Does Medicaid cover braces?

Updated October 12, 2026.

Yes, for children and young adults under 21, when braces are medically necessary. That generally means a severe bite or alignment problem, not a cosmetic one. Coverage for adults depends on the state.

Braces for children on Medicaid

Every Medicaid beneficiary under 21 gets the Early and Periodic Screening, Diagnostic and Treatment benefit, known as EPSDT (National Health Law Program). For dental care it must at least include relief of pain and infections, restoration of teeth and maintenance of dental health, and all services must be provided if they are medically necessary (Medicaid.gov). Braces fall under that rule: they are covered when a child needs them for health reasons.

What "medically necessary" means for braces

For orthodontics, Medicaid generally treats braces as medically necessary only when a child has what is called a handicapping malocclusion: a severe bite or alignment problem. States have some flexibility in how they decide this (National Health Law Program), so the rules and the paperwork differ from state to state. Straightening teeth for appearance alone isn't covered.

Why orthodontic problems can be a health issue

Medical necessity is about health and function, not looks. The AAO says misaligned teeth that are left untreated may lead to tooth decay, gum disease, abnormal wear of tooth enamel and difficulty chewing (AAO), and Cleveland Clinic notes that braces can help restore functions such as chewing and speaking (Cleveland Clinic). Problems that are severe enough to interfere with these are the kind a state program is likely to consider.

Young adults aged 18 to 20

EPSDT covers Medicaid beneficiaries under 21, not just under 18 (National Health Law Program). So a 19- or 20-year-old on Medicaid can still ask for orthodontic treatment under the same medical-necessity rules as a child. Treatment should be requested before the 21st birthday; ask the state program how it handles treatment that would continue past it.

What happens at the orthodontic evaluation

The AAO recommends every child see an orthodontist by age 7, and many orthodontists offer that first check at no cost (AAO). For a Medicaid request, the evaluation matters because it produces the evidence the state looks at. At a first visit, the orthodontist reviews dental and medical history, examines the teeth and bite, and takes records such as X-rays, which show the position of the teeth, roots and jawbones (AAO). Panoramic X-rays can also reveal missing, extra or impacted teeth (AAO).

Braces under CHIP

Separate Children's Health Insurance Program (CHIP) plans must cover dental services needed to prevent disease, promote oral health, restore oral structures to health and function, and treat emergencies, or offer a benchmark dental package (Medicaid.gov). Whether that includes braces depends on the state's program, so ask your state CHIP office.

Does Medicaid cover braces for adults?

Not for appearance. Healthline notes that some states may cover braces for adults to treat a medical condition (Healthline). Adults without coverage can see braces for adults and affordable braces for other ways to lower the cost.

For adults, the most useful tools are usually an interest-free in-house payment plan, typically 12 to 24 months (AAO), and pre-tax money: braces count as a dental expense when they treat a dental problem (IRS Publication 502), and the 2025 health FSA limit is $3,300 (IRS Publication 969). Metal braces have the lowest price range, $3,000 to $7,000 (CareCredit).

Medicaid, CHIP and private insurance compared

How to get braces through Medicaid

1. Find a dentist or orthodontist who accepts your state's Medicaid or CHIP plan. Your plan's member services can give you a list.
2. Have your child examined. The orthodontist assesses how severe the problem is and takes records such as X-rays and photos.
3. The office then usually asks the state program to approve treatment, using the state's own rules for what counts as medically necessary.
4. Treatment starts once it's approved. Ask what is included, such as retainers afterward, and whether anything would be billed to you.
5. Keep copies of every letter from the program, including any approval or denial, in case you need to appeal or your child changes plans during treatment.

What Medicaid programs pay, compared with typical prices

State programs set their own fees. As one example, South Carolina's children's program pays $2,400 for comprehensive orthodontic treatment (SC DPH), while typical prices for metal braces are $3,000 to $7,000 (CareCredit). When a request is approved, ask the office to confirm in writing that there will be nothing extra to pay.

Questions to ask

• The state Medicaid or CHIP office: does my child's plan cover orthodontics, how is medical necessity decided, and which orthodontists in my area accept the plan?
• The orthodontist: does my child's problem look severe enough to qualify, will you submit the request, and what would we owe if it's approved, or if it's denied?
• Both: are retainers after treatment covered, and what happens if my child loses Medicaid eligibility during treatment?

If Medicaid says no

Ask the office and the plan to explain the decision in writing and how to appeal. A denial isn't always the last word: ask whether more records, such as further X-rays or measurements, would help, or whether the orthodontist can resubmit the request. If braces aren't covered, compare prices: metal braces cost $3,000 to $7,000 (CareCredit data), and you can spread the cost with a payment plan. See also braces for kids.

For children under 18, the AAO lists charitable programs, including AAOF Gifted Smiles, Smiles Change Lives and Smile for a Lifetime, that provide orthodontic treatment at low or no cost (AAO). Many orthodontists also offer interest-free in-house plans, typically over 12 to 24 months (AAO), and an HSA or FSA can cover part of the cost when braces treat a dental problem (IRS Publication 502).