​How much orthodontic treatment is allowed under Medicaid?

Every child is entitled to an immediate consultation at MedicaidBracesNY at either the Lynbrook or Brooklyn office. Medicaid will pay MedicaidBracesNY to evaluate a patient’s orthodontic needs. Our director of orthodontics will perform a complete orthodontic clinical examination and take a set of orthodontic records, which will be forwarded to Medicaid or your Medicaid managed care plan.

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How do I get Medicaid braces at MedicaidBracesNY?

MedicaidBracesNY will send your orthodontic records and a comprehensive narrative to Medicaid or your Medicaid managed care plan. He will describe the orthodontic condition and request the appropriate treatment from Medicaid.

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Do I automatically get Medicaid braces because MedicaidBracesNY requests it?

The final decision is made by a consultant who interprets the Medicaid orthodontic guidelines and applies them to your case. Although the guidelines are specific, they are open to interpretation. MedicaidBracesNY takes great pride and care in preparing each request to ensure the consultant fully understands the orthodontic issue.

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What happens if I am denied Medicaid orthodontic treatment (braces)?

You are entitled to appeal the decision made by Medicaid or the Medicaid managed plan. Our director of orthodontics is an expert at preparing and submitting your orthodontic records and treatment requests to Medicaid. If Medicaid denies the request, MedicaidBracesNY will personally oversee your appeal.

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What if my Medicaid orthodontic appeal is denied?

You are entitled to a Fair Hearing. Call MedicaidBracesNY immediately upon receiving a denial of an appeal. You have a limited time to request a Fair Hearing, where a judge reviews the facts of your case and makes a ruling. MedicaidBracesNY will connect you with a community advocate to assist you through the process. He will work closely with your advocate to ensure you receive the care you are entitled to.

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What happens if I am denied orthodontic treatment and want to pay MedicaidBracesNY directly?

MedicaidBracesNY understands how disappointing it is for parents when a child is denied Medicaid orthodontic treatment. We are committed to making treatment possible and available. MedicaidBracesNY will extend every courtesy and offer manageable payment plans so that every child may receive the necessary orthodontic care.

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MedicaidBracesNY is a strong child advocate and the lead architect of the "No Child Left Behind" program, which assists families who find the cost of extraordinary orthodontic care beyond their reach.