1. (1) The CAREAssist Dental Program provides assistance with out-of-pocket dental expenses related to a specific dental plan or plans identified by the Authority.
2. (2) Clients are eligible for the CAREAssist Dental Program as long as their primary prescription coverage is not provided by the Oregon Health Plan at the time of application.

3. (3) The Dental Program provides assistance with the cost of:

   1. (a) The monthly premium on a dental plan identified by the Authority, paid directly to the insurance carrier or benefits administrator.
   2. (b) Out-of-pocket dental expenses for services approved by the identified plan. The plan must cover a portion of the specific procedure before CAREAssist assumes any financial cost.

4. (4) The Dental Program cannot provide assistance with the cost of:

   1. (a) Out-of-pocket dental expenses related to any dental plan other than the plan or plans specified by the Authority.
   2. (b) Dental services for which the CAREAssist-sponsored dental plan will not pay, either because the service is disallowed or the client has maximized the annual dental benefit, as determined by the dental plan administrator.

Statutory/Other Authority

ORS 413.042, 431.250 & 431.830

Statutes/Other Implemented

ORS 431.250 & 431.830

History

PH 23-2016, f. & cert. ef. 8-2-16