Do I have dental insurance with OHP?

Q: Is Oregon Health Plan covered by Medicaid?

The Oregon Health Plan (OHP) is Oregons Medicaid program. There are several health care programs available for low-income Oregonians through OHP.

Q: What does Medicaid cover in Oregon?

OHP is Oregons Medicaid program. It provides free coverage for people in Oregon who meet eligibility criteria. Coverage includes doctor visits, hospital care, mental health services, dental, and some vision care.

This page lists the five dental plans that serve Oregon Health Plan members who are not enrolled in a coordinated care organization (CCO) for dental care.

Table of Contents Show

Find Dental Plans Near You:
If you have a dentist you want to keep seeing:
If you have questions about a dental plan's services, providers or availability:
Healthy smiles, covered
How to get care
What is the Oregon Health Plan (OHP)?
Advantage Dental Services (OHP)
How do I make an appointment?
What if I have a dental emergency?
Does Oregon Medicaid include dental?
Is Oregon Health Plan covered by Medicaid?
What is OHP Plus in Oregon?
What does Medicaid cover in Oregon?

Find Dental Plans Near You:

Enter your county's name in the "Search" field, then click the blue button at the end of the field.

Look at each plan's provider directory to find providers near you.
You can choose any plan that serves your county, unless it says "Closed to new members" after your county's name.

If you have a dentist you want to keep seeing:

Ask your dentist which plan(s) they accept.

If you have questions about a dental plan's services, providers or availability:

Contact the plan at the number(s) listed below. The dental plan will know best about the providers you can see.
You can also view providers by dental plan at InsureKidsNow.gov. This list is updated quarterly.

Healthy smiles, covered

As a Health Share member, you are eligible for all dental benefits covered by the Oregon Health Plan (OHP), at no cost. Dental care can improve your overall health – make sure you and your family see your dentist at least once every year.

What are my dental benefits?

Health Share members can get great dental care at no cost, including:

Cleanings
Exams
Fillings
Fluoride
Sealants
Stainless steel crowns for molars (back teeth)
Care for gum disease
Full dentures every 10 years (and partial dentures every 5 years) no matter how long ago your teeth were removed.

Download a Member Handbook to see all the benefits available to you.

Member Handbook

How to get care

Watch this short video to learn more about Health Share’s dental benefits and how to get care.

What is the Oregon Health Plan (OHP)?

The Oregon Health Plan (OHP)/Medicaid provides health care coverage including medical, dental and mental health care, and substance abuse treatment for low-income adults and children living in Oregon.

Advantage Dental Services (OHP)

Advantage Dental Oral Health Centers are closely affiliated with Advantage Dental Services, a Medicaid (OHP) plan. Please choose the link below that best meets your needs.

I am an OHP Member

I am a Provider

There are several health care programs available for low-income Oregonians through OHP.

1. OHP Plus for children ages 0-18 and adults ages 19-64
2. OHP Plus Supplemental for pregnant adults age 21 or older
3. OHP with Limited Drug for adults who qualify for both Medicaid and Medicare Part D

To qualify for OHP, individuals and families must meet income and residency requirements. Residents of Oregon may also qualify based on age and disability status.

1. You MUST live in Oregon
2. You MUST meet the income bracket:

Adults (ages 19-64) In households that earn up to:
- $1,436 a month for a single person
- $1,945 for a family of two
- $2,961 for a family of four

Children (0-18) In households that earn up to:
- $4,298 a month for a family of two
- $6,545 for a family of four

Pregnant women in households that earn up to:
- $2,677 a month for a single pregnant woman
- $4,077 for a family of four
- $5,477 for a family of six

Other factors that also may influence OHP/Medicaid eligibility include other health care resources and disability status. The best way to see if you qualify is to apply.

Still not sure if OHP is right for you? Go to OregonHealthCare.gov and answer the screening questions. This will help you find the application that works best for you and your family.

Resources:
OHP information
Guide to get setup for Oregon Health Plan
How to Apply Online

What is the applicant portal?

The applicant portal helps with:
- Completing an application for health coverage
- Selecting a Coordinated Care Organization (CCO) preference
- Obtain contact information for community partners and application assistance
- Report changes
- Complete renewal

Need Help? Trained community partners across the state can help you fill out an application. It's free. Visit OregonHealthCare.gov to find community partners in your area. You can also learn more about how to fill out the application in the Application Guide.

What dental benefits are covered?

Here are some of the things that are covered. There may be a limit on how often you can have each one. Call your dental plan to learn more. If you do not know who your dental plan is, call your CCO or OHP Client Services.

Care to keep your teeth healthy
- Cleaning and exam once a year
- X-rays
- Fluoride varnish (treatment that keeps teeth strong and healthy)
- Sealants for children and youth under age 16 (coating on back teeth to prevent decay)
Treatment for problems
- Fillings
- Extractions (having a tooth pulled)
- Dentures for youth over age 16 and adults
- Stainless steel crowns for back teeth (other crowns for children and youth under age 21 and pregnant women)
- Root canals on back teeth for children and youth under age 21
Emergency dental care
Help getting to dental appointments

How do I find a dentist?

If you have a coordinated care organization (CCO):

Most Oregon Health Plan members have a coordinated care organization (CCO). A CCO connects your insurance plan and your doctors so all your care works together.

To find or change your dentist: Call your CCO. If you do not know which CCO you have, call Oregon Health Plan Client Services at 800.273.0557
Do you have a dentist you like? Call your CCO to see if there is a plan that works with your dentist

If you have fee-for-service OHP (FFS, also called Open Card)

Call the Nurse Advice Line at 800.562.4620

If you do not know if you have a CCO or FFS:

Call Oregon Health Plan Client Services at 800.273.0557

(The Citizen Alien Waived Emergent Medical (CAWEM) program covers dental emergencies only. CAWEM Plus for pregnant women has full dental coverage. Please report your pregnancy to OHP to get CAWEM Plus.)

How do I make an appointment?

Call your dentist
- Call early, it may take several weeks to get an appointment
If you will miss your appointment, call your dentist at least one day before. Be sure to reschedule
Do you need a free ride? Call your coordinated care organization (CCO) to learn how this works. Schedule the ride at least two days ahead

What if I have a dental emergency?

Call your dentist right away
If you do not have a dentist or cannot reach your dentist, call your coordinated care organization (CCO) or our 24hour emergency care line at 866.268.9631
If you have a true emergency (like bleeding that won’t stop) go to an emergency room

Learn more about dental emergencies.

Does Oregon Medicaid include dental?

Is Oregon Health Plan covered by Medicaid?

The Oregon Health Plan (OHP) is Oregon's Medicaid program. There are several health care programs available for low-income Oregonians through OHP.

What is OHP Plus in Oregon?

OHP Plus (BMH): For people eligible for Medicaid or the Children's Health Insurance Program (CHIP). OHP with Limited Drug (BMD, BMM): For people who are eligible for both Medicaid and Medicare Part D.

What does Medicaid cover in Oregon?

OHP is Oregon's Medicaid program. It provides free coverage for people in Oregon who meet eligibility criteria. Coverage includes doctor visits, hospital care, mental health services, dental, and some vision care.