Oregon Health Plan FAQ
- What dentist can I see?
- Can I see a specialist with my plan?
- What are the benefits on my dental plan?
- What do I do if I have a dental emergency?
- How do I get reinstated if my coverage ends?
- What is the address for filing a claim?
What dentist can I see?
You must receive care from a primary dentist that participates in the Oregon Health Plan. For a list of participating Oregon Health Plan dentists, contact Customer Service or your caseworker. You can also request that a current Member Handbook be sent to you for a list of Oregon Health Plan dentists.
Can I see a specialist with my plan?
Your primary dentist will first need to see you to determine whether or not a specialist is an appropriate choice for your situation. If he or she feels it is in your best interest to see a specialist, then his or her office staff will contact ODS Customer Service to get a referral.
What are the benefits on my dental plan?
The Oregon Health Plan pays for covered dental services in full. Each month that you are eligible for coverage you will receive a green and white striped Medical Care Identification sheet that shows your coverage for the month. It is important that you take your Medical Care Identification sheet with you to each appointment, or the dentist may choose not to see you. If you have further questions about a specific service, contact Customer Service.
What do I do if I have a dental emergency?
Call your primary dentist for instructions. If you have an accident while you are out of the state of Oregon, contact either your primary dentist for instructions or Customer Service.
How do I get reinstated if my coverage ends?
Contact your caseworker if there are any problems with your eligibility. If you do not know who your caseworker is, you will find his or her identifying code halfway down your Medical Care Identification sheet in the box marked "Worker." The telephone number is to the right on the same line as the identifying code.
What is the address for filing a claim?
Send claims to:
ODS Companies
601 SW 2nd Ave.
Portland, OR. 97204
Please be sure the following information is included:
- Patient's name, identification number, and group ID number
- Date of treatment
- Diagnosis
- An itemized description of services and charges
If the treatment is for an accidental injury, include a statement explaining the date, time, place, and circumstances of the accident when you send us the physician or professional provider's bill.