Does Medicaid cover braces?

The question of whether or not those on Medicaid can get braces depends on their age, where they live, and medical necessity. In all fifty states Medicaid does cover braces if they are considered "medically necessary."

But what does this mean exactly?

In general terms it means that Medicaid will not pay for braces for members who wish to get them to correct cosmetic issues. Some medical conditions that would allow for braces, in some cases, include excessive overjet, a cleft palate, or overbites and cross bites.

According to Growing Family Benefits, those on Medicaid can get braces covered if they are medically necessary, like if an individual has a "deformity that affects their oral health and or interferes with chewing or speech."

In an effort to define exactly what Medicaid was required to cover when it came to orthodontics, in 2019 the American Association of Orthodontists asked the federal government what it meant by "medically necessary."

However, states still have a fair amount of leeway in how they determine if braces will be covered under Medicaid. Some professionals believe that a good first step would be to contact an orthodontist in your area, set up a consultation, and have them examine your teeth. The doctor will be able to tell you if braces are medically necessary to verify for Medicaid that the procedure complies with their coverage guidelines.

Source: Does Medicaid cover braces?

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