Does Medicaid Cover Braces in Colorado?

does medicaid cover braces in coloradoPeople get braces for different reasons. Some people get them for self-esteem while others need them to fix a medical issue.

Regardless of the reason, you may be wondering: how am I going to pay for them?

Some employers offer dental insurance, but if you are on Medicaid, the coverage works differently.

Does Medicaid cover braces in Colorado?

Age Restrictions

For your orthodontic braces to qualify for Medicaid, you need to be a certain age.

Medicaid will only cover braces for those under 21. While Medicaid does offer some dental benefits for adults over 21, these do not include braces.

However, for someone under the age of 21, there is one more qualification to meet: if your braces are necessary medically. A child can be evaluated once per year to assess the medical necessity of braces since a child loses baby teeth, gains adult teeth, and grows wisdom teeth. A full year must pass between evaluations.

Evaluation Process

When you make your evaluation appointment, office staff will typically confirm your insurance carrier. Make sure the staff knows that you are on Medicaid.

During the evaluation, the child will have photos and X-rays taken of their teeth. The dentist will use these photos to complete a report, which will be sent to Medicaid following the exam.

If you are approved, Medicaid will completely cover the cost of the braces.

If you are denied, the dentist can appeal. Medicaid may deny the request again. Following that, you can make an appeal.

When To Get Evaluated

The American Association of Orthodontists recommends that your child see a dentist by the time they are seven years old.

Do not wait too long to have your child assessed! The earlier the better. It is always better to do preventative care rather than damage control.

In the case that your case gets denied, it’s best to plan your evaluations carefully. Medicaid typically allows a child three evaluations before dismissing covering braces altogether. So, it is best to strategically have your child assessed throughout their growth period as their teeth change.

Do You Have More Questions About Medicaid and Braces in Colorado?

Our office is here to help! Contact Dentistry at Happy Canyon today. Our experienced and educated dentists and staff know the ins-and-outs of oral health and Medicaid coverage.

Schedule an appointment today.

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