Jersey Care - do they cover braces?

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Forum -> Children's Health

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amother

Ivory

Tue, Dec 11 2018, 10:21 pm

My orthodontist told me that they are required to try to get coverage with Jersey Care before starting treatment. I just got a letter that coverage was denied due to "incomplete information". I am wondering if it is worth figuring out what they are missing and getting it to them or if it would just be a waste of time. Do they give coverage for "regular issues" - like aligning teeth, maybe correcting a bit of a crossbite?

If you got coverage with them - was it for some kind of more major issue?

TIA!!

oneofakind

Tue, Dec 18 2018, 4:17 pm

for sure give them the information and get them to cover. my medicaid nieces and nephews got braces, my kids with regular insurance didn't.

esther36

Tue, Dec 18 2018, 7:00 pm

Not true! My kids r on Jersey Care and my daughter was denied coverage too. Im paying almost 6,000 dollars out of pocket. It's extremely hard to get Jersey Care to cover braces.

amother

Purple

Tue, Dec 18 2018, 7:21 pm

My orthodontist told me it's very unusual to be approved for braces by Jersey care, even though my child's teeth are very bad he didn't think it was worth trying.

Mommyg8

Tue, Dec 18 2018, 7:26 pm

oneofakind wrote:

for sure give them the information and get them to cover. my medicaid nieces and nephews got braces, my kids with regular insurance didn't.

Medicaid (New York) covers more than Jersey care.

amother

Teal

Tue, Dec 18 2018, 7:33 pm

Is Jersey Care the equivalent to Child Health Plus?
My kids are on CHIP. One child with terrible orthodontic issues was denied coverage for an oral appliance needed before we are even starting braces.

As far as I know, only Medicaid will ever pay for braces. No other insurance will cover it.
If I'm mistaken, feel free to correct me.

Mommyg8

Tue, Dec 18 2018, 7:43 pm

amother wrote:

My dh's insurance covers about half the cost. But you have to really chase them for the money.

amother

Natural

Tue, Dec 18 2018, 9:06 pm

Two of my children had braces fully covered by Jersey Care. Definitely make sure they have all the information needed. If there's a possibility you may get coverage, its worth a try.

amother

Purple

Tue, Dec 18 2018, 9:10 pm

amother wrote:

Two of my children had braces fully covered by Jersey Care. Definitely make sure they have all the information needed. If there's a possibility you may get coverage, its worth a try.

How recently was this? I was told they stop covering braces a few years ago.

esther36

Tue, Dec 18 2018, 11:04 pm

I got denied last June and the orthodontist office told me its extremely rare to get covered by Jersey Care even with a real reason for needing braces...

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