We don't have any knowledge about the Medicaid system. 3rd party providers typically don't pay for procedures that only serve a cosmetic function. But, and similar to the way you describe, sometimes the circumstances associated with a condition give it a different priority.
You post: "I have tried a lot of things..."

Clearly some types of tooth staining are harder to resolve than others (tetracyline), some of which may require extended treatment time to achieve the type of results desired.

As far as the technique used, all forms teeth whitening boil down to two issues: 1) Whitener concentration and 2) A tooth's total exposure time to it. That's why professional in-office treatments (high concentration/short treatment time) and at-home systems (low concentration/longer treatment times) can be equally effective.

With at-home systems, some are typically considered to be more effective than others. Dentist-dispensed tray-based system (and the dentist's knowledge that comes with it) are usually regarded as the best.

Over-the-counter systems (tray based or strips) may provide a reasonably effective alternative. (Some dentists choose to dispense whitening strip products to their patients as opposed to a tray system).

While it's really impossible for us to know what's best for your situation (that's what consulting with your dentist can provide), we will say that with diligence and effort some people (although we're sure it's the exception and not the rule) have been able to achieve fairly remarkable results, with at-home technique.

Best regards.

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