Dental coverage can help pay for preventive care, exams, cleanings, fillings, and other dental services. Dental coverage options in Oregon may be available through Explore Health, the Oregon Health Plan (OHP), Medicare Advantage plans, or VA health care.
Dental plans are available through Explore Health during Open Enrollment and some Special Enrollment Periods.
You may be able to enroll in:
- A dental plan as part of a health plan
- A separate stand-alone dental plan
What dental plans may cover
Coverage varies by plan, but many plans help pay for:
- Preventive care and cleanings
- Exams and X-rays
- Fillings
- Crowns and root canals
- Orthodontic services for children
Comparing dental plans
When comparing plans, consider:
- Monthly premiums
- Deductibles
- Copays and coinsurance
- Annual coverage limits
- Provider networks
- Covered dental services
Some plans may have waiting periods or limits on certain services.
Dental coverage for children
Many Explore Health plans include dental coverage for children as an essential health benefit. This coverage may be included in the health plan or offered through a separate dental plan.
Most people enrolled in OHP receive dental services through a local dental care organization or coordinated care organization (CCO).
Dental benefits may include:
- Exams and cleanings
- X-rays
- Fillings
- Tooth extractions
- Dentures
- Emergency dental care
- Other medically necessary dental services
Covered services may vary based on age and eligibility.
Finding dental care through OHP
Your dental care provider or CCO can help you:
- Find a dentist
- Understand covered services
- Schedule appointments
- Get referrals if needed
Original Medicare usually does not cover routine dental care such as:
- Cleanings
- Exams
- Fillings
- Dentures
However, Medicare may cover certain dental services related to medically necessary procedures or hospital care.
Medicare Advantage dental benefits
Many Medicare Advantage plans include additional dental coverage, which may help pay for:
- Preventive services
- Basic dental care
- Major dental services
- Dentures or other dental appliances
Coverage, provider networks, and out-of-pocket costs vary by plan.
People with Medicare should review plan details carefully each year to understand available dental benefits.
Some veterans may qualify for dental care benefits through the VA.
Eligibility for VA dental benefits depends on factors such as:
- Service-connected disabilities
- Former prisoner of war status
- Other eligibility categories
- Enrollment in certain VA programs
VA dental benefits may include:
- Preventive dental care
- Restorative services
- Emergency dental treatment
- Dentures and specialty services in some cases
Not all veterans qualify for comprehensive dental coverage through the VA.
Oregon Veteran Dental Program
Oregon also offers the Oregon Veteran Dental Program, which expands Oregon Health Plan (OHP) dental benefits to some veterans who do not qualify for full OHP coverage.
Who may qualify?
Veterans may qualify if they:
- Live in Oregon
- Are not eligible for OHP (Medicaid)
- Meet veteran status requirements
- Have income at or below 400% of the federal poverty level
What services are covered?
Eligible veterans receive the same dental benefits available through OHP dental coverage, which may include:
- Cleanings and preventive care
- Fillings and extractions
- Emergency dental care
- Some dentures
Veterans enrolled in the program receive care through local Coordinated Care Organizations (CCOs).
Important things to know
- The Oregon Veteran Dental Program is separate from federal VA dental care.
- Applying for the program should not affect existing federal VA health benefits.
- Veterans apply using the OHP application process. If someone is not eligible for full OHP, they may automatically be screened for the dental program.
Need help applying?
Veterans can:
- Apply through ONE.Oregon.gov
- Work with an OHP community partner
- Contact OHP Customer Service
- Speak with a County or Tribal Veteran Service Officer (VSO) for help understanding available benefits
For more information about veteran dental benefits in Oregon, visit the Oregon Department of Veterans' Affairs Dental Program.
Need help choosing dental coverage?
Free help is available to compare dental coverage options and understand eligibility for:
- Marketplace dental plans
- Oregon Health Plan dental coverage
- Medicare Advantage dental benefits
- VA dental benefits
Local enrollment partners can help you understand your options and enroll in coverage.