Free Medicaid braces evaluations for Delaware children and teens under 21
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Medicaid Braces for Delaware Kids

Medicaid braces for kids and teens in Delaware: free evaluation, pre-auth handled.

If your child is under 21 and enrolled in Delaware Medicaid - Highmark Health Options, AmeriHealth Caritas Delaware, Delaware First Health, or the Delaware Healthy Children Program (CHIP) - they may qualify for fully covered orthodontic treatment under the federal EPSDT benefit. Stellar Orthodontics gives every child a free Medicaid evaluation and handles the pre-authorization paperwork.

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EPSDT in plain English

The federal Medicaid benefit that covers your kid's orthodontic care.

EPSDT - Early and Periodic Screening, Diagnostic and Treatment - is the part of federal Medicaid law that requires states to cover all medically necessary services for children and teens under 21. In Delaware, that includes orthodontic treatment when a case meets the state's medical-necessity criteria.

EPSDT is what makes Medicaid braces possible. It's also why coverage ends at the 21st birthday: the same benefit doesn't extend to adults. For families with kids approaching the cutoff, that's a real timing consideration - a 19-year-old who qualifies and starts treatment can complete a typical 18-to-24 month case while still under EPSDT.

  • Federal benefit. Same baseline rules in every state.
  • Covers medically necessary orthodontic care for under-21 patients
  • Delaware implements it through DSHP and CHIP managed-care plans
  • Coverage ends at the 21st birthday

Quick eligibility check for kids

  • Patient is under 21 years old
  • Enrolled in DSHP (Highmark, AmeriHealth Caritas, or Delaware First Health) or CHIP
  • HLD Index score of 26+ or an auto-qualifying condition (cleft palate, impacted anterior teeth, severe deep overbite, severe crossbite, severe traumatic deviation)
  • Pre-authorization approved by the managed-care plan

Want the deeper breakdown? See our full eligibility guide with HLD Index walkthrough.

Call (844) 727-2237
By age

When to bring your child in, by age.

Not every age needs treatment. But every age can benefit from a check-up - especially because the Medicaid evaluation is free at Stellar regardless of whether your child ends up qualifying for treatment.

Ages 7–10 (early evaluation)

The American Association of Orthodontists recommends a first orthodontic check by age 7. At this age most kids have a mix of baby and permanent teeth, and a Stellar orthodontist can spot bite, growth, or eruption issues before they become bigger problems.

What Medicaid covers at this age: Phase 1 treatment when there's a medically necessary reason - severe crossbite, severe overbite with impingement, or impacted teeth. Routine "watch and wait" monitoring is not a Medicaid-billable service, but Stellar's evaluation is free.

Ages 11–14 (the main braces window)

The most common braces age. Most permanent teeth are in place by 12, and many comprehensive cases start here. Patients often finish treatment in time for high school photos and senior year events.

What Medicaid covers: The full comprehensive braces benefit, assuming HLD criteria or an auto-qualifying condition. Traditional metal braces are the covered modality. Color elastics swap every visit - most kids look forward to it.

Ages 15–20 (last chance before EPSDT ends)

Older teens often face a coverage timeline pressure: the EPSDT benefit ends on the 21st birthday. Cases that qualify can still start treatment in the late teen years and complete within the coverage window.

What Medicaid covers: Same comprehensive benefit as 11–14, with the cutoff at 21. If your teen is 19 or 20, call us promptly - treatment timing matters for completing the case within the covered window.

What kids actually get

What pediatric Medicaid braces look like at Stellar.

Modern braces are nothing like the braces from a generation ago. The brackets are about half the size, the wires use heat-activated alloys that move teeth more gently, and the visit cadence is shorter. Kids tend to be less anxious than their parents expect.

  • Traditional metal braces. The covered modality. Smaller, lighter, gentler than what most parents remember.
  • Color elastics every visit. Kids choose new colors at each adjustment. School color combos, holiday themes, favorite sports teams.
  • Adjustment visits every 6 to 8 weeks. About 30 minutes per visit. Same orthodontist every time.
  • Sports mouthguard custom-fit to the braces. Your kid doesn't sit out of football, soccer, lacrosse, or anything else.
  • Treatment timeline: 18 to 24 months for most kids. Some longer, some shorter, depending on case complexity.
  • Retainers included. After braces come off, custom retainers protect the new smile long-term.
Young patient at Stellar Orthodontics receiving Medicaid pediatric orthodontic care in Delaware
How it works

From the first phone call to braces day, step by step.

1. Free evaluation

Call (844) 727-2237 with your child's Medicaid info. We book the free evaluation at the closest of our four Delaware offices. About 60 minutes, no cost.

2. HLD scoring

Our orthodontist completes the full exam and scores the HLD Index. You learn whether your child qualifies before leaving the office.

3. Pre-authorization

If your child qualifies, we submit the complete records package to your managed-care plan electronically. Approval typically takes 2 to 4 weeks.

4. Braces day

A 60 to 90 minute appointment to bond the brackets and place the first wire. No injections, no drilling, no pain. Most kids walk out smiling.

For Parents

What parents of Medicaid braces kids actually want to know.

Can my child get braces on Delaware Medicaid?

Yes, if your child is under 21, enrolled in DSHP (Highmark Health Options, AmeriHealth Caritas Delaware, or Delaware First Health) or CHIP, and meets medical-necessity criteria via the HLD Index or an auto-qualifying condition. The EPSDT benefit covers medically necessary orthodontic care for kids and teens under 21.

What age should my child first see an orthodontist on Medicaid?

The American Association of Orthodontists recommends a check by age 7. Most kids won't need braces that early, but a check-up lets us spot bite or growth concerns while early intervention is still simple. Stellar's evaluation is free.

What is EPSDT?

Early and Periodic Screening, Diagnostic and Treatment is the federal Medicaid benefit for children and teens under 21. It requires state Medicaid programs to cover all medically necessary services. Medically necessary orthodontic treatment qualifies in Delaware.

Does Medicaid cover Phase 1 (early) treatment?

If a Phase 1 case meets Delaware Medicaid's medical-necessity criteria, yes. Cases involving severe crossbite, severe deep overbite with palatal impingement, or impacted teeth typically qualify. Pure growth-monitoring is not a Medicaid-billable service, but it's free at Stellar.

What treatments are covered for Medicaid kids in Delaware?

Traditional fixed metal braces, all diagnostic records, scheduled adjustments, repairs during treatment, removal, and initial retainers. Clear ceramic braces and Invisalign are upgrades requiring private payment. Limited-scope Phase 1 appliances are covered when medically necessary.

Will my kid hate going to the orthodontist?

Most kids surprise their parents. Modern braces are dramatically smaller and gentler than they were a generation ago. Color elastic swaps at each visit are usually the favorite part. Our team is trained to make children comfortable from the first appointment.

What if my child loses Medicaid coverage mid-treatment?

Call us as soon as you know. Stellar walks you through the options - recertifying coverage, switching to a private-pay plan with monthly financing, or adjusting the appointment cadence while you sort out coverage. We will not abandon a child mid-treatment.

Can my teen on Medicaid still play sports with braces?

Yes. We fit a custom orthodontic mouthguard for any Stellar braces patient who plays contact sports. The mouthguard protects the teeth and the appliances. Wind instruments, dance, cheer, and theater all work fine with braces.

Find your closest office

Free Medicaid braces evaluations at all four Stellar locations.

Free Medicaid evaluation for your kid - we handle the paperwork.

Call (844) 727-2237 to schedule. Bring your child's Medicaid card and date of birth. The evaluation takes about 60 minutes and you leave knowing whether your child qualifies.

Call (844) 727-2237
Free Kids Medicaid Evaluation: (844) 727-2237