Understanding how dental insurance works at a pediatric dental office can save you time, money, and a lot of guesswork. At Purple Tooth Pediatric Dentistry & Braces in Mt Holly, NC, we accept Delta Dental and NC Medicaid, and our front desk team handles the claim filing so you can focus on your child. Before your child’s first appointment, we will pull your benefits and walk you through exactly what is covered and what your out-of-pocket cost may be, with no surprises at checkout.
Dr. Jonathan Kaczmarski, DMD, built this practice to serve every family in Gaston County, regardless of insurance type. Whether your child is enrolled in Delta Dental through an employer plan or covered by NC Medicaid, we will make sure they get the care they need. If you have questions about your coverage before scheduling, call us at (704) 885-2266. Learn more about Dr. Jon and our approach to pediatric care.
Purple Tooth is in-network with Delta Dental, which means your benefits stretch further here than at an out-of-network office. If your family has Delta Dental through a Gaston County employer like Gaston County Schools, Amazon, Freightliner, CaroMont Health, or another area employer, we file your claims directly and help you maximize your coverage before the end of each benefit year.
Delta Dental typically covers preventive care, including cleanings, exams, and X-rays, at little to no cost when you are in-network. Coverage for restorative treatment varies by plan. Our front desk team pulls your benefits before your child’s appointment and goes over exactly what is and is not covered, so you are never guessing. Call us at (704) 885-2266 to verify your coverage before scheduling.
If your plan is not Delta Dental but offers out-of-network benefits, you may still be able to see us and receive partial reimbursement directly from your insurer. Common plans among Gaston County families include BCBS of NC, MetLife, and United Concordia. We are happy to provide the documentation you need to submit your own claim. For families interested in financing options, visit our dental financing page.
Purple Tooth accepts NC Medicaid for pediatric dental care, including preventive and restorative services. NC Medicaid covers children ages 0 through 18 in households at or below 210% of the Federal Poverty Level. North Carolina Health Choice (CHIP) extends coverage to children in households between 133% and 211% of FPL who do not qualify for standard Medicaid. Covered services include cleanings, exams, X-rays, fillings, and crowns. For a full list of what is covered, visit the NC DHHS Dental and Orthodontic program page.
NC Medicaid also covers orthodontic treatment in certain cases. Dr. Jon has treated many children using Medicaid ortho benefits and can assess during a consultation whether your child may qualify. Eligibility is based on the severity of the malocclusion and other clinical criteria. If you are unsure whether your child qualifies, bring their Medicaid card to the appointment and we will verify coverage before any treatment begins.
Many Gaston County families qualify for Medicaid or CHIP without realizing it. Enrollment resources are available at medicaid.ncdhhs.gov. If you are looking for payment plan options rather than insurance coverage, see our dental financing page.
To help us verify your coverage and prepare before your visit, bring the following to your child’s appointment:
If you have Delta Dental, our team will handle claim submission on your behalf. If you have Medicaid, we will verify eligibility before treatment begins. If you are unsure what your plan covers, call us before the visit at (704) 885-2266 and we will do our best to look it up for you. For families without insurance or looking for payment plan options, our dental financing page covers CareCredit, our in-house ortho payment plan, and membership plan options.
Yes. Purple Tooth is an in-network Delta Dental provider. Being in-network means your benefits typically cover more, and your out-of-pocket costs are lower than they would be at an out-of-network office. We file claims directly with Delta Dental on your behalf.
Yes. We accept NC Medicaid for preventive and restorative pediatric dental care, including cleanings, exams, X-rays, fillings, and crowns. NC Medicaid covers children ages 0 through 18 who meet income eligibility. Bring your child’s Medicaid card to the appointment and we will verify coverage before the visit begins.
NC Medicaid does cover orthodontic treatment for eligible children in certain cases, based on the clinical severity of the malocclusion. Dr. Jon can assess whether your child may qualify during a consultation. We are experienced working through the prior authorization process for Medicaid ortho cases.
We do not bill other carriers directly, but if your plan offers out-of-network benefits you may still be able to see us and receive partial reimbursement from your insurer. We will provide the documentation you need to submit the claim yourself. Call us at (704) 885-2266 and we will help you understand your options.
Yes, always. We pull your insurance benefits before the appointment and provide a clear breakdown of what is covered and what your out-of-pocket cost may be before any treatment begins. There are no financial surprises at Purple Tooth.
We offer membership plans and financing options for families without dental insurance. Visit our dental financing page or ask our front desk team about available options when you call or come in.
Dr. Jonathan Kaczmarski, DMD, completed his pediatric dental residency in New York and has built Purple Tooth Dental to serve every family in the Mt Holly and Gaston County area, regardless of insurance status. We are in-network with Delta Dental, accept NC Medicaid and CHIP, and work with families who have out-of-network coverage to help them get the most out of their benefits. Learn more about our practice and our full range of pediatric dental services.
To schedule your child’s first visit or ask about insurance coverage, book online or call us at (704) 885-2266. If you are looking for payment plan or financing options, visit our dental financing page.
In-network with Delta Dental · NC Medicaid and CHIP accepted · Claims filed directly on your behalf · No-surprise cost breakdowns before every appointment
