August 17, 2023, Update:
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:
https://www.oregon.gov/oha/HSD/OHP/Tools/Orthodontic-Coverage-Fact-Sheet.pdf
A Smile for Kids would like to extend a great big "Thank You!" to the entire OHA Medicaid Dental Policy Team for making this happen.
August 10, 2023, Update:
For OHP members:
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 or get an impression of your teeth and send for approval to your Coordinated Care Organization (CCO), who makes the final decision. The 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.
July 21, 2023, Update:
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.
For OHP members:
If you are under 21 years of age and a member of the Oregon Health Plan (OHP), this is a great opportunity to check if you are eligible for braces through Oregon's updated Medicaid program.
Please begin by contacting your primary care dentist to schedule a Medicaid orthodontic evaluation or reach out to your Dental Care Insurance:
ODS Community Dental: Call 800-342-0526 or contact A Smile for Kids at 541-280-9799
Open Card: Call 800-562-4620 or contact A Smile for Kids at 541-280-9799
Advantage Dental: Call 866-268-9631 or visit your primary care dentist
Capitol Dental Care: Call 800-525-6800 or visit your primary care dentist
CareOregon Dental: Call 888-440-9912 or visit your primary care dentist
Willamette Dental Group: Call 855-433-6825 or visit your primary care dentist
Cascade Health Alliance: Call 888-989-7846 or visit your primary care dentist
Kaiser Permanente: Call 866-653-0338 or visit your primary care dentist
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. For Current or Prospective OHP Providers: Please contact Michael Emery at A Smile for Kids by calling 541-497-0020 or emailing michaelv@asmileforkids.org to find out more. Best regards, Christian Moller-Andersen Executive Director, A Smile for Kids