Medicaid Orthodontist Colorado
Does Medicaid Cover Braces in Colorado?
One of the most frequently ask question what your Colorado orthodontist faces is does medicaid cover braces? The answer to this question is very simple yet detailed. Yes, in the state of Colorado, your child can get braces with Medicaid if they are deemed medically necessary. If you are wondering about what kind of costs are associated with Medicaid, our Medicaid Orthodontist in Colorado will give you a free initial consultation to evaluate your orthodontic health. This is especially important if your child is covered by Medicaid, CHIP or TRICARE. Afterward, our Medicaid Orthodontist will help you get braces via Medicaid insurance.
What Is Medicaid? What Does It Cover?
Medicaid is a program funded by the state and federal governments that offer affordable health coverage to millions of eligible adults, children, pregnant women, elderly adults, and people with disabilities. Medicaid is an assistance program, administered by states that seek to offer healthcare benefits to low-income families and individuals who may not be able to afford healthcare coverage otherwise.
Children who are included in a Medicaid plan can get Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services whenever they visit a dentist. This means that eligible kids must receive dental treatments that provide at the very least:
- Dental health maintenance, including cleanings and checkups
- Teeth restorations
- Pain and infection relief
Medicaid usually covers dental services and orthodontic treatments, including braces that are deemed medically necessary for your child. But Medicaid covers only children and teen under 21 whose orthodontic needs are declared “medically necessary”.
How would I Know If Braces Are Medically Necessary for Me?
Orthodontic treatment can be considered medically necessary if the case includes the treatment of bite problems or other severe orthodontic issues. The treatment may also be covered when provided in conjunction with other medical issues, such as a syndrome, craniofacial deformity, trauma, speech problems, etc. For instance, if someone has a severe overbite or under-bite, they might be medically required for orthodontic treatment. If untreated, these issues could impair one’s physical or emotional health.
You can have your child evaluated for orthodontic treatment once per year in the state of Colorado. To determine medical necessity, the Medicaid Orthodontist will review your child’s X-rays, photographs, dental molds, and other dental records. If your child gets denied for braces the first time, you can try again the year after. Typically, Medicaid will allow up to three attempts to be approved for orthodontic treatment. If the child get denied for treatment before they have all adult teeth, it may be a good idea to wait a year and try again. Also, if your child gets denied for orthodontic treatment, you have a right to file an appeal with the Medicaid to have the case re-evaluated.
Process of Pre-Approval of Medicaid Braces in Colorado
You can start the orthodontic pre-approval process by scheduling a consultation at our office. Our Medicaid Orthodontist in Colorado will accept Medicaid insurance. Furthermore, you will receive that initial consult at no cost. During the consultation, we will obtain the necessary pictures, X-rays, digital impressions, and other dental records required by Medicaid for pre-approval. We will also thoroughly evaluate your child’s bite and orthodontic issues they are suffering from. We will then fill out all necessary forms and reports needed for the Medicaid office to review your case. All the reports and forms will be sent to Medicaid administrators for their review and approval decision. They will evaluate the case and typically provide their decision within four to six weeks. They will notify both our office and your family about their decision once it’s made. If your child gets denied for orthodontic treatment, and we noted in our report that the case was extremely severe, we are able to appeal the case on your behalf. If our appeal is denied, you can appeal the decision yourself.
If your child is approved, you would call our offices and make an appointment for Medicaid Braces. Before the braces appointment, please make sure that your child gets a dental exam and cleaning and if there is any dental issue like gum disease and cavities, they must be taken care before braces are put on. Our Medicaid Orthodontist will guide you about your child’s orthodontic treatment plan, dietary restrictions, oral hygiene, home care instructions, and will answer any of your questions and concerns. After braces are on you will need to bring your child for periodic appointments to adjust braces. Your Medicaid Braces will be covered in full. By the end of the orthodontic treatment, your child will be given retainers to maintain their newly acquired smile.
Where Can I Find Medicaid Office in Colorado?
Our highly trained, professional, and experienced Medicaid Orthodontists have served many patients
We serve the following areas: Arapahoe County (Aurora, Centennial, Cherry Hills Village, Englewood, Glendale, Greenwood Village, Sheridan), Denver, Jefferson County (Arvada, Edgewater, Golden, Lakewood, Littleton, Wheat Ridge, Westminster), El Paso (Colorado Springs, Fountain, Manitou Springs, Calhan, Monument, Palmer Lake, Ramah), Pueblo County (Pueblo), Park County (Fairplay), Morgan (Fort Morgan), Clear Creek County (Idaho Springs), Douglas County (Highlands Ranch, Lone Tree, Castle Rock, Castle Pines, Acres Green, Parry Park, Roxborough Park, Westcreek, Meridian, Sedalia, Stonegate, Louviers), Teller County (Cripple Creek, Victor, Woodland Park, Green Mountain Falls), Fremont County (Canon City, Florence).
If you’re ready to schedule your free consultation and see if you can get Medicaid to cover your child’s braces, call our Medicaid orthodontist at (719) 596-3138 find out if Medicaid Braces are right for you!