Monday, November 16, 2009

Will Medicaid pay for braces if they are medically necessary due to severe problems w/ my childs teeth?

My daughter has some pretty severe problems with her teeth that are starting to cause her a great deal of pain. She is on Medicaid and I know that they don't normally pay for braces, but will they if it is medically necessary or something more severe than just "cosmetic"?? Anyone have any information from experience they can share with me? Thanks

Will Medicaid pay for braces if they are medically necessary due to severe problems w/ my childs teeth?
Depending on what state you live in this is possible. Some states will pay for a childs braces if it is deemed medically necessary. now the definition of "medically necessary" is where the problem arises. some states will only take a very small number of cases a year if that and by small I mean 2-3. also another problem arises in that the fees medicaid pays for braces are very small. they are generally 1/2 of what is usual and customary. also in order for medicaid to pay for ortho the cases are usually extremely severe and most likely costs more. This problem causes many orthodontists to not provide treatment even if it is approved because they are getting probably a third of what they could get for another case. If I were you I would look into first getting approved and then search around for an orthodontist who would be willing to provide treatement. you will probaly be better off looking into a dental school as there fees are probaly more in line with medicaid fees. It is very difficult I understand but Good luck. I think I 've only seen 1 case approved in my years of woking with medicaid so dont get your hopes up.

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