Written by the Diamond Braces clinical team · Updated November 3, 2026
Yes, you can get braces with Medicaid in many cases, mostly for children and teens under 21 whose bite or alignment problem is judged medically necessary. Federal law requires every state Medicaid program to cover dental care for enrollees under 21, and that can include braces when a case qualifies. Coverage for adults is much more limited and varies by state.
How Medicaid Covers Orthodontic Treatment
Medicaid is run jointly by the federal government and each state, so orthodontic benefits are not the same everywhere. Each state decides how it judges whether braces are medically necessary (National Health Law Program).
Braces Medicaid for Kids
Children and teens under 21 who are enrolled in Medicaid are covered by the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit, which requires states to cover dental services (Medicaid.gov; U.S. Department of Health and Human Services). Under EPSDT, braces are covered when the state finds the treatment medically necessary, for example a severe bite problem or crowding that affects chewing, speech or oral health. Braces for appearance alone are usually not covered.
Braces Medicaid for Adults
Dental coverage for adults is optional for states, so adult orthodontic coverage is much more limited (U.S. Department of Health and Human Services). Most adults pay for braces another way. Check your own state's plan before assuming you are or are not covered.
What Qualifies as Medically Necessary
Medically necessary orthodontic treatment means the bite or alignment problem affects function or health, not just appearance. Examples that may qualify include:
- Severe crowding that makes teeth hard to keep clean
- Significant overbites, underbites or crossbites that affect chewing or speech
- Jaw alignment problems connected to a diagnosed condition
- Cleft lip and palate or other craniofacial conditions
Many states use a scoring index to rate how severe a case is, and an orthodontist usually completes that evaluation as part of the approval request (National Health Law Program).
How to Check Medicaid Eligibility for Braces
- Call your state Medicaid office or your managed care plan and ask about orthodontic benefits
- Book an evaluation with an orthodontist who accepts your Medicaid plan; they can tell you whether your case is likely to meet your state's criteria
- Ask about age limits, since EPSDT coverage applies to enrollees under 21
- Ask for your case's severity score if your state uses one
Because the rules vary by state, the clearest answer comes from your Medicaid plan and a participating orthodontist.
What If Medicaid Does Not Cover Your Case
Low-Income Braces Options
At Diamond Braces, metal braces are $3,200, as low as $89 a month with insurance and $0 down with financing.
Payment Plans and Financing
Monthly payment plans, private dental insurance with orthodontic benefits and third-party financing can spread the cost of braces over the course of treatment. Ask your orthodontic office which options it offers.
Community and Dental School Resources
Some dental schools and community health centers offer reduced-cost orthodontic care provided by supervised residents. This can help if you do not qualify for Medicaid coverage.
Affordable Care at Diamond Braces
If you are not sure whether your case would qualify for coverage, book a free consultation. Our team can review your options and help you check your insurance before your visit. Contact your local office to confirm whether it participates in your Medicaid plan.
Find a Diamond Braces office near you.
Final Thoughts
Getting braces with Medicaid is possible, especially for children and teens under 21 with a medically necessary bite or alignment problem. Adult coverage is far more limited. Check with your Medicaid plan, get an evaluation from a participating orthodontist, and ask about financing if Medicaid does not cover your case.
Frequently Asked Questions
Does Medicaid cover braces for adults?
Rarely. Adult dental coverage is optional for states, and most do not cover braces for adults. Check your state's plan.
What is considered medically necessary for Medicaid braces coverage?
Cases where the bite or alignment problem affects chewing, speech or oral health, such as severe crowding, significant bite problems or cleft palate, are the ones most likely to qualify. Each state sets its own criteria.
How do I know if my child qualifies for braces through Medicaid?
An orthodontist who accepts your child's Medicaid plan can evaluate the case and tell you whether it is likely to meet your state's criteria. Many states use a severity score.
Is there an age limit for Medicaid orthodontic coverage?
The EPSDT benefit that covers children's dental care applies to Medicaid enrollees under 21.
What can I do if Medicaid does not cover my braces?
Ask about payment plans and financing, private insurance with orthodontic benefits, and dental school or community clinic programs.
Does Diamond Braces accept Medicaid?
Diamond Braces accepts many insurance plans and offers financing. Contact your local office to confirm whether it participates in your Medicaid plan.
Sources
- Medicaid.gov, Early and Periodic Screening, Diagnostic, and Treatment
- U.S. Department of Health and Human Services, Does Medicaid cover dental care?
- National Health Law Program, Medicaid Coverage of Orthodontia for Children
