Does MassHealth Cover Braces and What You Need to Know

MassHealth does cover braces, but there are some requirements you need to meet.

If you're under 21, MassHealth will cover orthodontic services, including braces, as long as they're medically necessary.

To qualify, your MassHealth plan must be a MassHealth Standard or MassHealth Premium plan, and you must have a diagnosis from a licensed dentist or orthodontist that shows you need orthodontic treatment.

MassHealth coverage for orthodontic care is a great resource for families with children under 21 years of age. MassHealth (Medicaid) dental benefits do cover braces for children under 21 years of age.

If you're a MassHealth recipient, you're in luck - your dental benefits will cover a significant portion of your child's orthodontic care. This can be a huge help in making orthodontic treatment more affordable.

Your orthodontist's team will work with you to figure out how your MassHealth coverage applies to your child's situation. They'll help you maximize your benefits and make sure your child receives the necessary treatment.

It's essential to review your MassHealth policy to understand the details of your coverage. This will help you know what to expect and how to navigate the process.

MassHealth covers a wide range of dental services for children under 21 years of age.

Anesthesia is covered for general, nitrous, intravenous, and non-intravenous procedures. This means that if your child needs a dental procedure that requires anesthesia, MassHealth will cover the cost.

Braces are covered, but only with prior authorization. This means that you'll need to get approval from MassHealth before your child can get started with orthodontic treatment.

Cavity arresting medicament is also covered, which can help prevent tooth decay. Cleanings, crowns/caps, and root canal treatments (except for third molars) are all covered as well.

Deep cleaning, dentures, partials, and plates are all covered, including temporary dentures. Tooth removal and fillings are also covered, along with fluoride treatments and oral exams.

Some periodontal services are covered, and MassHealth will also cover X-rays. Additionally, other medically necessary dental services may be covered with prior authorization.

MassHealth Programs can be a bit complex, but let's break it down. One program worth mentioning is the Children's Medical Security Plan (CMSP), which is accepted by Smiley Dental. This plan allows for an annual maximum of $750/year at Smiley Dental, covering services like plaque or stain removal, routine cleanings, fluoride treatments, sealants, and fillings.