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Braces & Medicaid (OHP) in Oregon

Updated: Nov 16

Braces are now covered by Medicaid in Oregon. Read below to find out more about the OHP Benefit:

The Oregon Health Authority (OHA) has officially updated the information around Medicaid coverage of the new orthodontic benefit. You can see the new information here: ​ Your dentist or orthodontist can't tell you right away during your first evaluation visit if you qualify for the Orthodontic Medicaid Benefit or not. They will take measurements and/or get an impression of your teeth and send for approval to your Coordinated Care Organization (CCO), who makes the final decision. Your dentist or orthodontist does not decide if you qualify or not. ​ If you are denied the benefit, you will receive an official denial letter and have the right to appeal. If you are denied and you do not receive the letter of denial, you have not been evaluated correctly. Please contact your CCO to address directly with them. ​ The Oregon Health Plan/Medicaid Orthodontic benefit (braces) has been in effect since January 1, 2023, for OHP Members under 21 years old. You can see the benefit in the OHP Member handbook (page 21) by clicking HERE. Please begin by contacting your primary care dentist to schedule a Medicaid orthodontic evaluation or reach out to your Dental Care Insurance:

  • Open Card: Call 800-562-4620 or contact A Smile for Kids at 541-280-9799

If you are 17 years or younger and have already completed an orthodontic evaluation with a dentist AND have received a Medicaid denial letter, we suggest you proceed with the ASK program intake form HERE. Please note, if you have ODS Community Dental as your dental network providers, A Smile for Kids currently offers additional services to their members. For those with other dental network providers, please contact your provider directly as listed above. If you have not signed up for the Oregon Health Plan yet, click here to check your eligibility and how to sign up.

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