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Stellar Orthodontics accepts all three Delaware Medicaid managed-care plans - Highmark Health Options, AmeriHealth Caritas Delaware, and Delaware First Health - plus the Delaware Healthy Children Program (CHIP). If your child is under 21 and enrolled in any of these plans, the orthodontic evaluation is free, and medically necessary treatment may be fully covered.
Most private orthodontic practices in Delaware do not accept Medicaid. Stellar Orthodontics does - at every one of our four Delaware offices, with the same standard of care every patient receives.
The largest Diamond State Health Plan in Delaware. Members can see any in-network orthodontist for medically necessary treatment with pre-authorization. Stellar Orthodontics is in-network at all four Delaware offices.
Highmark coverage detailsOne of Delaware's longest-running Medicaid managed-care plans. Orthodontic benefits are available for members under 21 with a qualifying HLD score or auto-qualifying condition. Stellar accepts AmeriHealth Caritas at all four offices.
AmeriHealth Caritas coverage detailsThe newest Delaware Medicaid managed-care plan, operated by Centene since 2023. Members have the same medically necessary orthodontic benefit as the other DSHP plans. Stellar is in-network at all four offices.
Delaware First Health coverage detailsDelaware's CHIP program for children whose families earn slightly too much for traditional Medicaid. DHCP includes the same medically necessary orthodontic benefit. Stellar accepts DHCP at all four offices.
Call about CHIP coverageDelaware Medicaid covers orthodontic treatment that is considered medically necessary - not cosmetic. There are two paths to qualification, and your child only needs to meet one.
Path 1: The HLD Index. Delaware uses the Handicapping Labio-Lingual Deviations Index to score how much a patient's bite is affecting function and oral health. Measurements include overjet, overbite, crowding, crossbites, and missing teeth. A total score of 26 or higher generally qualifies for coverage.
Path 2: Auto-qualifying conditions. Certain conditions automatically qualify for medically necessary coverage regardless of HLD score, including cleft lip or palate, impacted maxillary anterior teeth, severe deep overbite with palatal impingement, severe traumatic deviations, and other developmental conditions.
At your free Medicaid evaluation, our orthodontist completes the HLD scoring and reviews your child's case for auto-qualifying conditions. You leave knowing exactly where you stand.
Not sure if your child qualifies? That's exactly what the free evaluation is for. Or read our full eligibility guide (HLD Index walkthrough + auto-qualifying conditions). Parents may also want our guide to Medicaid braces for kids (EPSDT, age-by-age walkthrough).
We handle the paperwork. Your job is to bring your child in for the evaluation and the appointments.
Call (844) 727-2237 or request a visit online. We confirm your plan, schedule the free evaluation, and tell you what to bring (just the Medicaid card and your child's date of birth).
At the visit, we complete a full orthodontic exam, take digital photos and x-rays, and score the HLD Index. You learn on the spot whether your child meets the qualifying threshold.
If your child qualifies, we submit the complete records package to your managed-care plan electronically. Pre-authorization typically takes two to four weeks.
Once authorized, we schedule the braces placement and begin treatment. No member cost-share for covered services. Same orthodontist every visit.
When your child qualifies and pre-authorization is approved, Delaware Medicaid covers the full course of medically necessary fixed orthodontic treatment:
Delaware Medicaid reimburses for medically necessary fixed braces. If you'd like to upgrade to a more discreet option, the difference is private pay. We'll walk through financing if you go that route.
Same Medicaid acceptance, same standard of care, same paperwork support at every office. Pick the one closest to you.
2304 Concord Pike
Wilmington, DE 19803
Serving Brandywine, Hockessin, Pike Creek, Greenville, Talleyville, Claymont, Bellefonte. Largest Medicaid catchment in the state.
Wilmington Medicaid details818 Kohl Avenue
Middletown, DE 19709
Serving the MOT area - Middletown, Odessa, Townsend, Glasgow, Bear, and the high-growth Medicaid corridor along Route 1.
Middletown Medicaid details125-2 Greentree Drive
Dover, DE 19904
Serving Dover, Camden, Wyoming, Felton, Cheswold, Magnolia, Frederica. Convenient for Dover Air Force Base families.
Dover Medicaid details26670 Centerview Drive, Suite 16
Millsboro, DE 19966
Serving Millsboro, Georgetown, Long Neck, Frankford, Selbyville, Dagsboro, Ocean View. One of the few board-certified orthodontic practices serving Sussex County Medicaid families.
Millsboro Medicaid detailsDr. Can Nguyen is board-certified by the American Board of Orthodontics - a credential held by fewer than one in three U.S. orthodontists. Your child's Medicaid case receives the same clinical rigor as any private-pay case.
Pre-authorization paperwork is the single biggest barrier to Medicaid braces. Our team handles the entire submission - records, photos, HLD documentation - so you don't have to navigate the plan portals yourself.
Four Delaware offices means we can serve Medicaid families from North Wilmington to the Sussex County beaches without asking you to drive across the state.
Yes. Delaware Medicaid (the Diamond State Health Plan and the Delaware Healthy Children Program) covers medically necessary orthodontic treatment for children and teens under 21. Coverage requires a qualifying score on the HLD Index or one of several auto-qualifying conditions, plus pre-authorization from the patient's managed-care plan.
We accept all three Delaware Medicaid managed-care plans: Highmark Health Options, AmeriHealth Caritas Delaware, and Delaware First Health. We also accept the Delaware Healthy Children Program (CHIP).
Schedule a free Medicaid evaluation at any of our four Delaware offices. Our orthodontist will complete the HLD Index assessment and tell you whether your child meets the qualifying threshold. If they do, we handle the pre-authorization paperwork.
If your child qualifies and we receive pre-authorization, there is no member cost-share for the covered orthodontic services. If qualifying records are denied, we will walk through private-pay and financing options before any treatment begins.
The Handicapping Labio-Lingual Deviations Index is the standardized scoring system Delaware Medicaid uses to determine medical necessity. Several measurements (overjet, overbite, anterior crowding, crossbites, missing teeth) are scored and added. A total of 26 or higher generally qualifies, along with auto-qualifying conditions like cleft palate or impacted anterior teeth.
Generally no. Delaware Medicaid covers traditional fixed appliances (metal braces) for medically necessary cases. Clear aligners and ceramic braces are an upgrade option and require private payment or financing.
Yes, as long as they are under 21 and enrolled in DSHP or CHIP. EPSDT (Early and Periodic Screening, Diagnostic and Treatment) coverage runs through age 20.
Adult orthodontic coverage under Delaware Medicaid is very limited and exception-based. If you are over 21, please call us. We will be honest about whether your situation qualifies, and if not, we will walk through affordable private-pay options.
Typically two to four weeks once records are submitted. We submit complete photos, x-rays, and HLD documentation electronically to your managed-care plan.
Yes. We accept Medicaid transfer cases. Bring your previous records and we will coordinate continuation of treatment with your managed-care plan.
Not always, but it helps. Many Delaware Medicaid plans accept a self-referral for orthodontic evaluation. We can confirm requirements with your specific plan when you call.
We have four Delaware locations: North Wilmington (2304 Concord Pike), Middletown (818 Kohl Avenue), West Dover (125-2 Greentree Drive), and Millsboro (26670 Centerview Drive). All four accept Medicaid. See all locations for hours and directions.