Can I Get Braces with Medicaid?

The answer is yes! If braces are deemed medically necessary for your child, Medicaid can assist in getting them. Some orthodontists will offer a no-cost consultation to discuss your child’s needs. This can be very convenient if you’re looking into the cost of braces with Medicaid, CHIP, or TRICARE.

Keep Reading to Get Answers to These Questions:

  • What is Medicaid and what does it cover?
  • How do I know if braces are medically necessary for my child?
  • What is the average cost of braces?
  • What are the most common kinds of braces?
  • Where can I find a no-cost consultation for braces?
  • Where can I find affordable payment options for braces?
  • Why should I choose a Kids-First dental office or orthodontics?

Ready to schedule a no-cost consultation today? Find a Kool Smiles Kids Club partner dentist near you here. Or keep reading to learn more about braces and how you can find affordable treatment for your child.

What is Medicaid and what does it cover?

Medicaid is a government-funded program that ensures affordable health care is made available to families and individuals. This includes eligible adults, children, pregnant women, elderly adults, and people with disabilities. This program offers healthcare benefits to low-income families and individuals who may need assistance with affording healthcare coverage.

Children who are covered by Medicaid are entitled to Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services when they go to the dentist. Meaning children with Medicaid must receive dental care that provides the following:

  • Regular dental care maintenance, including teeth cleanings and checkups
  • Tooth restorative care
  • Pain and infection management or treatment

Find out if your family qualifies for Medicaid or CHIP here. You can find out if coverage includes the cost of braces. Many times, Medicaid covers dental care and orthodontic services, like braces, when they are deemed medically necessary for your child.

Medicaid will typically cover children 21 and under with orthodontic needs, that are deemed medically necessary. Scheduling a no-cost consultation can help you find out if this is an option for your family and if Medicaid can help with the cost of braces.

Kool Smiles partners can schedule a no-cost orthodontic consultation to help you figure out if your child’s braces are considered medically necessary and if Medicaid can cover some of the cost.

How to Know If Braces Are Medically Necessary

You will need to have an orthodontist or dentist confirm if braces are medically necessary for your child. There are a number of considerations your dentist or orthodontist will need to review in order to deem braces as medically necessary. Some of which are:

  • Cleft palate
  • Structural jaw issues making it difficult to open your mouth
  • Issues with eating or chewing normally
  • Issues with speech impediments from tooth or jaw problems
  • Any extreme underbite, crossbite or overbite
  • Overjet teeth – When teeth protrude outwardly and sit over the bottom teeth
  • Impacted teeth with an eruption
  • Missing teeth due to hereditary conditions (like hypodontia)

Typical Cost of Braces

If your child needs braces, you should will have to cough out some $3,000–$10,000. Quite naturally, it’s impossible to pin a particular figure as the price of braces. The price could fluctuate as a result of many factors such as the presence or absence of insurance coverage; the amount of time the braces is to be worn; the existence of broken or loose wires, cracked brackets and other complications; the type of braces chosen; and the severity of the dental conditions like an overcrowded teeth or a bad bite.
While people with Medicaid pay lower for braces, with privately-insured patients paying around $3,500 because of their partial coverage for orthodontic treatment, those without Medicaid or those whose Medicaid cannot cover cosmetic dentistry, can expect to pay close to $6,000 for children’s braces.

What are the Types of Braces Available?

If your orthodontist or dentist deems braces medically necessary for your child, then it’s time to consider what type of braces is best for your kid’s smile.
There are three basic types of braces in the market, namely traditional metal wire braces, lingual braces and clear braces. Each one comes with its strength and weaknesses.
Your choice of braces will be dependent on your child’s needs. By frankly consulting with an orthodontist or a dentist and allowing them to properly access your child, you will know the best option for you.
Lingual braces, unlike traditional braces, are placed on the back of teeth instead of the front. Placing the braces on the back makes the braces less noticeable and, therefore, a great option for those who are conscious about the look of it in their mouth. It can however, be initially uncomfortable until your child gets used to the braces crowding against their tongue. Not everyone will like to wear lingual braces.
Ceramic and metal braces are less expensive compared with lingual braces, and are easier to clean. Unlike lingual braces too, the brackets are attached to the front of teeth rather than the back. Placing it in the front makes it more visible and could affect the self-esteem of the patients. The brackets of ceramic braces are clear or tooth colored,, and so are slightly less noticeable than metal options. But because of their nature, ceramic braces stain or break faster than traditional braces.

How to Get Braces and Orthodontic Consultations

We are committed to providing affordable orthodontic care. We work with parents to select the best type of braces for their kids. We take them through the process so that they feel comfortable with the procedure. We also help you find the best payment solution, even if your dental procedure isn’t covered by Medicaid. We do this by providing information on payment options if you don’t have a Medicaid plan that can take care of it. And then we offer enticing affordable pricing options for our patients and make available payment terms that fit our patient’s budget.
Medicaid and Other Affordable Payment Options for Braces

We offer the following payment options:

  • Amerigroup Medicaid
  • Medicaid
  • Private dental insurance
  • CHIP
  • TRICARE
  • CareCredit (we can help you apply)
  • Cash
  • Credit

You can learn more about braces payment options by calling is and talking to our professionals.

Why Us?

It is at the core of our beliefs that great dental care should be affordable and accessible for every family. To that end, we have decided to place ourselves as the goto leave for all orthodontic services through:

Affordability. We’re affordable and will work with you to choose what’s best for you at the least cost, including if you have no insurance.
Convenience. We establish a presence in communities with the greatest need, making dental care more convenient for local families. Our dental healthcare professionals know how difficult it is to schedule a dentist appointment for your child, so we offer extended evening and Saturday hours at most of our locations. Thus giving parents more time to get a no-cost braces consultation for their child without interrupting their busy work schedule.
Comfort. We greatest joy is seeing our patients and their loved ones comfortable and satisfied at the end of the day. Our partner dentist offices are family-friendly offices, including indoor play areas for kids. Kids play here while waiting to be attended. Our partners patiently explain all the procedures, making it easier for you and your kid to know what you are to expect before, during and after the dental treatment. They are patient enough to entertain all your questions and give insightful answers. We’re your best bet for best dental service, accepting Medicaid for braces while bracing up to make you smile at all stages of the procedure and forever.