Does ARKids cover braces? We see a lot of parents in Arkansas who often ask this very question as their children need orthodontic treatment. Understanding insurance coverage through ARKids is crucial. ARKids, designed for children in Arkansas, may cover certain orthodontic services, including braces. This article explores the specifics of ARKids coverage, the orthodontic services potentially included, and addresses common queries, enabling informed decisions regarding your child’s orthodontic care.

Understanding ARKids Coverage

The ARKids First program offers essential health insurance to children from low to moderate-income families in Arkansas, covering various medical services, including orthodontic care when medically necessary. Knowing the details of ARKids coverage is vital. Eligibility typically involves meeting criteria like age, income requirements, and treatment necessity as assessed by a licensed orthodontist. While ARKids strives to offer comprehensive care, it may not cover all orthodontic treatments. Navigating the coverage specifics ensures children receive quality orthodontic care.

Applying for ARKids coverage involves a straightforward process. Families can submit an online application or visit their local Department of Human Services office. Preparing necessary documentation ahead of time can expedite the process. Once enrolled, understanding your coverage specifics can help maximize benefits and ensure quality orthodontic care.

Orthodontic Services Covered by ARKids

Parents need clarity on what ARKids covers regarding orthodontic care. When considering if ARKids covers braces, it’s important to know ARKids typically provides coverage for various types of braces, ensuring effective treatment for children. Traditional metal braces, known for their durability, are generally covered.

Besides braces, ARKids covers essential orthodontic treatments like retainers and expanders. Retainers maintain results achieved after braces, while expanders create more space in the mouth for better alignment. These treatments are crucial for a successful orthodontic journey. However, coverage may have limitations and conditions, such as eligibility criteria or prior authorization requirements. Understanding these details helps maximize benefits and ensure comprehensive care.

What to Expect at Westrock Orthodontics

When your child becomes a patient at one of our Westrock Orthodontics clinics in Arkansas, you can count on us to work diligently to make things as smooth as possible. We understand that dealing with Medicaid programs and ARKids can be daunting, so here is a breakdown of the process so you can plan better. 

What the patient needs to come prepared:

• Active Medicaid status
• Dental Cleaning in the last 6 months
• Completion of any pending dental work
• An ARKids ID, which you can apply for at the Arkansas Department of Human Services website.

What happens at your first visit:

• We will review your dental records and any imaging, x-rays or digital scans
• The patient is then scored based on the guidelines set by Arkansas to determine if the patient records can be sent to the state for further review
• If the patient meets the requirements, we will send off the records to the state
• In about 2 weeks, we will receive a response from the state with an approval or denial for treatment

Frequently Asked Questions about ARKids and Braces

ARKids does offer coverage for orthodontic treatment, including braces, under certain circumstances, typically when medically necessary. Consulting with your orthodontist and ARKids caseworker helps clarify eligibility criteria and ensure your child’s needs are met.

Should braces be deemed necessary, the first step is a comprehensive orthodontic evaluation to outline the need for braces and associated costs. Your orthodontist can assist in submitting the required documentation to ARKids for approval, ensuring you understand what to expect financially and facilitating a smoother treatment journey.

If ARKids denies coverage, review the denial letter carefully to understand the reasoning. You have the right to appeal, supported by documents like your orthodontist’s recommendation and relevant medical records. Assistance is available to ensure your child receives essential orthodontic care without unnecessary delays.