PrimaryHealth is working with the four dental organizations in our local area. These dental organizations are Advantage Dental, Capitol Dental, ODS Community Health, and Willamette Dental. Your assigned dental organization will coordinate your dental benefits. To find out what dental organization you have been assigned to, look at your member card. You may also call PrimaryHealth and ask our Member Services staff. If you have questions about your dental benefits, call Member Services at either your dental organization or PrimaryHealth. If you want a different dental organization, call PrimaryHealth for assistance.
Here is how you can reach the four dental organizations that serve PrimaryHealth members:
Advantage Dental Services, LLC
442 SW Umatilla Ave. Suite 200
Redmond, OR 97756
Mon-Thurs: 8:00 am – 5:00 pm
Friday 8:00 am – 3:00 pm
Capitol Dental Care, Inc.
3000 Market St. NE Suite 228
Salem, OR 97301
Mon – Fri: 7:00 am – 7:00 pm
ODS Community Health, Inc.
10505 SE 17th Ave.
Milwaukie, OR 97222
Mon – Fri: 7:30 am – 5:30 pm
Willamette Dental Group
6950 NE Campus Way
Hillsboro, OR 97124
Mon – Fri: 8:00 am – 5:00 pm
Summary of Dental Benefits
Finding a Dentist
Each dental organization has a group of Primary Care Dentists in the service area. Call your dental organization to find out more about the dental providers you may choose from. Your dental organization can help you select a Primary Care Dentist for each member of your family. You will need to choose a dentist that is in your dental organization’s group. Your dentist will take care of your dental needs.
Making an Appointment for Routine Care
Call your dentist to make an appointment as soon as possible. Let them know what dental organization you are assigned to. Dentists are not always open to new patients. If the dentist you call is not open to new patients right now, call your dental organization for help. If you want to change dentists after you have started care with your current dentist, you will need to call your dental organization.
It is important to keep appointments. Please arrive on time. If you need to cancel, give at least 24-hours’ notice. If you need help with child care or getting to an appointment, contact PrimaryHealth or your caseworker for assistance. If you miss too many appointments, a provider can refuse to see you and your family.
Urgent Dental Care
Urgent dental care is dental care needed to prevent harm to your health. Examples of urgent dental care are a toothache, swollen gums, and a lost filling. For urgent dental care call your dentist as soon as possible. If you cannot reach your dentist or you do not have a dentist, call your dental organization. You will usually be seen within 2-3 weeks, depending on your condition.
A dental emergency is dental care requiring treatment within 24 hours or sooner. Emergencies include:
- Severe toothache
- Bleeding that will not stop
- Dental pain that keeps you awake, not relieved by over the counter medications
- Infection in the gums or a tooth, or severe swelling of the gums around a tooth
- A tooth that has been knocked out
For a dental emergency, please call your dentist. If you cannot reach your dentist or if you do not have one, call your dental organization. Your dental organization will help you nd emergency dental care. If you have an emergency after-hours that cannot wait until the next day, call your dentist. The answering service will connect you to your dentist. Routine or urgent dental care calls should be made during regular business hours. If you aren’t sure if you have an emergency, you should call. If you are having trouble breathing or swallowing, that is an emergency. You have the right to use any emergency room in a true emergency.
Emergency While Away
For a dental emergency while you are away from home, call your dental organization. Your dental organization will work with the dentist to let him/her know what services are covered. Your dental organization will pay for services to stabilize the emergency. Call your dental organization or dentist for follow-up care. Follow-up care is NOT an emergency.
Restorative Dental Treatment Benefits
Restorative dental care is dental care to help restore the health of your teeth, like fillings, crowns, and dentures. The Oregon Health Plan Plus Package has limited coverage for restorative treatments. Treatments must be appropriate and cost-effective. Your dental organization can provide information about what treatments are covered. Your dentist and dental organization will work with you on a treatment plan that will get the best outcome.
Routine Dental Care and Prevention
Dental disease can be prevented with twice a day brushing, flossing, a low-sugar diet and regular dental check-ups. Regular dental visits are particularly important for children and pregnant women.
Specialty Dental Care
Your Dentist, if necessary, may refer you to a specialist. Your dental organization must approve this referral. If you go to a specialist without prior approval from the dental organization, you may have to pay the bill. Please contact PrimaryHealth before you ever pay a bill for medical or dental services.
A List of Services
Basic dental care is covered. Many services have limits and not all services are covered. Some services included are:
- Preventive exams (check-up’s), cleanings, and x-rays
- Basic restorative care, like fillings
- Complex restorative care, like dentures
Call your dental organization for more information about which services are covered and which require prior approval. Your dentist will discuss your treatment plan with you at your visit.