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For qualified children and teens under 21, the covered services have no member cost-share - including the diagnostic records, traditional fixed metal braces, all adjustments, repairs, removal, and the initial retainers. This page covers exactly what is covered, exactly what is not, and what your options look like if you'd like an upgrade or if pre-authorization is denied. Honest pricing, no surprises.
If your child is under 21, enrolled in DSHP or CHIP, qualifies via the HLD Index or an auto-qualifying condition, and receives pre-authorization, the covered Delaware Medicaid orthodontic services carry no out-of-pocket cost. The free evaluation at Stellar is free either way.
The most common surprise for families isn't a hidden fee - it's the distinction between what Medicaid covers (traditional metal braces) and what counts as an upgrade (Invisalign, clear ceramic braces). We explain the difference in writing at your free evaluation, before any decision is made.
When your child qualifies and pre-authorization is approved, Delaware Medicaid covers the full course of medically necessary fixed orthodontic treatment:
A handful of services fall outside the Medicaid orthodontic benefit. None of them are surprises - we walk through them in writing at your free evaluation.
The four common scenarios where Medicaid coverage doesn't fully apply. Each one is explained in writing at the free evaluation so there are no surprises later.
If the HLD score is below threshold and no auto-qualifying condition applies, the case is technically cosmetic under Medicaid rules. The free evaluation still cost nothing. If you choose to proceed, traditional metal braces typically run $3,000 to $6,500 in Delaware. Monthly financing available.
Even when the case qualifies for covered metal braces, some families prefer Invisalign or clear ceramic braces for aesthetic reasons. The full upgrade fee is private pay because Medicaid does not partially fund upgrades. Most families upgrade only the upper arch to manage cost.
The initial set of retainers at debond is covered. Retainers that are lost, broken, eaten by the family dog, or warped in a school cafeteria napkin are private-pay replacements. Stellar charges a transparent flat rate so the cost is predictable.
If your child loses Medicaid coverage during active treatment, Stellar walks you through the options: recertify, transfer to a private-pay plan with monthly financing, or pause the adjustment cadence until coverage is restored. Original authorization typically covers the case to completion if treatment was already approved.
If you're over 21 and want braces or Invisalign, you're almost always private-pay because the EPSDT benefit only covers patients under 21. Stellar accepts most major dental insurance for adults and offers monthly financing. Adult orthodontics in Delaware.
If multiple children in the same household need treatment, sibling discounts apply to any private-pay portions (upgrades, replacements, or non-qualifying cases). We discuss family financing structure if more than one patient is in active treatment.
Whether you're paying for an upgrade, replacement retainers, or a full case after a denial, we make sure the cost is approachable. Honest pricing, no high-pressure sales.
See our Financing & Insurance page for the full breakdown.
For qualified patients under 21 with pre-authorization approved, the covered services have no member cost-share. That includes diagnostic records, traditional fixed metal braces, all adjustments, repairs, removal, and the initial set of retainers. The free Medicaid evaluation is free regardless.
If denied and you choose to proceed privately, traditional metal braces in Delaware typically run $3,000 to $6,500. Clear ceramic braces typically run $4,000 to $7,500. Stellar offers monthly payment plans, HSA/FSA payments, and sibling discounts. The free evaluation still cost nothing.
Delaware Medicaid covers traditional fixed metal braces only. Invisalign is a full upgrade and the entire Invisalign fee is private-pay; Medicaid does not contribute toward upgrades. Invisalign in Delaware typically runs $3,500 to $7,500 depending on case complexity. Monthly financing available.
The difference between covered metal braces and clear ceramic braces is private-pay. The upgrade fee varies by case and is presented to you in writing before any decision. Many families upgrade only the upper arch to lower the total.
The initial set of retainers at the end of active treatment is covered. Replacements (if lost or broken later) are typically private-pay at a transparent flat rate.
EPSDT coverage ends on the 21st birthday. If your child ages out during active treatment, the case is typically grandfathered to completion under the original authorization. Call as soon as you know the birthday is approaching so we can plan the timeline together.
Adult Medicaid orthodontic coverage in Delaware is very limited and exception-based. Most adults over 21 are not eligible for the routine orthodontic benefit. Call (844) 727-2237 to discuss your specific situation - we'll be honest about whether you qualify and what financing looks like if you don't.
Monthly payment plans, most major dental insurance accepted, HSA and FSA payments, sibling and multi-patient discounts, and a transparent written estimate at the free consultation with no surprise fees.