ALL Kids covers braces in Alabama only when a child has a specific qualifying medical condition, such as cleft palate, a recognized craniofacial syndrome, or jaw deformity caused by trauma or disease. Standard orthodontic treatment for crowded teeth, gaps, or a typical overbite is not covered, no matter how pronounced the misalignment looks or how strongly a dentist recommends treatment.
With braces running $3,000 to $7,000 out of pocket, the distinction matters. Here is where ALL Kids draws the line, what conditions qualify, and what the approval process looks like.
What ALL Kids Will and Won’t Pay For
ALL Kids treats orthodontics separately from routine dental care. Every enrolled child gets cleanings, exams, fillings, and other standard dental services. Braces are a different category and require the child to have a qualifying medical condition. Cosmetic orthodontics and treatment for ordinary bite or alignment problems are excluded, which reflects federal CHIP rules allowing coverage only when orthodontic services prevent disease or restore oral function.1Medicaid.gov. EPSDT – A Guide for States: Coverage in the Medicaid Benefit
In practice: if the orthodontic need stems from a birth defect, a named syndrome, or significant trauma affecting facial growth, ALL Kids will likely approve braces after prior authorization. If the issue is crowding, spacing, or a moderate bite problem, it won’t.
Qualifying Conditions
Alabama’s CHIP program publishes a specific list of conditions that qualify a child for orthodontic coverage. As of early 2026, braces are covered only for:2Insure Kids Now. Summary of Benefits Report for Alabama CHIP
- Cleft palate or cleft lip deformities, including cleft lip with alveolar process involvement
- Velopharyngeal incompetence, where the soft palate does not close properly against the back of the throat, affecting speech and swallowing
- Short palate, submucous cleft, or alveolar notch
- Trauma, disease, or dysplasias causing significant impact on facial growth or jaw deformity
- Craniofacial anomalies, including hemifacial microsomia, craniosynostosis syndrome, Marfan’s syndrome, Apert’s syndrome, and Crouzon’s syndrome
- Other syndromes submitted for individual review
Retainers are covered when they’re part of an approved treatment plan for one of these conditions.2Insure Kids Now. Summary of Benefits Report for Alabama CHIP The “other syndromes by review” category means the list isn’t absolutely closed, but approval outside the named conditions is difficult and requires strong clinical documentation.
How Prior Authorization Works
An orthodontist cannot start treatment and bill ALL Kids afterward. Prior authorization is required before any orthodontic work begins, and anything done without it will not be covered, leaving the family responsible for the full cost.3Alabama Department of Public Health. ALL Kids Benefit Booklet
Your orthodontist starts the process by contacting Blue Cross and Blue Shield of Alabama’s Health Management Department at 1-800-248-2342. The provider can also submit a written request to BCBS at 450 Riverchase Parkway East, Birmingham, Alabama 35244-2858.3Alabama Department of Public Health. ALL Kids Benefit Booklet The submission should include the child’s contract number, clinical documentation of the qualifying condition, and the treating provider’s contact information. Program dental consultants review the materials against the qualifying conditions list.
All approved orthodontic treatment must be provided by an orthodontist in the BCBS of Alabama preferred provider network. Out-of-network services won’t be covered.4Alabama Department of Public Health. ALL Kids Dental Benefits
For children with cleft palate or complex craniofacial conditions, Alabama’s Children’s Rehabilitation Service operates craniofacial orthodontic clinics around the state, though availability varies by location.5Alabama Department of Public Health. Children’s Rehabilitation Services Programs A CRS clinic is often where treatment is coordinated, and the multidisciplinary team can produce the documentation the authorization process requires.
If the Request Is Denied
A denial isn’t necessarily the final word. The ALL Kids benefit booklet lays out a formal appeals process. You have the right to request copies of every document Blue Cross relied on in making the decision, along with a written explanation of how medical necessity criteria were applied to your child’s case.3Alabama Department of Public Health. ALL Kids Benefit Booklet
This is where it pays to push. If your child’s condition falls into the “other syndromes by review” category, an initial denial often reflects incomplete documentation rather than a final clinical judgment. Ask the orthodontist whether additional imaging, specialist evaluations, or a letter from a craniofacial team could strengthen the appeal. Denials are overturned far more often when the appeal brings new clinical evidence rather than restating the original request.
Routine Dental Care Is Not Affected
A braces denial does not mean your child loses dental coverage. Every enrolled ALL Kids child receives comprehensive dental benefits. Diagnostic and preventive services like exams, cleanings, and X-rays are covered at 100% with no copay across all three plan groups. Restorative work such as fillings and root canals is also covered, with small copays for the Low Fee and Fee groups.4Alabama Department of Public Health. ALL Kids Dental Benefits Dental coverage and orthodontic coverage are distinct categories under the program, and regular dental care continues regardless of whether braces are approved.
For questions about a specific condition, coverage, or an existing authorization, ALL Kids Customer Service can be reached at 1-888-373-5437.6Alabama Department of Public Health. ALL Kids