More People Can Apply for OHP Dental Benefits
As of January 1, 2023, more adults qualify for Oregon Health Plan (OHP) dental benefits.
How Is This Possible?
The 2022 Oregon Legislature passed bills to expand OHP dental coverage to these groups:
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House Bill 4095 (2022) created the Veteran Dental Program, for Oregon veterans who do not qualify for OHP.
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Senate Bill 1538 (2022) created the COFA Dental Program, for Compact of Free Association (COFA) citizens who do not qualify for OHP.
The 2023 Oregon Legislature added funding for the Veteran Dental Program through House Bill 5029 (2023).Who Is Eligible?
People who live in Oregon and don't qualify for full OHP benefits.
For the Veteran Dental Program, you must also:
For the COFA Dental Program, you must also:
- Have household income at or below 138% of
the FPL, and
- Lawfully reside in the United States in accordance with COFA (i.e., the governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau).
Frequently Asked Questions
In order to apply for one of these dental-only programs, you need to apply for OHP. If you don't qualify for full OHP, then you will be reviewed for these dental-only programs. All help is free and available in multiple languages. You can apply:
The COFA Dental and Veteran Dental programs have the same dental care as OHP Plus, such as:
- Teeth cleanings
- Filling and extractions
- Emergency dental care
- Some dentures
- Prescriptions from your dentist
This is just some dental care that these dental programs cover. Learn more about OHP dental benefits.
This care is free. You do not need to pay for dental care covered by these programs.
You will be enrolled with a coordinated care organization (CCO). Your CCO will mail you a welcome packet. The packet will contain a CCO member ID card and information about covered services.
Ask your CCO about how to find a provider and access dental services.
Moda Health will cover prescriptions from your dentist if they are:
- Related to dental care you received and
- Filled at an Oregon pharmacy.
Call Moda Health at 1-800-913-4284 to:
- Ask for a new Moda Health ID card
- Ask for your Moda Health ID number ("Subscriber ID")
From the time you are approved for OHP Dental, it can take two or three weeks to enroll in a CCO.
You will be enrolled with Moda Health the first Thursday after you are approved for OHP Dental. Moda Health will mail you an ID card in 7 to 10 days after that.
If your insurance has prescription drug coverage, your pharmacy should bill your insurance first.
Moda Health can accept claims for 90 days from the date of service. If it is within 90 days of the date you filled your prescription, you can ask your pharmacy to rebill the claim.
If your pharmacy will not rebill the claim, you can ask Moda to pay you back. To do this, fill out this claim form. Mail or fax it to:
Navitus Health Solutions, LLC
PO Box 999
Appleton WI 54912-0999
Fax: 1-855-668-8550