Orthodontists that Take Medicaid Near Me


Approximately four million Americans avail orthodontic treatment to correct the misalignment of their teeth and improve their bite. Bite problems are among the most common dental concerns among patients, next only to tooth decay. Orthodontic treatment, the recommended option for such problems, can be quite expensive especially for individuals who cannot even afford basic dental treatment.


Do Orthodontists Accept Medicaid?

Most insurance plans don’t cover orthodontic treatment unless the procedure is medically necessary. The amount covered may vary across states.


To determine medical necessity, consult with your kid’s orthodontist first. An orthodontist is the best person to determine if the teeth misalignment and bite problems affect not only your kid’s oral health, but also his or her physical and emotional well-being as well. If they do, then Medicaid will cover a huge portion of the expenses for the orthodontic treatment.


When Should You Consult An Orthodontist?

An orthodontist is a dentist who specializes in repositioning the teeth using dental appliances. If your kid has a bite problem that makes it difficult to speak or chew, then you should find an orthodontist that will help fix the problem. Ideally, it must be someone who is not just near your location, but also one that accepts Medicaid.


General Dentist vs. Orthodontist: Is There A Difference?

When it comes to your kid’s bite problems, who should you consult? Do you really need an orthodontist for it, or would a general dentist suffice? To answer your question, it is best to consult an orthodontist. Orthodontists are specialists that spent extra years of studying after finishing dental school. The orthodontic residency lasts for two to three years, and it focuses specifically on studying bite problems — their causes, types, treatment, prevention, etc.


Oral Appliances Orthodontists Use To Fix Bite Problems

Orthodontists are best known for using braces to fix bite problems, but they are not the only appliances that can help. There are several other types of orthodontic appliances, and whether or not they’re covered by Medicaid depends on their medical necessity.


Below are the types of orthodontic appliances used in lieu or along with braces:

  • Brackets and wires
  • Ligaties, chains, and elastics
  • Invisalign or clear aligners
  • Retainers
  • Headgears


How Much Braces Cost If Covered By Insurance

Braces, or orthodontic treatment in general, is among the most expensive dental services you will need. This is partly due to the duration of treatment, which requires multiple follow-up visits and appointments.


On the average, the out-of-pocket expense by individuals with dental insurance is around $3,000. Dental insurance usually covers up to $2,000 of the cost, so those who don’t have insurance will have to pay around $5,000 for their braces.


For more severe cases of bite problems, the cost of braces can go over $8,000 since there are more problems to be corrected and also the duration of treatment is longer. Furthermore, apart from the braces itself, you should prepare for expenses incurred from supplemental procedures like:

  • Consultations and clinical exams
  • X-rays and other diagnostic tools
  • Additional procedures (i.e. cleaning, restorations, etc.)
  • Retainers and their replacement/s in case of damage or loss


Why Medicaid Won’t Cover Orthodontic Treatment

Some states impose stricter rules when it comes to Medicaid coverage of orthodontic treatment. Or it could also be that your kid will get the treatment mainly for cosmetic reasons. At any rate, if the orthodontic treatment is not covered, you can always discuss with your dentist any flexible payment options.


You may also consider getting a CareCredit, a credit card intended to pay for healthcare procedures. This card lets you pay for expensive treatments like orthodontic treatment in terms or chunks that are way less overwhelming.


FAQs: Orthodontic Treatment and Medicaid

Q: When is the best time to get orthodontic treatment?

Orthodontic consultation should start as early as age 7 or 8, but treatment can commence between ages 8 to 14.


Q: How long does my kid have to wear braces?

Depending on the severity of the bite problem and teeth misalignment, the duration of orthodontic treatment averages at one to three years.


Q: What will happen if my kid skips orthodontic treatment?

If orthodontic treatment for your kid is medically necessary and you skip it, there will be future problems in the long run. These problems could affect not only your kid’s oral health, but his or her overall quality of life as well. Without orthodontic intervention, your kid’s supposedly simple bite and teeth misalignment problems could lead to speech impairment, tooth decay and loss, and even jaw problems.


Q: Does Medicaid pay for orthodontic treatment of adults?

Medicaid doesn’t usually cover orthodontic treatment for adults. The plan only pays for emergency procedures, and braces isn’t considered as such. Of course, the coverage may still vary across states, but most don’t really provide for extensive dental care. Thus, adults with Medicaid will still have to shell out money if they really need (or want) orthodontic treatment.


Q: What procedures are covered by Medicaid for adults?

Based on the data obtained from 2016, there are 15 states wherein Medicaid covers for diagnostic, restorative, and preventive dental treatment for adults. Meanwhile, 19 states have more restricted coverage and a maximum dollar amount of $1,000 a year, while 13 states only provide for emergency treatment. Last but not the least, the four remaining states do not cover any dental care at all.


Your Medicaid coverage, if any, can be cut or extended anytime. Be updated with your coverage to find out if you qualify for more dental procedures.


Q: Do adults need to consult an orthodontist?

Absolutely. There is no age limit for dental care, and maintenance of oral health is a must for individuals of all ages. Poorly-aligned teeth and problems associated with such can affect overall health by causing malnutrition (due to inability to chew properly), discomforts, and other issues.


Oral and general issues caused by bite problems do not only affect kids. They can also affect adults, forcing them to be less productive both at home and in work. If your dentist recommends that you consult an orthodontist, it is worth heeding the advice.


Q: How much does Invisalign cost compared to traditional braces?

Invisalign is a type of braces that makes use of custom-made clear aligners to correct mild cases of bite problems and teeth misalignment. At an average price of $3,500-$8,000, they are generally pricier than your traditional braces made of metal brackets and wires. These aligners, although removable, must be worn all day except when eating and brushing your teeth. Dental insurance may cover Invisalign only if it’s medically necessary.


The Atlantic:


American Association of Orthodontists:


American Association of Orthodontists:


WebMD: https://www.webmd.com/oral-health/guide/children-and-orthodontics#1

CostHelper.com: https://health.costhelper.com/braces.html

HealthCare.gov: https://www.healthcare.gov/medicaid-chip/

TRICARE: http://www.tricare.mil/dental.aspx

CareCredit: https://www.carecredit.com/

MouthHealthy.org/ American Dental Association:


Medicaid.gov: https://www.medicaid.gov/medicaid/benefits/dental/index.html

KFF.org: https://www.kff.org/medicaid/issue-brief/access-to-dental-care-in-medicaid-spotlight-on-nonelderly-adults/

Colgate.com: https://www.colgate.com/en-us/oral-health/cosmetic-dentistry/adult-orthodontics/what-do-invisalign-braces-cost-are-they-worth-it-0113