For low income seniors, families, and people with disabilities, the state of Utah’s Medicaid medical insurance program offers medical coverage to people who qualify.
To be considered low income, you must have a gross annual household income that is equal to, or less than, the Utah guidelines. For example, a family of four must have an income of no more than $34,248.00 before taxes, per year.
If you meet the low-income guidelines there are further qualifications for eligibility. The qualifications set by the state of Utah are the following:
• You must be a resident of the state of Utah.
• You must be either a U.S. citizen, U.S. national, permanent resident, or a legal
• You must have a need for health care coverage.
• You must be either pregnant, the parent of a dependent child, or the related
caretaker of a dependent child under 18.
• You must either be blind, disabled, or have a disabled family member.
• Or you must be at least 65 years old.
Does Medicare Cover the Cost of Orthodontic Braces?
If your children are 21 years old or younger, covered solely by a Medicaid program, or are dual-eligibles with coverage from Medicare also, they can receive dental services. These services may include dental health maintenance like cleaning and check-ups, teeth restoration treatments, and treatment for pain and infection relief. These services are provided without charge by a Medicare approved dentist or orthodontist.
Depending on which program your children are enrolled in, they may also have coverage for the cost of braces if your orthodontist or dentist certifies that they are medically necessary.
In the state of Utah, your health care provider may determine that braces are medically necessary for your child if one or more of the following conditions is present:
• Cleft palate
• Structural issues of the jaw that cause difficulty in opening the mouth
• Eating or chewing difficulties
• Tooth or jaw problems that are causing a speech impediment
• Overbites, underbites, or crossbites that are severe
• Overjet positioning of the teeth (teeth are horizontal rather than vertical)
• Missing teeth cause by a pre-existing condition that may be hereditary (hypodontia)
Medicare does not cover the cost of orthodontic braces for cosmetic reasons.
If you and your family have Medicare but qualify for Medicaid, you may qualify to receive dental services through Medicaid as a dual-eligible. If you are not sure whether you qualify or would like more details about these medical insurance plans, call your state Medicaid office and speak to an agent who will give you the necessary information.
The Importance of Dental Insurance
Having proper dental care is highly important for everyone, but especially for young children and adults who may be more susceptible to immune issues. Costs for dental care can mount up with a large family, and even routine dental check-ups can be expensive. If you have a child, or children who need braces, it is important to have medical insurance to cover the costs.
Depending on where you live, the type of braces you need, if you require extra procedures like tooth extractions, braces generally cost an average of between $5,000.00 and $6,000.00.
Braces may not be necessary for everyone, but if your dentist suggests that your child needs them for health reasons, you should review your options and access to coverage by Medicare and Medicaid.