Image source: https://i.pinimg.com/736x/99/5d/23/995d23799ec932bd01e7b008d9c61d9f--medicaid-eligibility-i-need-to-know.jpg
Like any public health care, qualifying for Medicaid can be a bureaucratic nightmare. There are considerable requirements to be met and not every state can offer the same services. In most states though, children's braces fall under the Medicaid umbrella. Generally, a family of two needs to make less than a thousand dollars a month in order for their child to qualify for Medicaid. Though there are exceptions and often incredibly specific requirements state to state.Other qualifications for Medicaid include being a US citizen, proof of age, proof of income and the other usual identity documents required for public services.
Above all other things, if you want your child to be able to use Medicaid for braces there must be sufficient cause to do so. Meaning simple overcrowding cases won't be covered by your insurance. In order to use Medicaid and braces there needs to be a substantial, skeletal issue with your child's teeth. These can not be cosmetic braces.
The best way to get your child approved is to get them into an orthodontist early. Phase one treatments may not be covered by Medicaid, but they can help evaluate your child's needs. Phase one treatment generally starts around the age of seven, when children have their first permanent teeth. While this might be slightly too early for Medicaid it could help mark your child for enrollment into the Medicaid dental program. If your child has ever had braces before they WILL NOT QUALIFY for Medicaid, and braces will have to come out of your pocket. So if you want to get those braces in their mouths, it's best to go with Medicaid from the start.
Along with an evaluative appointment, the child will need to meet a set of written criteria. In most states this criteria is devised as a points system. In most states a child has to score 26 points on a dental health questionnaire in order to receive federally funded care. Points are awarded for different dental maladies.
Once your child is evaluated by an orthodontist, it will generally take 2-3 weeks before your state's Medicaid office can approve your child's case. Once it is approved however, your child can carry on with getting braces in the normal way.One important thing to remember is that there is a maximum allowable age for this coverage (generally 18-20). The sooner you start the sooner your child will be done with Medicaid and braces!
