Medicaid Coverage for Braces

Medicaid can be a tricky beast when it comes to what’s covered and what’s not covered. It’s important to note that Medicaid will vary slightly from state to state which makes it hard to cover what may or may not be covered, across the board. In short, braces aren’t covered on Medicaid, at least not on the basis that you for sure know they’re covered if you or your family ever decided to get them. Let’s dive deeper.

So, Are Braces Covered or Not?

Depending on your state, there are a couple of ways that your braces can be covered. If the braces are deemed medically necessary then yes, they will be covered on Medicaid. However, this can be tricky because, even though an orthodontist or dentist might deem it medically necessary, this doesn’t mean Medicaid will approve the reasoning. This often means that Medicaid users have to wait for the approval and there’s no guarantee they will be approved.

Sometimes, even if the braces are covered, they will only be covered up to a certain price point. In most cases, this pricing point isn’t even half of the cost of braces (which usually averages around $4,500 per child in any given state). This usually still leaves it a losing choice for parents, especially if they have more than one child in need of braces or other dental procedures. 

Are There Other Options?

Although it may seem a lost cause and a little hopeless, there are other options that may help braces become a reality despite the limitations Medicaid casts on them. Since the treatment of braces is usually spread across two years, most orthodontists will not expect full payment up front. Since it’s also a large sum, many of these offices allow payments over a period of two years which makes it a little easier to handle.

Another option is getting dental insurance. It’s important you check with your dental insurance company on what coverage they offer and when it’s available once you purchase that coverage. Braces are pricey and sometimes, there is a certain period of time insurance companies will make you wait before you’re eligible to be covered outside of the basic preventative treatments. Some companies, unless you buy a certain level of coverage, won’t cover braces at all. Therefore, if you plan on using insurance to cover braces, be sure you know how and if braces are covered on the plan options.

It can be a little stressful trying to find ways to cover expenses when it comes to medical or dental needs. However, just remember, whether it’s you or your child, it will be worth all that effort in the end. Not only for the beautiful smile but, the health benefits that beautiful smile brings.

By |2019-06-27T19:30:44+00:00June 21st, 2019|

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