Impacted By SmileDirectClub Closing?
Medicaid is a form of government-funded health care coverage available to low-income families and individuals residing in Illinois. Illinois has two Medicaid programs specifically for children, All Kids and Family Care.
All Kids insurance provides health care to children of low-income families, while Family Care provides coverage for children and their parents. Each of these programs includes dental care for kids and might assists in paying for orthodontic treatment (braces, Clear Aligners, surgical orthodontics). The dental program is administered by DentaQuest of Illinois.
Who can qualify for Public Aid/ All Kids orthodontic benefits?
Low income families in Cook County (Chicago, Arlington Heights, Mount Prospect, Des Plaines, Wheeling, Prospect Heights, Elk Grove, Rolling Meadows, Palatine, Schaumburg, Niles, Skokie, Glenview, Evanston, Wheeling, Park Ridge), Lake county (Buffalo Grove, Northbrook, Deerfield, Lake Zurich, Mundelein, Waukegan, Gurnee, Round Lake, Grayslake, Libertyville, Highland Park), DuPage county (Aurora, Barlette, Carol Stream, Wood Dale, Addison, Roselle, Bloomingdale), McHenry county (Woodstock, McHenry, Crystal Lake), Kane county (Elgin, Algonquin, Dundee, Cary), Boone county (Belvidere), Winnebago county (Rockford, Rockton, Loves Park), DeKalb county (DeKalb, Sycamore), Lee county (Dixon, Sterling), Will county (Joliet, Bolingbrook, Tinley Park), Kendall county (Oswego) and other counties, can qualify for orthodontic coverage under All Kids (Medicaid) program.
My child has All Kids coverage. Does it mean that he/she automatically qualifies for orthodontic treatment with braces?
No. Not all kids covered under the state insurance program qualify for orthodontic treatment coverage. Illinois Medicaid (All Kids, Medical Card) administrators must pre-approve all patients for braces before an orthodontist can start treatment. Only children with a Modified Salzmann Index score of 42 or higher will qualify for orthodontic treatment. Orthodontists use this Index to indicate the severity of a patient’s need for braces. However, all covered children younger than age 20 qualify to be considered for assistance in getting braces. Therefore if your son or daughter has Public Aid coverage he or she might be a candidate for covered orthodontic treatment.
Are all types of orthodontic treatment covered by Public Aid (Medicaid, Medical Card)
No. Only comprehensive (Phase II) orthodontic treatment (braces) can be covered by All Kids insurance. Early or interceptive treatment such as growth modification, palatal (upper jaw) expansion and multiple other fixed and/or removable orthodontic appliances are not covered by Public Aid. Therefore, you child must have all permanent teeth to be considered for All kids orthodontic coverage. If your child requires early (interceptive) treatment or a fixed or removable orthodontic appliance other than braces, you will be responsible for the cost of treatment. If your son or daughter still require braces after interceptive treatment, the pre-approval can be submitted to Medicaid administrators (DentaQuest) one all the primary (baby) teeth have been lost.
How do I know if my child qualifies for orthodontic treatment?
To find out if your child will be covered for orthodontic treatment, you must first come to our orthodontic office for an initial orthodontic consultation. At the complimentary consultation, our orthodontist will evaluate your child and will let you know if he/she qualifies to have the records (photographs, models of teeth, X-ray images) submitted for pre-approval to Public Aid office. If he/she does qualify, then we will take the necessary orthodontic records and will submit them to the Public Aid administrators (DentaQuest).
There is no charge to you for initial orthodontic consultation and necessary records. Once an orthodontic case is submitted for pre-approval, it normally takes 3-4 weeks for the case to be evaluated by the All Kids (Public Aid, KidCare, Medicaid) administrator. Our staff at Orthodontic Experts will contact you as soon as we receive the decision from All Kids. The decision will either be approved or denied.
What if my child is approved for All Kids orthodontic coverage?
If your child is approved for braces treatment, we will schedule you to come back to our orthodontic office for complete records. At this appointment all necessary X-rays, photographs, models, and measurements will be taken and our orthodontist will discuss your child’s treatment plan. After this appointment we can proceed with your child orthodontic treatment.
What if my child does not qualify for braces through All Kids (Medical Card) program?
If your child does not qualify for orthodontic treatment through All Kids program, you will get a letter from the All Kids administrators stating that the treatment was denied. Unfortunately, the case can only be submitted once in a lifetime, therefore previously denied cases cannot be re-submitted.
However, at Orthodontic Experts we believe that every child deserves a beautiful, confident smile, so we will work with you to help you establish a financial arrangement that will work for your family’s budget. We understand that your child’s future is very important to you and we will try to do everything possible to help you provide your child with a beautiful and healthy smile for a lifetime. We have multiple payment plans and options that could be customized to your budget.
Illinois Medicaid Managed Care Plans
We accept the following Illinois managed care plans:
- Harmony Health Plan
- Meridian Health Plan
- Family Health Network
- Cook County IlliniCare Health Plan
- Blue Cross Blue Shield of Illinois
- Cigna Health Spring of Illinois
- Community Care Alliance if Illinois (CCAI)
- Aetna Better Health
- DuPage, Kane, Kankakee, Lake, and Will Counties: Aetna Better Health and IlliniCare
- Boone, McHenery, and Winnebago Counties: Aetna, Community Care Alliance of Illinois (CCAIO)
- Rock Island and Mercer Counties: IlliniCare
- Illinois Medicaid
- All Kids
For more detailed information about orthodontic coverage by All Kids insurance visit our
Illinois Public Aid Braces website.
Visit one of our orthodontic office for a complimentary consultation and get the beautiful
smile that you deserve!
-Your Chicagoland Orthodontists and team-