Medicaid FAQ

If you are younger than 21 and Medicaid covers your dental treatment, you automatically have orthodontic coverage. You are entitled to braces if you fit the NYS Medicaid Orthodontic Program guidelines.

Every child is entitled to have an immediate consultation with Dr. Gorin at either the Lynbrook or Brooklyn office. The Medicaid orthodontic program will pay Dr. Gorin in the Brooklyn or Lynbrook office to evaluate a patient’s orthodontic needs. Dr. Gorin will perform a complete orthodontic clinical examination and take a set of orthodontic records, which will be forwarded to Medicaid or your Medicaid managed care plan.

Dr. Gorin will send your orthodontic records and a comprehensive narrative to Medicaid or your Medicaid managed care plan. Dr. Gorin will describe the orthodontic condition and request the appropriate treatment from Medicaid.

The final decision comes from a consultant that interprets the Medicaid orthodontic guidelines and how they apply to your case. Although there are very specific guidelines, they are open to interpretation. It is for this reason that Dr. Gorin takes great pride and care in preparing the request for orthodontic care for each and every patient so that the consultant gets a good picture as to the orthodontic problem.

You are entitled to appeal the decision made by Medicaid or the Medicaid managed plan. Dr. Gorin is an expert at preparing and submitting your orthodontic records as well as the request for orthodontic treatment to Medicaid. If a disappointing decision is returned by Medicaid, Dr. Gorin will personally oversee your appeal.

You are entitled to a Fair Hearing. Call Dr. Gorin immediately upon receiving a denial of an appeal. You have only a short period of time to request a Fair Hearing, where a judge reviews the facts of your case and rules. Dr. Gorin will put you in touch with a community advocate that will assist you every step of the way. Dr. Gorin will work closely with your advocate to make certain you receive everything that you are entitled to.

Dr. Gorin himself is a strong child advocate and is the lead architect of “No Child Left Behind,” a program that assists those families that find the cost of extraordinary orthodontic care and extraordinary orthodontic results simply out of reach.

Dr. Gorin is extremely sensitive to how disappointed the parents of a child that has been denied Medicaid orthodontic treatment must be. Dr. Gorin wants very much to make treatment possible and available. Dr. Gorin will extend every courtesy possible and also offer manageable payment plans so that every child may receive the orthodontic care that is required.

Dr. Gorin is extremely sensitive to how disappointed the parents of a child that has been denied Medicaid orthodontic treatment must be. Dr. Gorin wants very much to make treatment possible and available. Dr. Gorin will extend every courtesy possible and also offer manageable payment plans so that every child may receive the orthodontic care that is required.