Understanding Medicaid orthodontic (braces) coverage for children in Illinois can be confusing.
Children covered by Illinois Medicaid (also known as Public Aid, AllKids, KidCare or the Medical Card) may now be eligible for orthodontic treatment with braces. Not every child covered will qualify for orthodontic treatment with braces, but a comprehensive orthodontic examination by an approved Illinois Medicaid Orthodontic (orthodontist or dentist) provider can help determine eligibility. Each patient must be pre-approved by the State of Illinois program administrators before orthodontic treatment (braces) can start. The following information provides a detailed overview about orthodontic coverage in the state of Illinois.
What is Illinois Medicaid?
Medicaid is a form of government assisted health care available to low-income families and children in Illinois. Currently there are two government funded programs that offer general dental care and orthodontic treatment with braces in Illinois; All Kids and Family Care.
All Kids provides health care to children of low-income families, while Family Care provides coverage for parents of these children. Each of these programs provides specific dental care coverage and may assist in paying for orthodontic treatment, dental braces and orthodontist fees.
Approved Provider for Medicaid Orthodontic (braces) Treatment
Dr. Gustav Kozina and Den-Care Smile Center is an approved, licensed Illinois provider of General Dentistry, Oral Surgery and Orthodontic treatment with braces and accepts Medicaid, Medicaid, All Kids, Medical Card and Tarjeta Médica as well as most dental insurance plans.
The Illinois Department of Healthcare and Family Services (HFS), formerly known as the Illinois Department of Public Aid, administers the Illinois Medicaid dental program.
Do All Children Qualify for Braces on Medicaid?
Not all kids covered under the Illinois dental care program will qualify for orthodontic treatment with braces. State administrators must pre-approve all children before orthodontic treatment can begin and only children with severe needs will qualify for orthodontic treatment and braces. Orthodontists and dentists use special tests to determine the severity of a patient’s need for orthodontic treatment with braces. If your child is currently covered by Medicaid in Illinois, it would be in your best interest to have your child examined by an approved Illinois orthodontic provider to see if they might be a candidate for covered orthodontic treatment.
Free Medicaid Orthodontic Evaluation
To determine if your child is eligible for orthodontic treatment, you must first schedule an appointment with an approved orthodontic provider for an orthodontic consultation. A top-rated Medicaid orthodontic provider in North Eastern Illinois that serves patients throughout metro Chicago, including Cook, Lake, McHenry, DuPage, Kane, Boone, Winnebago and Will counties is Den-Care Smile Center (847-DENTIST). They offer FREE orthodontic (braces) consultations where they will examine your child and determine if they meet the criteria to have their orthodontic dental records submitted for pre-approval to the Illinois Medicaid office. If your child is deemed eligible, Den-Care Smile Center will submit the necessary documentation to state administrators on your behalf.
After a case is submitted for orthodontic treatment with braces it can take up to 4 weeks for the files to be reviewed and evaluated by an administrator. Dr. Kozina or a staff member from Den-Care Smile Center will contact you when the approval for orthodontic treatment with braces from All Kids is received.
In the event your child does not qualify for orthodontic treatment with braces through Medicaid, , Dr. Kozina and the staff at Den-Care Smile Center will work with you to provide an affordable payment option that will fit within your family’s budget.
To schedule a free orthodontic consultation for your child, please contact Den-Care Smile Center at 1-847-DENTIST. For more information about orthodontic coverage for children, please visit www.medicaidorthodontics.net.