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What Parents Need to Know about Affording Braces for a Child with Autism in Connecticut

Updated on February 19, 2014
 Creative Commons Attribution-Share Alike 3.0 Unported
Creative Commons Attribution-Share Alike 3.0 Unported | Source

Introduction.

During the past three weeks, in between snow, snow days, and winter illnesses, I have been genuinely straight-out busy.

Many people think that if they don't hear from me for a while, I'm possibly missing in action. But truth be known, I'm a researcher at heart. And the more people my research can help, the digger I deep.

I like to uncover the most hidden information that the public may otherwise never know.

If you are the parent of a child in Connecticut, and your child is on state insurance, I have some amazing news to share with you. There is financial help available to children who need braces.

Specifically, I am writing this for parents of children with Autism, but it applies to everyone who may be in need.

Background information.

Having had a really straight set of teeth most of my life, I never had to worry about orthodontics or braces.

But now having a child with Autism that also has excessive teeth crowding, I've been on a journey that has brought me to writing this article. It all started last spring 2013.

I went for a routine dental examine with my son where we go to his regular dentist every six months. My son's eye teeth seemed to be growing in behind teeth that were already there. I thought the dentist would just pull out the extra teeth. Because I've never been through this, I wasn't expecting involvement of specialists.

Within a few moments after looking at the teeth in concern, the dentist informed me that I would have to call an orthodontist. They referred me to a local orthodontist in the area. The dentist also has a child with Autism and assured me the orthodontist would be great with my son.

Anyone with a child with Autism knows the struggles and challenges in taking the child anywhere. Time countdowns to help transition the child from one activity to another. Informing the child's school that they will be out a portion of the day because they need specialist care. Packing a bottle of water and a healthy snack for the car ride. Making sure that there is a goody bag for your child so he or she doesn't become bored and suddenly start kicking up the back seat. Yes, these are the issues parents face daily, never mind the extra time and caution it takes to drive your child to an appointment.

We were ready. Teddy bear in hand. Coloring books and crayons for the waiting room. Snack pack for the car ride. Wet wipes for his hands. Mom's medical reports all categorized by date and in order by doctor. Off we went.

The office building was conveniently located right off the highway with a short two left turns. We rode the elevator and appeared on time for the appointment.

Of course we weren't expecting the giant fish tanks in the first part of the office suite, or the free snacks available to patients. My son grabbing for everything in site, touching and fingerprinting the fish tank to his heart's content. I finally convinced him that the toys in the basket to the right corner were much more fun to play with.

An assistant appeared and asked to take him back to an x-ray room alone at first, then she would call me to a room.

In the next office, my son waited for me, spinning around in the rolling chair and laughing happily excited to hear that he needs braces.

When the moment of truth was told, the braces would cost $5,000, and a co-pay of $2,500 was expected up front before any treatment began.

I felt crushed by the weight of the growing and mounting medical debt we already accrued for my son's specialist care.

Dealing with disappointment.

My son jumped up and down at the exciting news anticipating the opportunity to have braces! He didn't really know what braces are because no one else in the family has them. It was just the point that he would be getting something that really made him feel special. But with the news about the cost of braces, I had to break the disappointing news to him that braces weren't free. There was just no way we could come up with $2,500 any time soon, never mind the latter half of the expensive costs.

When the orthodontist left the room to give me time to think about it, I started asking the assistant some basic questions.

  • What types of insurance do you take?
  • Do you have a payment plan?
  • Does insurance pay any of it?

To which the assistant responded that my child is my responsibility and braces are not free. She went on to tell me that I should seriously think about placing his priorities first so he can get the braces he needs.

Offended and deeply troubled, of course this woman did not know our situation, but how dare she imply I didn't put my son's needs first? In fact, how dare she say that with a straight face while trying to charge me $5,000 for which they didn't accept insurance?

Don't lose hope!  There is always a second choice for your child.
Don't lose hope! There is always a second choice for your child. | Source

All hope is not lost.

With the estimate for the orthodontic treatments, I was handed a brochure. It was from the Smile for a Lifetime Foundation.

It's my understanding that Smile for a Lifetime Foundation operates in 33 states around the United States. They sponsor orthodontic care to children through pro-bono orthodontists.

To apply, one must do the following:

  • Fill out an application
  • Provide two letters of recommendation
  • Send in a 5.x7 color photograph of the child's face, with a smile and teeth clearly visible

Because there are more than 80 chapters of this organization, the requirements may differ from one orthodontist to the next. For example, a quick search online for Smile for a Lifetime Foundation uncovered one chapter that requires the child to perform a certain number of community service hours to pay forward the opportunity they received through this program.

There is also a set of qualifications a child must first meet in order to apply:

  • Must be a resident of a certain area
  • Must be under the age of 18
  • Must have income limitations or demonstrate financial need
  • Must have a significant aesthetic need for braces.

Again, these may vary depending on the orthodontist.

Grateful yet troubled by this news.

My curiosity got the best of me because there are two things in life that I do not tolerate well.

  1. Being told it's not possible.
  2. Being told there is nothing else available.

When I'm told that something is either not possible or I don't have a choice in the matter, I always prove them to be wrong.

I don't want to be told it's impossible. Life is about opportunity. It saddens me when people are limited not by their own abilities, but because someone else says so.

Well, I challenged this idea that there is nothing else available to children besides their parents facing hardship by shelling out $5,000 for braces. After all, what if the parents have more than one child that needs braces?

Believe this. You always have a choice!

I've always believed in the idea that we all have more than a choice at any given time. There may be challenges and obstacles in our path. It's up to us to choose to move over that and keep going.

That attitude guided me on a three-week long research project which led me here. I did have some detours and road blocks to accomplish what I set out to do, but with a little perseverance I found the answer.

Connecticut is generous toward children with special needs. There is a hidden gem for parents that are struggling, especially when medical bills are out of the reach of many families that have children with Autism. When a child has Autism in Connecticut, and normally a family would not qualify for state insurance for the child because of income limitations, there is an exception for when a child's medical bills are grossly in excess over those of other children who do not require as much specialized care.

I am not an expert on state insurance by any means. There are offices around the State of Connecticut that can help parents get started. For example, many divorced parents may be eligible for state insurance for a child with special needs even when they do not feel they meet the income qualifications. So, when parents find themselves in a hardship to provide braces for a child with Autism, Connecticut offers a possible opportunity.

I spoke to the experts personally and am going to sum it up here for you in this article.

Source

Connecticut offers hope to families with state insurance.

This pertains to all families in Connecticut on state insurance, but I want to discuss different circumstances here:

  1. If your family already receives state health insurance for your children and you find out your child needs braces, your child may be 100% covered under state insurance.
  2. If your family has a child with Autism and you have private insurance, you may be eligible for state insurance based on your child's health needs. If you haven't done so already, contact your local state insurance office to see if you would qualify based on income and other needs of the child.
  3. If your family has a child with Autism and you already have state insurance, your child may qualify for free braces.

State insurance covers 100% of the cost of braces when an orthodontist scores the child's teeth 24 points or higher. That score demonstrates a severe need for braces.

I had no idea that there is financial help available for braces in certain circumstances.

How to qualify for braces through state insurance.

One would think that it would be fairly easy to access dental offices throughout Connecticut. But when you are working with an office that accepts state insurance, finding an available one can become tricky.

The first place to start if you have state insurance already is to call 1-855-CT Dental or 1-855-283-36825.

If you don't have state insurance at this time, the customer service representatives that operate that phone number will be able to transfer you or assist you upon your call.

The customer service representatives are going to give you the names of dentists in your local area that accept state insurance. Have paper and a pen ready to write down the information.

By this time, you either know or don't know whether your child needs braces. You may have possibly been referred to an orthodontist previously, but that orthodontist doesn't accept state insurance. Therefore, if your child is special needs or your family receives state insurance, help may be available. It's just a matter of finding an orthodontist that accepts state insurance. The evaluation will determine whether or not your child qualifies based on the severity of the teeth.

Dentists that do not accept state insurance most likely will not know any orthodontists that accept state insurance. Therefore, start calling the dentist offices that accept state insurance. When I was doing this research, the first dentist was helpful. I didn't have to call anywhere else. (If your child is already seeing a dentist that accepts state insurance, but the issue of braces has never come up, simply ask at your child's next appointment if an orthodontic evaluation is necessary to determine if your child qualifies for braces covered by state insurance.)

While on the phone with the dentist that accepts state insurance, ask how your child may receive an evaluation by an orthodontist to determine if they are qualified for braces through state insurance.

The dentist office will give you the names of orthodontists in your area that accept state insurance.

There are not as many orthodontists that accept state insurance as there are that accept private insurance. Finding one can be tricky. As I found out through researching this topic, many orthodontists that accept state insurance are not taking new patients. So finding one locally and close to you may be challenging. You may need to find someone outside of your local area. But do not lose hope. They are out there.

In fact, I wanted to see how difficult it would be to find an orthodontist that accepts state insurance. I started calling dentists that advertise that they accept state insurance. Once I found dentists that accept state insurance, they gave me the numbers to area orthodontists that accept state insurance as well. It really was just a matter of finding dentists that take the insurance and they helped me locate the orthodontists.

When you get the numbers to orthodontists that accept state insurance, make an appointment.

At the appointment, the orthodontist will conduct an evaluation. A number system scores the child's teeth. If the child's teeth score above 24 points, the child will qualify for braces and state insurance will cover 100%. If the child's teeth score less than 24 points, then the need isn't severe enough for state insurance to cover.

What does this mean?

The state insurance program is not all-inclusive when it comes to braces. Your child's teeth must qualify for them.

But it's all or nothing. The state insurance program will not pick up a partial expense. They either pay 100% or they don't. And it's all based on this score that the orthodontist places on the severity of your child's teeth needs during the evaluation.

This information was obtained directly from various sources including Connecticut state insurance and several local dentist offices. It is subject to change. Please call and find out what your insurance covers before agreeing to out-of-pocket costs for your child's braces.

Qualification
Your child may qualify under Connecticut state insurance for 100% coverage of braces.
The qualification is determined by teeth severity, a number system used by orthodontists.
Qualification for braces is not determined by income, but rather the severity of the child's need for braces.
To determine if your child qualifies for state insurance, contact your local state insurance office. Children with medical bills in excess of what most children need often qualify for state insurance even when the household income is above the thres

Other Options.

There is a credit card called Care Credit. Ironically, I found out about this because I rescued a dog to train as a therapy dog for my son with Autism. At the first vet appointment, I was introduced to a Care Credit credit card application. Care Credit is not a major credit card such as Visa or Mastercard. However, it is often accepted at dentists, orthodontists, and animal vet offices.

While I'm not advocating for parents to go deeper in debt, Care Credit may be able to supply a line of credit to help pay for the braces if cash isn't available up front.

I also learned through my interviews of certain offices, that some orthodontists will accept payment arrangements. Some require half or all up-front before treatment begins.

So, if all else fails and state insurance will not approve your child for braces, there are still options out there although costly.

Summary
If you already have state insurance for your child, call and find dentists that accept it.
If you do not have state insurance, call your local state insurance office to find out if your child qualifies based on medical needs.
Once you have the numbers for dentists that accept state insurance, call and ask for the names and numbers of local orthodontists.
Make an appointment with an orthodontist that accepts state insurance for your child to have an evaluation for pre-qualification of braces.
If your child does not score high enough for state insurance to cover the cost of braces, there is financial assistance available such as payment plans, Care Credit Credit Card, or Smile for a Lifetime Foundation.

Did you know that financial help may be available for braces through state insurance?

See results

Conclusion.

The point of this writing this article is to help inform people in the State of Connecticut that otherwise had no idea that help may be available for their child.

I was personally not informed of this information when I sought help for my son's dental needs.

I hope someone out there can benefit from this knowledge and use it to get the help for their child that they otherwise would not pursue due to high costs.

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    • CraftytotheCore profile image
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      CraftytotheCore 3 years ago

      Wow Kidscrafts. The more I hear about the stupid tactics that medical offices are pulling, the more I feel it's time for change. They want you to buy a booklet that costs $250 in case you would be late? That seems unreal to me like it should be illegal. I have no idea why this is allowed to go on. Thanks so much for stopping by.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Linda! Oh I'm so glad you stopped by. It's a funny thing. It's very difficult to find resources in Connecticut. We have Yale, but that's on the other side of the state from where I live. I've been talking to people from all over the country recently and have learned that many states are way ahead of us and have so much to offer children with Autism.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Sha! Thanks for asking. I went to the new orthodontist a few weeks ago. This is where it gets interesting. My son has had the same dentist since birth. It's a local dentist that my whole family uses. How this all came about, was that my son has Autism and sensory issues. So he gets really afraid of losing his baby teeth. He has trouble pulling them out on his own. In a prior appointment, my son had a loose baby tooth and the dentist pulled it out. It wasn't a big deal. So then six months later, my son had additional baby teeth that were loose. I asked the dentist at that second check-up if they'd pull the loose teeth again. She sent me to this orthodontist that wanted a crazy amount of money. She wouldn't take out the teeth. The ortho said he wouldn't advise taking out the teeth.

      So then I go to this new ortho, he examines my son and says that the teeth need to come out. They are baby teeth that are already loose. He sent a letter to the dentist saying that the first ortho was wrong. The teeth need to come out because the adult teeth are already in and are coming in behind the baby teeth. The dentist office called and left a message saying they'd schedule an appointment to pull the teeth. But when I called back, they couldn't find the ortho's letter about the teeth.

      I got fed up at that point and found a pediatric dentist that will see my son this month. So we're still dealing with this. But also, I found out that the point system is only valid on adult teeth. So at this time, my son only scored a 10. He needs over 20 points in order for the state insurance to pay for the braces. But the second ortho says he would never charge $5,000 and he accepts payment plans. So that's good news anyway.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Mel! I haven't been around much because my son has been having a lot of medical issues. We've been traveling back and forth to Yale New Haven to have him checked out by specialists. It's been an exhausting time for us. Thank you for stopping by and saying hello. I really appreciate it. I went to the new orthodontist recently and he was very surprised that the other place wanted so much money up front too.

    • kidscrafts profile image

      kidscrafts 3 years ago from Ottawa, Canada

      Great information that will help others, I am sure!

      The reaction of the orthodontist's assistant was to make your feel guilty and nothing else. You should not take that personnaly because she probably says the same thing to each person who might say something about the price of the braces. I remember that when I went for the first appointment of the orthodontist for my younger son, the clerck at the desk wanted to sell me a booklet for 10 tickets in case I would be late! The booklet cost $ 250.00. I was shocked that they even expected people could be late for their appointments. I refused to pay and I made sure I was more than on time for every single appointment over the 5 years that my son was in the care of the orthodontist!

      I hope that you will get good care for your son!

      Have a great week!

    • mylindaelliott profile image

      mylindaelliott 3 years ago from Louisiana

      Very good information. I need to look for some of these resources in my state for the families I work with.

    • bravewarrior profile image

      Shauna L Bowling 3 years ago from Central Florida

      Great information here, Crafty. How did your son fare in all this? Will the state help you?

    • Mel Carriere profile image

      Mel Carriere 3 years ago from San Diego California

      I'm not in Connecticut, but I have put two kids through braces, and it's amazing to me they wanted all that money up front.

      Anyhow just wanted to say hello. I haven't seen you here in a while, but then again I haven't been around much. Hope you are doing well.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Alicia! You hit the nail on the head. It's painfully difficult to find resources here. Yet in other states around the United States, it's plentiful. It really makes no sense. I literally spent 3 weeks trying to find an Autism specialist in this area. I'm told they are either completely booked and have no availability for new patients, or the insurance companies pay so little that they just don't take insurance any more. I personally cannot afford $120-$250 an hour for services for my child. I figure anything I can uncover about free stuff out there the better off everyone will be and hopefully gain some services for a child who would otherwise have to go without.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi DDE! Thank you so much for commenting here. I truly hope someone finds it helpful. It was very hard finding this information.

    • AliciaC profile image

      Linda Crampton 3 years ago from British Columbia, Canada

      I love your determination, Crafty! This is another great hub that will be very useful for parents of a special needs child. It's a shame that the process for helping the children is so difficult, though. It shouldn't be like this!

    • DDE profile image

      Devika Primić 3 years ago from Dubrovnik, Croatia

      You have shared everything you know on What Parents Need to Know about Affording Braces for a Child with Autism in Connecticut with great interest. Your sound advice is most helpful and informative. Voted up!

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Faith! Thank you so much for commenting here. There is so much information that I'm learning about. It's just not getting out to those that need it. I have learned a lot in the past three weeks alone and plan on writing much more that I hope people find helpful.

    • Faith Reaper profile image

      Faith Reaper 3 years ago from southern USA

      Great advice and thank you for going the extra mile in caring to the benefit of others too. I do hope this will help many who are in the same situation. Beautiful photo there!

      Up and more and sharing.

      Blessings,

      Faith Reaper

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Thank you EP! I have learned when it comes to my family that no one is going to care for them like I do. Sadly, there is so much misinformation out there. A lot of negativity. But when I see a closed door, I look for an opened one for sure.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Ologsinquito, yes, my thoughts too. Thank you so much for commenting.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Jackie! Thank you very much. I truly hope this helps someone out there. I was given completely false information by all of the people I had asked prior to uncovering the truth.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Thank you Billy! I haven't been around much because it has been really bad weather here lately. The schools have been closed. The list goes on and on. Hopefully I'll be around more. I have to get over to your Hub and catch up on my reading!

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Suzanne! I know, it was rude, but I hear comments like that a lot from people who have no idea what they are saying. This same office told me there are no such things as "free braces", yet with a little digging, I found out that there is help for those that need it. Thanks for commenting.

    • CraftytotheCore profile image
      Author

      CraftytotheCore 3 years ago

      Hi Flourish! Yes, the teeth are growing in back of other teeth as well. That's why I initially thought the dentist would have to pull them out. I had no former experience with this. Thanks so much for stopping by and commenting!

    • epbooks profile image

      Elizabeth Parker 3 years ago from Las Vegas, NV

      What fantastic advice in this hub. I love that you are a closer and didn't stop until you found an acceptable solution. That speaks volumes about your character. Sharing!!

    • ologsinquito profile image

      ologsinquito 3 years ago from USA

      This information will probably help people in other states as well, if there are similar programs. At least it can help them with asking the right questions.

    • Jackie Lynnley profile image

      Jackie Lynnley 3 years ago from The Beautiful South

      I hope your research will help many besides yourself; and I guess most people would not think to go as far as you did and some maybe miss out that just could not afford. You are an angel. Up and sharing.

    • billybuc profile image

      Bill Holland 3 years ago from Olympia, WA

      A treasure chest of information for parents in this situation. Well done and great resource.

    • Suzanne Day profile image

      Suzanne Day 3 years ago from Melbourne, Victoria, Australia

      What a rude assistant telling you to place your child first. She obviously had no idea that the reason you were there in the first place was because you were doing so. Congratulations on finding out this helpful information to make your life and other people's lives who have the same problem easier! Voted very useful & rated.

    • FlourishAnyway profile image

      FlourishAnyway 3 years ago from USA

      You are very resourceful and feisty when told no, Ms. Crafty! Congratulations for digging deeper in order to get the services your son needs. We paid for my daughter's braces out-of-pocket, and she's already had them for 5 freaking years (what happened to the 2 year estimate?). Compliance with all the rubber bands and what not to eat is certainly an issue, and both headaches and a very sore mouth were problems at some points. However, I can tell that her teeth are gorgeous straight under those train trains. (Previously she had what we were calling "shark teeth," some teeth in back of others.) Best of luck to you both in the years ahead.