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Non-covered Services

Not all services are covered by the Oregon Health Plan (OHP) or InterCommunity Health Network CCO (IHN-CCO). OHP covers the health care services most likely to help you get better.

Some of the health care services not covered by Oregon Health Plan include:

  • Treatment for conditions that get better on their own without going to the doctor, like colds
  • Treatment for conditions that can be treated at home, such as corns, calluses and some skin conditions
  • Cosmetic surgeries or treatments that only improve appearance, not function
  • Services to help you get pregnant

Some of the dental services not covered by Oregon Health Plan include:

  • Desensitization(to reduce root sensitivity)
  • Implant and implant services
  • Mastique or veneer procedure
  • Orthodontia (except when it is treatment for cleft palate or cleft lip)
  • Overhang removal
  • Procedures, appliances or restorations solely for looks and cosmetic purposes
  • Temporomandibular joint (TMJ) dysfunction treatment
  • Teeth bleaching

If you have any questions about non-covered services please contact your assigned dental plan.

Payment for non-covered services

You can choose to get non-covered medical, dental, or mental health treatment and services. The provider’s office should tell you up-front if a service or treatment is not covered. They will tell you how much it costs. You must sign an Agreement to Pay form to say you will pay the bill for the non-covered service or treatment.

Tell the provider’s office and your caseworker right away if you have other insurance, such as Medicare or private insurance.

Bring the ID card for your other insurance to each appointment with your provider. Your provider must bill any other insurance before they can bill us for your services. We will only pay the provider after the other insurance has paid, except in some special cases. We will only pay for medical, dental, and mental health services covered by Oregon Health Plan.