Medicaid Braces in Utah

Utah Orthodontic Care is the only orthodontic practice in Utah currently accepting Medicaid. We accept Utah Medicaid at all 8 of our locations, and families anywhere in the state are welcome at any office. For children and teens who qualify, Medicaid can cover the cost of braces, and our team handles the Medicaid approval process for you, from the first evaluation through the prior authorization request.

Every first visit is free. You will leave knowing whether your child is likely to qualify, what treatment would involve, and what your options are either way.

Schedule a free Medicaid braces evaluation or call (801) 999-4431.

How Medicaid Coverage for Braces Works in Utah

Utah Medicaid covers orthodontic treatment for patients under 21 when it is medically necessary. Three things determine coverage:

Medical necessity. Utah Medicaid evaluates each case with a scoring tool called the Index of Orthodontic Treatment Need (IOTN). Bite problems, jaw growth issues, and conditions that affect chewing or speech are more likely to qualify than mild cosmetic crowding.

Prior authorization. Medicaid must approve treatment before it begins. We take the required records, complete the paperwork, and submit the request on your behalf.

Age. Coverage is generally available from about age 10 until a patient’s 21st birthday, depending on the stage of tooth development. Comprehensive orthodontic treatment is covered once per lifetime.

The Medicaid Braces Process, Step by Step

1. Free evaluation

Visit any of our 8 offices. We examine your child’s teeth, bite, and jaw development and tell you honestly whether the case is likely to meet Medicaid’s criteria.

2. Records and paperwork

If your child may qualify, we take the X-rays, photos, and measurements Medicaid requires and complete the IOTN score sheet.

3. Prior authorization

We submit the request to Medicaid and keep you updated. Medicaid makes the final coverage decision.

4. Treatment

Once approved, treatment begins at the office you chose, with regular visits to adjust and monitor progress.

If Medicaid Doesn’t Approve Treatment

Not every case qualifies, and we will never promise approval. If Medicaid does not approve treatment, or your child does not have Medicaid, we offer in-house payment plans from $119 per month with $0 down, no interest, and no credit check. We also accept most dental insurance.

Medicaid Braces for Kids and Teens

Many children who qualify for Medicaid coverage benefit from starting care at the right age. We recommend a first evaluation around age 7, even if treatment is years away, so we can monitor growth and time the Medicaid application correctly. Learn more about braces for kids, early treatment, and braces for teens.

Medicaid Accepted at All 8 Locations

Families from every community in Utah are welcome. Our offices are closest to these communities:

  • Layton: Layton, Clearfield, Clinton, Sunset, West Point, and Syracuse
  • North Ogden: North Ogden, Pleasant View, Harrisville, Ogden, Farr West, Plain City, and Marriott-Slaterville
  • Orem: Orem, Vineyard, and Provo
  • Roy: Roy, Riverdale, South Ogden, Washington Terrace, and South Weber
  • Sugarhouse: Sugar House, Salt Lake City, Millcreek, South Salt Lake, and Murray
  • Valley Fair: West Valley City, Taylorsville, and Kearns
  • West Jordan: West Jordan, Kearns, West Valley City, and Magna
  • West Valley City: West Valley City, Taylorsville, Kearns, and Magna

Dr. Aaron Tolman, a board-certified orthodontist at our West Valley and Valley Fair offices, is fluent in Spanish.

Medicaid Braces FAQ

Yes, in many cases. Utah Medicaid can cover braces for children and teens under 21 when orthodontic treatment is medically necessary. Coverage requires prior authorization from Medicaid before treatment begins, and Utah Medicaid covers comprehensive orthodontic treatment once per lifetime.

Utah Orthodontic Care is the only orthodontic practice in Utah currently accepting Medicaid. Families anywhere in Utah can schedule a free Medicaid braces evaluation at any of our 8 offices along the Wasatch Front.

Patients under 21 who are enrolled in Utah Medicaid and whose orthodontic needs meet Medicaid’s medical necessity criteria. Utah Medicaid evaluates each case with a scoring tool called the Index of Orthodontic Treatment Need (IOTN). Cases involving significant bite problems, jaw growth issues, or conditions that affect chewing or speech are more likely to qualify than mild cosmetic crowding.

Utah Medicaid orthodontic coverage is generally available from about age 10 until a patient’s 21st birthday. The exact age range depends on the stage of your child’s tooth development. We recommend a first evaluation around age 7 so we can monitor growth and plan the right time to apply.

It starts with a free evaluation. If your child may qualify, we take the records Medicaid requires, complete the IOTN score sheet, and submit the prior authorization request for you. Medicaid reviews the request and makes the coverage decision. Treatment begins once approval is received.

Not every case meets Medicaid’s criteria, and we will tell you honestly what we see at the evaluation. If treatment is not approved, we offer in-house payment plans from $119 per month with $0 down, no interest, and no credit check, so your child can still get care.

Utah Medicaid orthodontic coverage is for patients under 21. Adults 21 and older can use our interest-free payment plans with $0 down and no credit check. See adult orthodontics for treatment options.

Medicaid approval is for medically necessary orthodontic treatment, and the approved treatment is determined during the prior authorization process. We will explain which treatment options are covered for your child before anything begins.

All 8 locations accept Utah Medicaid: Layton, North Ogden, Orem, Roy, Sugarhouse, Valley Fair, West Jordan, and West Valley City. Families can choose whichever office is most convenient.

Bring your child’s Medicaid card and a photo ID for the parent or guardian. A parent or guardian must attend for patients under 18. No referral from your dentist is needed.

Yes. The first evaluation is free for every patient, whether or not they have Medicaid, and there is no obligation to start treatment.