Your Guide to SoonerCare and Orthodontics

You have a child. They have SoonerCare. They need orthodontics. How do the three of those work together? SoonerCare will cover orthodontic treatment for qualified patients up to age 18! Dental Depot Orthodontics is proud to offer free SoonerCare consultations to get your child on track to having their most confident smile yet.

Teen girl smiling with braces on
Your teen may qualify for orthodontics under their SoonerCare benefits!

So, how does someone become a qualified SoonerCare orthodontic patient? Well, it can be a little tricky to navigate on your own. Luckily, we’re here to help you through the whole process. Let’s start by breaking down what you need to do before having a consult.

Before Your Consultation

1.) A patient qualifying for SoonerCare must be under the age of 18.

On average orthodontic treatment lasts 2-3 years, so you should start seeking treatment well before the cut-off. If you wait too long you could run the risk of aging out of SoonerCare, and end up with an out of pocket expense. The American Association of Orthodontists recommend children have their first consultation around age 7, so it’s never too early to get started on the process to ensure full coverage benefits through treatment.

2.) SoonerCare requires a full dental cleaning to be done within 6 months of the consultation. They also require the patient to be cavity free for a minimum of one full calendar year to approve treatment. SoonerCare covers almost all general dentistry for patients 21 and under, so if your child needs to get this taken care of, give us a call to get them on the schedule!

3.) While in treatment patients will need to have a regular cleaning every six months to remain eligible for treatment. If cleanings are not maintained they could be disqualified from future treatment.

kid receiving dental work while in chair

So, in order to get your child’s consultation to see if they qualify for orthodontic coverage, they need to be under 18 (preferably by at least two years to give them plenty of time for treatment), need to be cavity-free for at least the last 12 months, need to have had a cleaning in the last 6 months, and will need to continue having cleanings every 6 months while in treatment.

Our consults are an extremely easy process that take no more than 45 minutes. At the appointment, an orthodontic assistant will take images of your child’s teeth, including a panoramic x-ray, a CEPH x-ray and a 3D iTero scan.

In addition to these images, SoonerCare requires all patients to be rated using a special scoring sheet to determine if the patient qualifies for orthodontic coverage.

Ultimately, all of these materials are submitted to SoonerCare for a final decision.

The SoonerCare Scoring System

SoonerCare requires that patients meet a minimum score according to their scoring rubric to qualify for orthodontic coverage. A certain number of points are assigned for every tooth that’s rotated, for every gap or space between teeth, every millimeter of an overbite, overjet, or underjet, and it all adds up towards their overall score.

However, there are three situations that automatically qualify a patient, as they make orthodontics a true medical necessity. They are:

  • Overjet of 9 mm or Greater
    With an overjet this deep, the bottom teeth can rub against the roof of the mouth.
  • Crossbite of Anterior Teeth
    When the upper teeth are positioned behind the lower teeth, it can lead to damage.
  • Reverse Underbite of 3.5 mm or Greater
    This occurs when the front teeth sit fully behind the bottom teeth.
showing of teeth that has a cross bite
showing of teeth that has a deep bite
Deep Bite
showing of teeth that has an underbite with a cross bite
Underbite with Crossbite

Not every patient will meet the point system. There is still good news to this though! Dental Depot offers two forms of financing so every patient has the opportunity to have the smile they deserve.

So if you’re ready to see if your child could qualify for full orthodontic coverage under SoonerCare, give us a call or request an appointment online to schedule their free consultation today at any of our four convenient OKC Metro offices.

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