Member Benefits
Below is a quick reference guide on which services are covered under the Oregon Health Plan. Please note that some services require a prior authorization.
Oregon Health Plan Quick Start Guide
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OHP Benefits ‐ Quick Reference Guide
| Services | Pregnant Women & Under 21 | 21 & Over who are Not Pregnant |
|---|---|---|
| Exams | 2 Every 12 mo.* | 1 every 12 mo. |
| Cleanings | 2 Every 12 mo.* | 1 every 12 mo. |
| Fluoride | 2 Every 12 mo.* | 1 every 12 mo. |
| Emergency Exam | Yes | Yes |
| Fillings | Yes | Yes |
| Root Canal | PA Required** | PA Required*** |
| Retreat Root Canal | PA Required–anterior only | PA Required–anterior only |
| Crowns | PA Required | PA Required |
| Dentures | PA Required | PA Required |
| Extractions | Yes | Yes |
| Wisdom Teeth | PA Required | PA Required |
* For children 18-years of age and under.
** Wisdom teeth, and 2nd molar for pregnant women, not covered.
*** Wisdom teeth and molars not covered.
Interpreter Services
Your FDCi membership also includes Passport To Languages translation services. Let your PCD Team know that you need a translator in your language for your next dental appointment.
Non-Emergency Transportation Assistance
If you have no way to get to a covered dental appointment OHP may help you. OHP pays for rides to health care that OHP covers. This benefit is called non-emergency transportation. There is no cost to you for this service. Travel can be by bus, local ride share, or even help paying for gas if using your car. This help may require prior approval. Call your CCO or local service for more information or to ask for a ride. The numbers to call:
• Health Share – Ride to Care (855) 321-4899
• Trillium – MTM (877) 583-1552
• All other OHP members: Tri-county MedLink (866 ) 336-2906
For more information on local ride services, call your CCO. Or go to OHP.Oregon.gov then (click) ‘Rides to Appointments’. You may also call Family Dental Care, Inc. for assistance in arranging a ride.
OHP Non-Emergency Medical Transportation Map link: Oregon Medicaid Non-Emergent Medical Transportation Brokerage Information
Are you wanting to find ways to improve your oral health, like quitting smoking?
Quitting smoking tobacco can improve your oral health and physical health. Your OHP Dental Care includes smoking cessation benefits. Let your PCD know if you want to start setting some goals to reach for a better & healthier YOU!