Dental braces are devices made of wires that physicians use to fix crowded or crooked teeth. Setting the braces helps align and straighten the jaws to improve their look or feel. The process is very tedious and requires an expert to do the same, which makes it so expensive. As a result, people from low-income families—children and adults, are usually challenged to afford the services. The good news is that Medicaid offers free braces to eligible residents in all fifty states, with the eligibility criteria differing in various states. For instance, there are states where free adult brace coverage is up to 18 years, while others are up to 21 years. In addition, you must be diagnosed with an orthodontic problem that needs to be treated for you to get a free brace.
This tutorial will examine how to get free braces with Medicaid for children and adults. Besides, we will look at how you can qualify for Medicaid brace coverage and the entire process of getting free braces with Medicaid. Don’t you qualify for Medicaid-free braces? Do not panic! We will also look at alternative ways of getting free braces without Medicaid coverage. Let’s start with the basics!
How to get free braces with Medicaid for children
Medicaid is a famous plan provided by the United States federal government to help residents solve several health problems. As seen above, Medicaid offers free braces to both adults and children. However, there are different ways through which you can get free braces with Medicaid.
Children can get braces from different plans, while others usually get them directly from Medicaid. For instance, a program known as CHIP provided by the government offers free braces to children if they have enrolled in Medicaid. CHIP is an abbreviation of Children’s Health Insurance Plan, and it mainly targets parents who need to pay for their children’s braces. Let us look at the CHIP and the qualification criteria.
Children’s Health Insurance Plan
CHIP plan is a state-sponsored insurance program that mainly targets low-income families to pay for their health care. The less fortunate citizens can use this plan to get free braces and braces consultations in the nearby clinics. However, the plan only targets children in the age bracket of 0-18 years in the states. It would be best if you did your research because some states offer the program to children between 0-21 years old.
To qualify for the CHIP program however, you must show a modest orthodontic condition that genuinely depicts the urgency of medical attention according to the dentist’s guidelines. The plan covers several orthodontic conditions as we have discuss below.
- Children with Cleft palate. This is a condition where the split palette typically affects how you speak or breathe.
- Children with excessive overjet, which is primarily associated with a bad bite where the upper front teeth typically stick out. As a result, a noticeable gap is left between the upper and the lower front teeth.
- Children who complain of pain which creates discomfort when chewing the food.
- When the children’s jawbone structure has some problems that cause pain, it is mainly felt when opening and closing the mouth.
- Children with severe bites like underbites, overbites, and crossbites.
- Teeth positioning problems like either impacted or crooked.
- Hyperdontia condition that is characterized by excess teeth, and hypodontia is the absence of teeth.
Those conditions are covered once you are eligible for the program. If you have qualified for the program, kindly apply for free braces or consultations for your children. Kindly note that you may have to pay for the consultation or be covered in the CHIP plan. The following section will examine how adults can get free braces under Medicaid. Continue reading.
How to get free braces with Medicaid for adults
As we have already mentioned, medicaid mostly pays for children’s orthodontic procedures. However, there are several exceptions where the coverage includes low-income adults, people with disability, and pregnant mothers. For instance, Medicaid will pay for adults’ braces if an accident results in dislodging or breaking jaws. Additionally, if you are ailing from a disease that affects the jaws, you can claim dental coverage from Medicaid. Medicaid also coverers braces for adults with the following conditions:
- Sleep Apnea
- TMJ
- Malocclusion condition leading to physical or emotional harm.
Please note that to qualify for adult-free braces, ensure that you present detailed information on the medical condition impacted by jaw problems. Kindly note that you can get the braces’ approval without undergoing treatment if you have severe pain or an infection. Also, Medicaid can approve the braces if the condition affects how your body functions normally.
How to qualify for Medicaid free braces
As seen above, Medicaid covers free braces for children and teens between 0-21 years old. However, there are states where Medicaid covers from 0-18 years. This means that you must check the eligibility as per your state.
Kindly note that for anyone to qualify for Medicaid free braces, you must first qualify for Medicaid program. Therefore, you should visit Medicaid official website and establish whether you meet the program’s eligibility criteria.
In addition, you must come from a low income household to qualify for free braces with Medicaid. You can also qualify for free braces with Medicaid if you are a low income pregnant adult. Please note that children qualify for free braces if it is medically necessary, while adults only qualify if the braces will solve their health problems.
What is the process of getting free braces with Medicaid?
The process of getting free braces with Medicaid varies in different states. However, the general process follows the step-by-step procedure we will discuss below.
Check if you are eligible for Medicaid
Medicaid has set eligibility criteria that are not uniform in all states across the country. So, to determine whether you are eligible, you must contact the Medicaid agency in your state or visit their official website. You will be required to provide information about your income and family size before you can be told your qualification status. There are other factors the agent can request to provide apart from the income.
Apply for Medicaid
After finding out you are eligible, you must apply for the program to start enjoying its benefits. You can use several channels to apply for the Medicaid program. One, you apply only on their website or contact customer service in your state. Also, Medicaid has several offices where you can walk in person and apply for the program if you are eligible. Kindly be prepared with all the documents and evidence needed to prove eligibility.
Find a Medicaid provider who offers braces
After you have enrolled for the Medicaid provider, you need to find a Medicaid provider in your area offering braces. Several dentists and clinics offer services under Medicaid across the country. You must search for the Medicaid provider on the website or call the Medicaid agent to help you with a provider in your area.
Visit the dentist or the clinic
After finding a provider, you must schedule an appointment with them to get your braces. The appointment helps you because you get to learn the policies the clinic has under the Medicaid program. In case of any information Medicaid needs, the dentist will help you provide it to them. To receive treatment, you must provide medical documents showing you qualify for the braces.
Receive your braces
Once you meet your dentist, they will determine if you need braces or treatment according to the medical document. They will then give you the necessary treatment, which may mean you get the braces before releasing you. The dentist will instruct you on how to take care of the braces to last long. They will also schedule a follow-up appointment to monitor how you use the braces.
What are other ways of getting free braces if I don’t qualify for Medicaid?
There are several other ways or programs that can help you get free braces if you do not qualify for Medicaid coverage. These are mostly dental charities that offer free braces for kids or even adults that are undergoing challenging circumstances in their lives. More often, these charities receive government grants or get help from the generous donors. They include;
Smile Changes Lives
Smile Changes Lives is a non-profit organization helping residents acquire affordable dental care since 1997. It has been organizing free programs offering free braces for people aged 7 to 21 years. The organization allows citizens in the children and teenage bracket to acquire free braces. Like Medicaid, there are eligibility criteria you must meet to qualify for the program, which includes;
- You must have healthy oral hygiene.
- You should not have unfilled cavities.
- You should not have braces on your teeth; otherwise, you will be disqualified.
- You must prove you need free braces for the Smile Changes Lives
- You must meet the financial guidelines set by Smile Changes Lives organization. Kindly note that they have set different financial guidelines in other states. This means that before you apply, check the set financial guidelines in your respective state.
Once you have met all the above eligibility criteria, you will be ready to receive free braces from the organization. However, Smile Changes Lives requires you to pay a $30 application fee which is non-refundable, and invest $650. The payment is a catch worth as it is much cheaper than paying the $8,000 for braces.
DentalSave Dental Plans
The DentalSave Dental plan mainly targets residents who do not qualify for the Medicaid or CHIP plan. The plan covers free braces and any orthodontic procedure the citizen needs to undergo. DentalSave program targets less fortunate residents looking for orthodontic procedures at lower prices or for free. The DentalSave plan covers children and adults and can help you save the money you would have used to pay for braces.
When you apply for the DentalSave plan, you will likely qualify for a 25% discount on the braces. However, this decision depends on the dentists you are working with. This means you can contact the dentist to know whether you will get free braces or pay a certain amount. You are to pay, then ask them the amount of money you are going to pay.
What are some of the tips for making braces more affordable?
As seen above, it is not easy for an adult to get free braces under the Medicaid program unless the illness you suffer leads to dental problems. However, there are several other plans, especially if you can generate cash to help you get braces at affordable prices. These include the following:
- Dental saving plan. You can devise a plan to help you save some bucks, which you will use to pay for your orthodontic treatment. This may require you to have a payment plan with the orthodontist, which will see you pay for the braces over time.
- At-home aligners. They are mainly meant to moderate cosmetic fixes. They are typically cheap as they can cost you about $1,000 with a payment plan.
- Dental loans. They typically help you pay for the treatment upfront and get to repay the loan after receiving the treatment.
Why are braces medically necessary?
Yes. Braces have several benefits, especially for those who face medical jaw conditions. Here are some medical benefits that braces bring to you.
- Prevents the teeth and the gum. There is a high chance you will have a misaligned bite when you have misaligned teeth in your mouth. This can sometimes cause your teeth to break, which can cause pain when chewing. With braces, the teeth are usually aligned correctly to prevent this.
- Braces prevent teeth from erupting in the wrong position. This mostly helps the children who, after undergoing an X-ray, they can determine the direction in which the teeth will erupt. If the teeth erupt heading in the wrong direction, then braces can be used to fix the problem and guide the teeth in the correct position.
- Braces correct the teeth crowding. If you have teeth crowding issue, there is a high chance that you will have a bite alignment problem. Fixing the problem will make your teeth healthier and give you the comfort you need when biting.
- Braces correct overbite, underbite, or crossbite. When you have misaligned bites, you mostly have problems with speech and chewing. One of the main goals of orthodontic treatment is to align your bottom and top teeth to fit well in a process called occlusion.
- Braces prevent jaw pain. When you have misaligned bites, your jaws will work harder than they should. This will tire your jaws, bringing headaches, lockjaws, or sinus pain. Such pain is normally transferred to the jaws.
- Braces prevent heart disease. When you have poor oral hygiene, most times, there is a tartar buildup in the gums, which results in bacteria growth. On many occasions, such bacteria enter the bloodstream and can lead to heart diseases like cardiovascular. However, when you have braces, they will align your bites; however, you must maintain oral hygiene.
- Prevents tooth decay. When you have misaligned teeth, it is sometimes difficult to clean them correctly. When cleaning, you can hardly reach all the points in your mouth, which leaves the area prone to decay.