New benefit helps teens and young adults smile with confidence

For teens and young adults, the need to fit in with others is important. Orthodontic care can go a long way in supporting a young person’s self-esteem. That's why we are excited to announce a new grant to help our
youth that did not meet medical necessity for orthodontics.  

How to qualify

• Youth must be currently enrolled in YouthCare HealthChoice Illinois.
• Orthodontic services must have been recommended by the youth’s orthodontist.
• Request for orthodontic services must have been submitted to a Medicaid dental plan within the last six months and have been denied based on medical necessity criteria. 
• Orthodontics cannot be covered already by Department of Child and Family Services (DCFS), or currently in the appeal process, state fair hearing, or other avenues of payment.

Required Documents

• Youth’s Medicaid ID number
• Copy of Adverse Benefit Determination (denial) stating that requested services are not medically necessary and the date of denial for orthodontia services
• Copy of cost estimate and payment terms from a Medicaid orthodontia provider
• Optional: Submit letter from behavioral health therapist 

Please compile all required documentation listed above and email YouthCare’s Rapid Response Team on behalf of eligible youth. Requests will not be considered unless all required documents are submitted together with the request. Incomplete applications will not be considered or held for future review.

Application review

YouthCare’s team will review applications every 60 days for as long as the grant has funds. If a member does not qualify for the grant, YouthCare will route the requests to begin the process through Medicaid.

For additional questions, please contact the member’s care coordinator or Member Services at 844-289-2264 (TTY: 711), Monday through Friday, 8 a.m. to 6 p.m. or ilyouthcare@centene.com.