Does Medicaid Actually Cover Braces?

At Vita Dental, we often get questions about Medicaid as a payment for braces. Many people ask about the types of braces and the people eligible to get braces courtesy of Medicaid. Today, we want to explain the eligibility of Medicaid in our orthodontic treatment and expound on the types of braces that Medicaid covers.

We all know that Medicaids the largest medical cover program for families in the United States. Children are the largest beneficiaries of this program. It said that out of every ten kids, three of them are under Medicaid cover. The program meant to originally meant for disabled persons, has grown and developed to help more than just the disabled.

Thanks to Medicaid disabled kids and those from low-income families can now have the same medical cover as those with private insurance. Underprivileged children are however not the only beneficiaries of Medicaid. People like Expectant women and the elderly in the society are also eligible to enroll with this type of cover. There are requirements one must meet to be able to qualify for Medicaid cover. One question people ask is; does Medicaid pay for braces?

Depending on the state one resides in, the scope of services one receives will vary. In our case, we will look mainly at the benefits the residents of Texas enjoy courtesy of Medicaid. There are mandatory benefits that come with the program and some optional ones that are determined by the coverage one is on. One question that is common is if Medicaid pays for braces. So, does Medicaid actually cover braces? If it does, what are the types of braces it can cover?

The primary beneficiaries of Medicaid orthodontic services insurance cover in almost every state are the children. This makes perfect sense considering that almost 59% of all the dental problems reported in America are children cases. Medicaid however covers some adult orthodontic cases in Texas as well. The medical necessity of a patient is what will determine the dental services they will receive. However, some minimal standards must be met when receiving dental care and these include:

1. Teeth Restoration
2. Pain and Infection Relief
3. Dental Health Maintenance

For adults, here are the cases that may lead to you receiving dental services at Vita Dental under the coverage of Medicaid;

Any dental health issues that come up during a check-up can be treated under Medicaid cover if a doctor deems it medically necessary. That means Medicaid will cover braces if a dentist decides they are important. It does not matter if the service is under Medicaid cover or not.
Under the program, the dental services necessary for the promotion of oral health, restoration of oral structure for the enhancement of health functions and prevention of diseases must be provided to enrolls.

Another thing that will tell if Medicaid pays for braces is prevalent. For instance, if a problem affects a patient’s lifestyle, this is something that the dentist will determine. What this means is that a doctor will look at how a condition is interfering with an individual’s standards of living. If someone is not able to open their mouth properly, chew or talk, then braces become a necessary treatment. A patient with a cleft palate or lip will also be eligible for Medicaid payment for their braces.

Medicaid does cover for braces if an individual wouldn’t be able to function properly without them. Braces for cosmetic purposes will usually not be covered under the program. It is crucial to point out that in some states, it may be quite complicated to use the program to pay for braces.
One must also find dentists that accept Medicaid cover. Some states have taken measures to make it less complex for people to get the dental services they need with Medicaid. One can also find more information from their state office if they have some concerns.

On the specific type of braces that the dentist is allowed to install on a patient covered by Medicare, it all depends on the severity of the condition. At Vita Dental, we offer almost every type of braces available in the industry and we are not as choosy. We opt for the treatment we deem the most appropriate and deliver it.

Whether you are on Medicaid or any other insurance cover, we always listen to your story. Don’t suffer in silence. Visit our offices or give us a call and we will give you a detailed breakdown of how we charge our services. We will also advise you on your eligibility to receive treatment under Medicaid. Whether you are a guardian or are suffering from a dental problem yourself, we will always have a viable solution for you. Book an appointment today and visit our offices for the most comprehensive dental care in Texas.