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Does Medi-Cal (Denti-Cal) cover braces?

hayashsm

Yes, but only in certain circumstances. The Medi-Cal Dental (Denti-Cal) program expanded it's benefits to include orthodontic care almost 30 years ago. Orthodontic benefits are only to age 21 and are only provided for the following medically necessary conditions:

- Handicapping Malocclusion

-Cleft Palate/Lip

-Craniofacial Anomalies

To find out if one of these medically necessary conditions applies to you, first you must find a provider

2) The orthodontist will then perform an oral exam to determine if the patient has a condition or combination of conditions that meet the criteria to warrant authorization of orthodontic treatment

3) If a patient appears to meet the criteria, the orthodontist office staff must take impressions (molds) and mail them to Denti-Cal to obtain approval. They may also take x-rays and/or photos to submit.

4) Once the orthodontic office receives authorization to perform treatment, the braces (or other appliance) can be placed!


Examples of conditions that are considered medically necessary:


-Deep impinging overbite






-Severely excessive overjet











-Anterior crossbite


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