Anonymous
Anonymous asked in HealthDental · 1 month ago

Q about braces?

My bottom teeth are severely crowded. One of my bottom teeth are chipping because it’s in the wrong place and grinding on a sharp tooth, my eye tooth is really high up and almost overlapping my tooth next to my left front tooth. I tried to apply for braces through my insurance about 3 years ago while ago (my teeth have changed drastically since then*in a bad way*) **they denied it**. I go through Children’s health insurance program (chip) in Wisconsin, will I be able to apply for braces again? And do I need a referral to go to a orthodontist?? And if I happen to need to pay out of pocket will most dentist require a down payment? I’m 17 by the way!

Thank you!

4 Answers

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  • Zarnev
    Lv 7
    4 weeks ago
    Best Answer

    CHIP is welfare health coverage. As such, they have strict eligibility requirements for braces and will most likely just repair the problem teeth. However, you can have your dentist reapply for coverage since it has been awhile since the last time.

    You may or may not need a referral. That depends on the particular company that is administering your health coverage.

    Source(s): Independent Ägent
  • 1 month ago

    Ask your dentist

  • 1 month ago

    Braces are usually not covered under most dental insurance plans, unless it is "medically necessary." Even then, it might not be covered under Chip or other state Medicaid plans unless it is causing a severe problem.

    Here's an article about what type of orthodontia is covered and not covered in Wisconsin under Chip:

    https://www.forwardhealth.wi.gov/WIPortal/Subsyste...

    So look over that page, and then if you think your problem is really severe, talk to your regular dentist about a referral for orthodontia treatment to fix it, and make sure to point out all the problems and severe pain and other issues you're having due to the improper tooth positioning and not because of some bad habit (like teeth clenching/grinding) but just that it grinds when chewing food or has significant discomfort at rest with jaw closed. And ask if they can vouch for you, to make their chart notes indicate they believe based on their examination, that they feel it is "medically necessary." If you have been denied in the past, let your dentist know and see if they can help, because a lot of times, the insurance adjuster person may have not had the "key words" noted in the reports, or the request, to be able to approve it. Usually most doctors/dentists have to address these issues on behalf of their patients, so may know what to do or can help you.

    If they still won't cover, then check into other discount programs, as there are some that are relatively cheap with huge discounts, but you still would likely have to pay something, but if it is really causing that many problems, it's probably worth it. Good luck.

  • 1 month ago

    i would go see a dentist about all this

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