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Orthodontic treatment, like braces, correct many tooth and jaw alignment issues and can significantly improve your quality of life.
By bringing the teeth and jaws into proper alignment, dental braces make oral hygiene easier and more effective. They can also improve your ability to eat, breathe, and talk.
It’s possible that you’ve put off necessary orthodontic treatment due to a lack of funds or insurance. However, you or your child may be eligible for orthodontic coverage through Medicaid.
In this article, we’ll talk about:
Medicaid offers coverage for braces in cases where they’re medically necessary, at least for children and adults under 21. Some states provide coverage for low-income adults over 21 as well.
Remember that to qualify for Medicaid, your income must be below a certain threshold. This threshold differs from state to state.1
Medicaid is a US government program that offers health insurance for low-income families. By federal law, this includes mandatory dental benefits for children (but not adults).2
This doesn’t mean braces will be covered in all cases. Medicaid is also unlikely to pay for orthodontic treatment for adults over 21.
Braces will only be covered by Medicaid if they’re considered medically necessary. The requirements differ from state to state (see the next section).
In general, though, braces are more likely to be considered necessary in cases of:
If you’re seeking orthodontic treatment for purely cosmetic reasons, Medicaid won’t provide coverage.
Each state has its own Medicaid program. The federal government established Medicaid and provides some of its funding. However, state governments have the most authority over who qualifies for Medicaid and what services are covered.
Each state can set its own definitions for qualifying orthodontic treatment. For example, in Texas, Medicaid covers treatment for “severe, handicapping malocclusion.”3 North Carolina, however, uses a slightly broader term: “functionally impairing malocclusions.”4
In practice, states can decide how to interpret these terms. For example, according to Texas orthodontists, Texas Medicaid will not cover braces in most cases.5,6 And in North Carolina, Medicaid may deny coverage even if an orthodontist considers braces necessary.7
You’ll have to contact a local orthodontist that accepts Medicaid to know whether you or your child are eligible for coverage. Some states also have separate benefits through CHIP (the Children’s Health Insurance Program).
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Without dental insurance, braces cost an average of about $6,000. However, the price may vary from less than $2,000 on the low end to over $10,000 in the most expensive cases.
The amount you end up paying for braces will depend on various factors, including:
Braces are expensive not because of the cost of materials but because of how much time, effort, skill, and money goes into ensuring they’re placed safely and effectively.
Other options are available if you don’t qualify for Medicaid or are on Medicaid, but they won’t cover braces. For example, your orthodontist may offer a payment plan that allows you to pay for braces in affordable monthly amounts.
Some dental programs and charities may allow you or your child to get free or discounted braces. Dental schools and community health centers may also offer affordable orthodontic treatment.
Smile for a Lifetime and Smiles Change Lives (SCL) are nonprofit organizations that provide nearly free orthodontic treatment for children.
You can apply with either organization to get treatment for your child. Both charities limit their applications to children and adolescents up to 18. They also require that your child have good dental hygiene and that you have an income below a certain level.
In addition, you’ll have to pay an application fee ($20 for Smiles for a Lifetime or $30 for SCL) plus a final payment ($480 or $650) once a participating orthodontist is located.
Other options for low-cost orthodontic care include dental schools and community health centers.
Many dental schools feature clinics staffed by graduate students. Under supervision, these students may provide orthodontic treatment with braces or Invisalign at about two-thirds the cost of a typical private practice.8
Community health centers (CHCs) are federally funded nonprofit healthcare providers. There are nearly 1,400 CHCs throughout all 50 states. Many CHCs offer low-cost dental services; some provide orthodontic procedures like braces.
Search for dental schools and community health centers near you. Check their websites to find out what you need to do to apply for treatment, or contact them via phone or email.
Getting free braces through Medicaid as an adult isn’t impossible, but it is unlikely. Although some states have significantly expanded their coverage, Medicaid is largely intended for children ages 21 and under.
The federal government doesn’t require state Medicaid programs to provide any minimum dental coverage for adults. Many states don’t provide non-emergency dental services to adults.
If you qualify for Medicaid and your state offers adult dental care, you must prove that your braces are a medical necessity. For example, your braces may be covered if you lose teeth or break your jaw in an accident.
Yes, you can get braces if they aren’t a necessity. Braces can address slight imperfections in your teeth. However, most insurance plans, including Medicaid, will not provide orthodontic coverage for cosmetic purposes alone.
In most cases, the ideal time for braces is between about 8 and 13 years old. In this age range, a child is both:
Old enough to have lost some of their baby teeth (their permanent teeth have all begun to come in)
Young enough that their jaws are still growing, making tooth movement easier
However, it’s possible for people of every age to benefit from orthodontic treatment. Some situations call for braces at an earlier or later age.
Unfortunately, Medicaid will not cover Invisalign or any other clear aligner treatment. Unlike braces, which are deemed necessary sometimes, Medicaid doesn’t consider clear aligners like Invisalign medically necessary.
If you qualify for Medicaid in your state, you may be able to get free braces for yourself or your child. However, the braces have to be considered medically necessary.
In addition, states vary in how strict they are in offering coverage. It’s possible that your state Medicaid office will deny coverage even if your orthodontist considers braces to be necessary. This is especially likely if you’re an adult over 21.
If Medicaid doesn’t cover your orthodontic treatment, there are other ways to get free or reduced-cost braces. These include payment plans, charities, dental schools, and community health centers.
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