Dental Frequently Asked Questions

All Member FAQs

What dentist can I see?

You must receive care from a primary dentist that participates in the Oregon Health Plan with Moda Health. For a list of participating Moda Health Oregon Health Plan dentists, contact Dental Customer Service or the online provider search may be used. You can also request that a current Member Handbook be sent to you for a list of Oregon Health Plan dentists.

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I currently live in Columbia/Clatsop county and am assigned to a clinic with multiple dentists to choose from. May I choose to go to another clinic?

In order for your dental services to be covered, you will need to see your assigned dentist. If you have a dental emergency while outside of the Columbia/Clatsop county, contact customer service and they will assist you in finding a dentist that will be able to see your for an emergency dental appointment.

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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 Moda Health dental Customer Service to get a referral.

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What are the benefits on my dental plan?

The Oregon Health Plan pays for covered dental services in full. The patient is not responsible for co-payments or other charges for covered dental procedures on the Oregon Health Plan. If you receive a bill from your dental office, please contact your dental office with your questions. If you have further questions regarding dental bills received, please contact dental customer service.

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How do I know if I am eligible and what benefits I am eligible to receive?

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. This medical card is sent to you by Oregon Medical Assistance Program (OMAP) and will show your benefit package and dental plan. 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 regarding eligibility or your benefit package, contact your caseworker or your local Department of Human Services (DHS) office.

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How do I get reinstated if my coverage ends?

Contact your caseworker if there are any problems or questions 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.

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Why do I sometimes receive a letter from Moda Health after a dental visit?

Moda Health will send a denial letter to the member anytime that a services is not covered on your plan due to limitations or your benefit package. You have the right to appeal any denials on your plan and that letter provides you with the service that was denied and the steps for filing an appeal of that denial.

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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 Dental Customer Service. A dental emergency is dental care requiring immediate treatment. Always contact your primary dentist for instructions and they will be able to assist you or contact customer service as needed to get a referral to have another dentist see you for care of the dental emergency.

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