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or another way that is best for you.
Call 800-699-9075 (TTY 711).
INFORMATION FOR OHP MEMBERS | UPDATED 7/28/2023 | PAGE 1 OF 2
Orthodontic benefits for Oregon Health
Plan members under age 21
What are orthodontic benefits?
They are services to:
■ Straighten teeth,
■ Fix spacing between teeth,
■ Help with other face, jaw or mouth issues that cause bite problems, and
cleft lips or palates.
These services may include:
■ Braces
■ Retainers
When are orthodontics covered?
For members under age 21, OHP may cover orthodontics when severely
crooked teeth cause problems with the following activities:
■ Speaking
■ Breathing
■ Eating
■ Sleeping
Members must have good oral health and any cavities must be treated first
before starting orthodontics.
To find out if you or your child qualify:
See your OHP dentist. The dentist will:
■ Do an evaluation of your or your child’s jaw, mouth, or teeth.
■ Check for healthy gums and no cavities.
■ Send the evaluation to your dental plan for approval. The plan will
decide if orthodontic treatment is covered.
INFORMATION FOR OHP MEMBERS | UPDATED 7/28/2023 | PAGE 2 OF 2
Don’t have a dentist?
Call your CCO. Find your local CCO and dental network here.
Don’t have a CCO?
If you are not in a CCO, call OHP Care Coordination at 800-562-4620.
If your CCO or dental plan denies orthodontic treatment:
They will send you a written notice telling you this.
■ You can ask to appeal the decision.
■ The written notice will tell you how to do this.
To learn more, visit the OHP website.
Frequently Asked Questions (FAQ)
My child has crooked teeth, but I don’t know if it’s serious enough to
qualify. How will I find out?
The dentist will send the evaluation to your dental plan. The plan will decide if
your child qualifies for orthodontic treatment.
What if my child has cavities?
Your child will need to have all cavities treated by the dentist before
orthodontic treatment can begin.
Can adults qualify for orthodontic benefits?
The benefit is for OHP members who can begin orthodontic treatment before
they are 21 years old.
If my child needs braces but we don't qualify, what can we do?
Ask your dentist or orthodontist about financing options or low-cost programs.
It’s been a week and I haven’t heard if my child is approved for braces.
The approval process may take a few weeks. You can call the dentist who did
the evaluation and ask for an update.