Orthodontist That Accept Medicaid For Adults


When Medicaid Covers Braces For Children

Common Orthodontic Question: Can Medicaid Cover Braces?

Medicaid covers braces for children more frequently than for adults. The Early Periodic Screening, Diagnosis, and Treatment program requires states to pay for orthodontic services necessary to prevent disease, promote oral health, and restore oral structures to health and function.

In other words, each state can come up with a unique standard as this definition leaves plenty of room for interpretation.

Dental Care For Children Ages 0

  • Dental Exams
  • Sedation
  • Problem focused
  • Pain management

Some Services may require permission from a dental plan before the dentist performs the service. This is called a prior authorization. Services must be medically necessary in order for dental plans to pay for them. For more details about dental services, contact the recipientâs dental plan starting December 1, 2018.

  • Additional dental exams
  • Dental consultations
  • Dental office diabetic testing
  • A visit to the dental office to get comfortable with the office and the dentist before dental work is done for persons with disabilities

What Dentist Takes Medicaid For Braces

Any nearest orthodontist that accepts the insurance claims for the orthodontic procedures can be contacted to confirm whether he provides the medicaid for braces or not. The Medicaid insurance program definitely provides a chance for the children to have braces treatment under a medicaid funded insurance program. Teenagers under 18 can also avail this offer. Plus, if a teenager is deserving and having lower income, he can also appeal for medicaid relief on the medicaid website.

You should definitely search about how to find a best orthodontist near you that actually accepts the medicaid or the insurance claim for the advanced dental procedures. Almost all reputable orthodontists have already placed a list of dental insurances we accept like CHIP and medicaid. If there is written medicaid in the list, go avail that.

Also Check: How Do You Apply For Medicaid In Ny

General Dentist Vs Orthodontist: Is There A Difference

When it comes to your kids bite problems, who should you consult? Do you really need an orthodontist for it, or would a general dentist suffice? To answer your question, it is best to consult an orthodontist. Orthodontists are specialists that spent extra years of studying after finishing dental school. The orthodontic residency lasts for two to three years, and it focuses specifically on studying bite problems their causes, types, treatment, prevention, etc.

What Doesnt Medicaid Cover

Dentist Lafayette Indiana Take Medicaid  Find Local ...

Again braces are approved for medical reasons only. Some of the procedures with regard to orthodontics that Medicaid wont pay for include:

  • Treatment to correct crowded teeth.
  • Braces meant for aesthetic purposes.
  • If the patient has shown a lack of enthusiasm to maintain oral health and hygiene standards.
  • Medicaid wont also pay for premium orthodontic care options such as Invisalign for both kids and adults because Medicaid is a mass program that pays for the least expensive treatment option.

    Recommended Reading: How Much Money Disqualifies You For Medicaid

    Will Medicaid Cover Braces For Adults

    Medicaid is for the most part insurance for kids 21 and under. In recent years, it has expanded to cover low-income or indigent adults, the disabled and pregnant women. In the case of braces, however, its extremely uncommon that an adult will qualify.

    In rare cases, Medicaid covers braces, such as when illnesses affect the jaw and neck and make repositioning the teeth necessary, like in cases of:

    • Temporomandibular joint disorders
    • Osteoporosis
    • Handicapping malocclusions

    Again, the reason for braces must be medical. If Medicaid doesnt cover braces, private options like dental insurance, cash discounts and tax-exempt savings accounts can help.

    If youre on Medicaid, chances are money is tight. The good news is that dental insurance isnt all that expensive. Unlike medical insurance, dental insurance is affordable. Considering that braces can cost anywhere from $3,000 to $7,000, if you have dental insurance your policy may cover as much as 25% of the cost, or in this case around $1,500. Its not free, but there are ways to save money.

    Also Check: Who Gets Medicaid In Florida

    How Can I Get Braces With Medicaid

    First, it is important to understand that Medicaid will only cover orthodontic braces for children under 21. There are some new dental benefits of Medicaid braces for adults but this does not extend to braces or orthodontics. So if you are an adult with Medicaid and want braces, while our Medicaid orthodontist can definitely support you, it is important to understand that Medicaid insurance may not help you with the costs associated with braces. However, this is why we have a large variety of payment options

    Moreover, if your orthodontic needs are declared medically necessary, we will help you find out if your Medicaid insurance will cover the costs for braces. Even though your childs braces may not be completely free, but Medicaid orthodontic coverage can help pay for most of the costs. Additionally, It is important to note that Medicaid will not cover adult braces for free.

    You May Like: Does Medicare Medicaid Pay For Dentures

    Dental Benefits Under Medicaid Program

    Medicaid is one of the nations public health insurance programs to help low-income people get affordable healthcare. This is considered as long-term health care coverage for Americans and it is a federal and state program that works as a help of healthcare costs for limited-income people. There are two components of this affordable healthcare that are Medicare and Medicaid.

    Medicare provides health coverage for the elderly and Medicaid covers healthcare costs for people who dont afford to go. Medicaid is vastly known as medical and Health-related services for low-income people and it provides free health insurance for low-income and disabled people. It is also a means-tested program funded by the State and Federal governments and Managed by the States.

    When it comes to dental benefits under the Medicaid program, it is more flexible to go for assessment on what dental benefits are provided to adult Medicaid enrollees. Most of the states provide emergency dental services for adults and less than half of the states currently provide comprehensive dental care. The adult may be lucky to hear that there is no requirement for dental coverage under Medicaid.

    Our Dentists Accept Medicaid & Chip

    Does Medicaid Cover Braces For Children

    Keem Smile Dentistry is Family and Cosmetic Dentist Office Located In Houston TX 77084. Our dentist provides quality, professional, general, cosmetic and orthodontic dental care to children and adults of all ages.We are a Texas Health Care Provider and we Proudly Accept Medicaid patients in our office. We have been providing Exceptional Dental care for patients of all ages with Medicaid in Houston TX. We are Open Weekend so you dont have to take a day off from work to see a dentist We are Equipped With the latest technology for accurate diagnosis and Our Dentists. are Experienced. Please call us at 832-906-6127 to Schedule Your Next Dentist Visit With Us, Your Dentist That Accepts Medicaid Near You. Thanks

    Texas Mediciad Plans We Accept

    • Traditional Medciaid

    So if you have or may know anyone that is in need of dental care and can benefit from one of these procedures then have them contact us to schedule an appointment or you can also Book Online. Our office offers same day appointments and same day emergency services and can help you maintain the health of your gums and teeth. So scheduling your dental check-up and cleanings every six months is the key to preventing the need for any additional procedures or surgeries. As long as you keep up with your daily oral care as well as take a trip to our Medicaid dentists every six months, the chances of you having cavities or other tooth related problems are dramatically decreased.

    Read Also: What Is The Household Income Limit For Medicaid

    Get To Know Your State Policy

    It is important to know that your state is currently expanding Medicaid eligibility for adults. The different states may have different policies on Medicaid and dental care. Surely there is a Medicaid office in your state where you may get detailed information on how Medicaid and dental care is working.

    Q: How Much Does Invisalign Cost Compared To Traditional Braces

    Invisalign is a type of braces that makes use of custom-made clear aligners to correct mild cases of bite problems and teeth misalignment. At an average price of $3,500-$8,000, they are generally pricier than your traditional braces made of metal brackets and wires. These aligners, although removable, must be worn all day except when eating and brushing your teeth. Dental insurance may cover Invisalign only if its medically necessary.

    Also Check: How Can I Print My Medicaid Card

    Children’s Oral Health Initiative

    The Centers for Medicare & Medicaid Services is committed to improving access to dental and oral health services for children enrolled in Medicaid and CHIP. We have been making considerable progress in our efforts to ensure that low-income children have access to oral health care. From 2007 to 2011, almost half of all states achieved at least a ten percentage point increase in the proportion of children enrolled in Medicaid and CHIP that received a preventive dental service during the reporting year. Yet, tooth decay remains one of the most common chronic childhood diseases.

    To support continued progress, in 2010 CMS launched the Children’s Oral Health Initiative and set goals for improvement by FFY 2015. To achieve those goals, we have adopted a national oral health strategy through which we are working diligently with states and federal partners, as well as the dental provider community, children’s advocates and other stakeholders to improve children’s access to dental care.

    To support state Medicaid and CHIP programs in achieving their improvement goals, we developed Keep Kids Smiling: Promoting Oral Health Through the Medicaid Benefit for Children and Adolescents . It provides an overview of the children’s dental benefit in Medicaid, support for evidence-based policies at the state level, and details of successful strategies with state examples.

    Are Braces Covered By Wisconsin Medicaid

    Dentist Accept Medicaid at Keem Smile Dentistry

    The Medicaid approval process for dental care depends on various factors such as the age of the patient, current oral health condition, and the type of orthodontic treatment required. Medicaid covers dental care and orthodontic services, like braces, when they are deemed medically necessary for your child. Some examples include cases that consist of a cleft palate or severe anomalies of the face that cant be adjusted without braces.

    The first steps in finding out if you are qualified would be getting a referral from your primary dentist for an examination with an orthodontist, though it is not necessary and we would be more than happy to see you if you do not have a referral. The administrators of the State of Illinois Medicaid are required to pre-approve all children for braces coverage before orthodontic treatment can begin. Additional pre-orthodontic services that can be covered include extractions and restorations, and these services would be provided by a dentist. We believe everyone should have the opportunity for a Dream Smile, so we are always available to help you navigate your coverage.

    However, just because a patient may have moderate or severe orthodontic issues, and/or has been advised by a dental professional that they need braces, this does not mean that the patient will qualify for coverage.

    Also Check: How To Apply For A Replacement Medicaid Card

    If Medicaid Is Not An Option What To Do

    Without help from Medicaid, we understand that you need excellent options and here at A Perfect Smile Orthodontics, we offer in-house, very low interest financing that means braces can cost as little as $99 a month.

    We also offer a no-cost consultation here at A Perfect Smile Orthodontics where Dr. Taylor will check out you or your childs teeth and determine if you will benefit from braces or other orthodontic treatment..

    Many PPO insurance plans offer some orthodontic benefits. The amount covered by insurance varies depending on the insurance plan. If your insurance plan does not cover the full amount for affordable braces, we offer no-interest financing and low monthly payments to make the balance affordable. To find out if you or your children can benefit from affordable dental braces just call us and schedule a FREE CONSULTATION and we will work with you to find solutions that work for you.

    What Does The Dental Benefit Cover

    See the Childrens Dental Benefits page for more information about benefits for Health First Colorado members under age 21.

    The adult dental benefit is available to eligible adult Health First Colorado members and covers:

    • Annual dental exams and cleanings
    • Diagnostic and restorative dental services
    • Extractions
    • Other procedures requiring *prior authorization are also available.

    Emergency services and dentures are not subject to the $1,500 limit per state fiscal year.

    The replacement of lost, stolen, or unrepairable broken dentures are an once per member lifetime benefit.

    Recommended Reading: How To Obtain A Medicaid Provider Number

    Read Also: Will Medicaid Pay For A Lift Chair

    Welcome To Dopazo Orthodontics

    Here at Dopazo Orthodontics, we have worked hard to become recognized as one of the best Jacksonville orthodontic offices. Dr. Leandra Dopazo and our team are especially interested in making all our patients feel right at home!

    We put your needs first, to achieve efficient and comprehensive treatment in a supportive and nurturing environment. With services that include braces for all ages, Invisalign® aligners for adults and teens, and Damon Smile self-ligating braces, youll achieve your new smile faster and easier than you may have thought possible.

    When you choose Dopazo Orthodontics, you are welcomed into our family. Our care is personalized to meet your needs and our practice designed to give you comfort.

    Come see why our practice, our doctor, and our treatments have earned such a great reputation! Schedule a complimentary initial consultation at our Jacksonville orthodontic office today!

    Dental Care: Why It’s Important

    Medicaid Fraud in Dentistry: The Investigation

    It is important for babies, children, and adults to see a dentist at least twice a year. The earlier children see a dentist, the healthier their gums and teeth will stay for their whole life. Children should begin seeing a dentist by age 1, even if they do not have teeth yet.

    Problems with teeth and gums can be avoided by seeing a dentist early in life and on a regular basis. Brushing, flossing and avoiding sugary foods and drinks can help with healthy teeth and gums.

    If a tooth problem does occur, it can have serious effects on your overall health. Tooth problems can also cause problems like not being able to bite and chew food, problems in school, or missing school because of pain. Also, unhealthy teeth can cause problems with speaking.

    Read Also: How To Get Help With Medicaid

    Today Dental Alexandria Virginia

    When you are living in Virginia, today dental Alexandria can be a good option. Most of the adults lose their hope of treatment due to higher costs or insurance coverage. Luckily you may have Medicaid coverage and you may contact this platform to get your dentist for dental work. You can visit the website on how to get started.

    What Is The Badgercare Plus Program In Wisconsin

    In addition to Medicaid, Wisconsin also administers BadgerCare Plus, a similar program for groups of people who need healthcare coverage but who may not qualify for Medicaid or who need different kinds of services. BadgerCare Plus is also sometimes informally referred to big bear luxury cabin as just BadgerCare. BadgerCare Plus is a health care program for all low-income and disable residents of Wisconsin who are not elderly, blind, or disabled but still need healthcare coverage. It does not have an open enrollment period, and people can apply at any time.

    Eligibility criteria:

    Dental services are only available to the children under the age of 18 years and pregnant women. BadgerCare Plus reimbursement is allowed only for services that meet all program requirements. Orthodontic diagnosis only is however allowed for the members ages 21 and under. Groups that are eligible for BadgerCare Plus are:

    Choosing any of these programs will help the residents of Wisconsin to get an aid in their dental treatments.

    If you are looking for an expert orthodontic treatment in Wisconsin, orthodontic experts should be your first choice because we are a home to high-end technology with highly skilled staff that makes a great deal of effort to satisfy our patients in Wisconsin. Schedule your appointment with us and we are here to assist you in having your smiles back.

    Also Check: Alabama Medicaid Application For Child

    Dental Places That Accept Medicaid

    Adults often face a stark reality when looking for nearby dental places that accept Medicaid patients for specific procedures. The odds of success are about 50%, and you might need to find an alternative.

    Dental assistance programs might prove more fruitful because when three possible shortcomings apply to your situation.

  • Oral care coverage varies extensively from state-to-state
  • Dental specialties have the widest state disparities
  • The least costly alternative rule limits treatment options
  • Delta Dental
  • How Do I Find A Dental Service Provider Easily


    It is important to find a dental service station where Medicaid insurance is acceptable. There are numerous ways to find dental service stations. But the easiest way may be by going to My Community Dental Centers. You also can call the hotline numbers of the dental service stations and you may ask if they accept Medicaid.

    Recommended Reading: What Does It Take To Get Medicaid

    Does Medicaid Cover Braces

    As a Medicaid Orthodontist we get a lot of questions all the time about Medicaid coverage and how it works for getting braces. Many folks dont realize that we are, to the best of our knowledge, the leading Medicaid Orthodontist in Colorado. As such, we thought wed provide a little insight. It is indeed a bit complicated!

    First and foremost, it is important to understand that Medicaid will only cover orthodontic braces for children under 21. While there are now some dental benefits for adults with Medicaid, this does not extend to braces or orthodontics. So if you are an adult with Medicaid and want braces, while we can definitely assist you, realize that your Medicaid insurance will not help with the costs.

    For children under 21, however, Medicaid will pay for the costs of braces in full if they determine that the need for braces is medically necessary. You can have your child be evaluated for this medical necessity once per year. So if they get reviewed for braces and are denied, you can try again but you must wait one year in between evaluations. Typically they will allow three attempts. If they are denied before they have all their adult teeth, it may be a good idea, depending on your finances, to wait a year and try again. If they are denied after they have all their teeth, we typically can not apply again and it would likely be time to discuss private financing. .


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