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Non-covered Services

See What’s Not Covered

Not all services are covered by OHP or IHN-CCO. We try to cover the most important services to treat common medical and dental problems and keep you healthy.

Some of the health care services not covered by OHP include:

Medical Services

Cosmetic surgeries or treatments that only improve appearance, not function.
Services to help you get pregnant.
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 (like corns, calluses, and some skin conditions).
Treatments that are not approved by the Federal Drug Administration (FDA) or that may not be proven to work.

Dental Services

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.