to file a grievance.
Phone: Call Trillium Customer Service - 1-877-600-5472 ask to speak to a Care Manager.
Website: You can find the Flexible Services Request Form electronically at:
Email: You can send questions on Flexible Services and completed forms to CHW@TrilliumCHP.com
Fax: You can fax complete forms to 1-866-703-0958