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Invisalign Medicaid for NY and NJ

If you have Medicaid insurance in New York, New Jersey, or Connecticut, you may be wondering if you can use your insurance to cover the cost of Invisalign. While Medicaid does cover some orthodontic procedures for qualifying patients, Invisalign is considered a cosmetic procedure and is not covered.


In this video, Diamond Braces Treatment Coordinator Samantha Sanchez explains further why this is, and how Medicaid dental insurance can be used.


How to Use Medicaid Insurance Coverage for Orthodontia


It is possible to get braces covered by Medicaid insurance. Like many areas of coverage under subsidized insurance, however, Medicaid only covers certain kind of patients and procedures.


To qualify for coverage under Medicaid, the patient must be under 21 years old, and the patient’s general dentist must determine that orthodontic intervention is necessary.


Medicaid covers metal braces only: other orthodontic procedures, like ceramic braces or clear aligners, are considered cosmetic procedures and aren’t covered by subsidized insurance programs like Medicaid.


In sum: Medicaid insurance can be used to cover patients under 21 with a referral from a dentist for metal braces. If you don’t meet these criteria, you’ll need to pay out-of-pocket, or find another insurance provider.


Why Doesn’t Medicaid Cover Invisalign?


Medicaid is a public, subsidized insurance program, which offers heath-care coverage for low or no premiums. It doesn’t cover everything, however: like many other areas of healthcare, there are restrictions to what procedures are covered with Medicaid.


Metal braces are the original form of orthodontic care: they are safe, effective, and comfortable to wear. They are still the most popular form of orthodontic care!


Metal braces have been followed by several innovations in orthodontic care, including invisible braces. These other forms of treatment are equally effective, safe to use, and comfortable. Many of them add an aesthetic advantage: Invisalign clear aligners, for instance, are nearly invisible when worn, making them a go-to option for adults or anyone concerned with their appearance.


But because this is a cosmetic feature, Medicaid doesn’t consider it for coverage. They cover the original form of treatment, metal braces, much like a generic drug: it is safe and effective.


This is why Medicaid does not cover Invisalign.


Other Insurance Providers Do Cover Invisalign


If you want to use insurance to cover your Invisalign clear aligners, it is possible! You just need to shop around for another plan.


Many private insurance plans cover at least part of Invisalign – often up to several thousand dollars. They also likely cover other orthodontic treatments such as ceramic braces or lingual braces.


Many jobs offer competitive benefits packages with health insurance – be sure to ask about these benefits when applying to new jobs.


Even Without Insurance, Payment Plans Can Help You Pay for Invisalign


There are still ways to make Invisalign affordable, even without insurance! Most orthodontic practices offer flexible payment plans to help break up the cost of Invisalign into smaller monthly payments.


Ask your orthodontic provider if they offer these kinds of payments – by paying in monthly installments, you can achieve a healthy, happy smile with all the benefits of invisible aligners without stretching your finances!