Bill > H5041

This bill mandates that various insurance plans and health coverage providers in Massachusetts must cover medically necessary treatments for craniofacial disorders, which are conditions affecting the skull and face, to improve function or appearance. This coverage specifically includes conditions like ectodermal dysplasia, dentinogenesis imperfecta, and amelogenesis imperfecta, but it excludes purely cosmetic surgery or dental and orthodontic treatments not related to the underlying congenital condition. The bill ensures that these craniofacial disorder benefits are not subject to higher out-of-pocket costs, such as deductibles, coinsurance, or copayments, than other benefits provided by the insurer, and it applies to state employee insurance, Medicaid, and various types of private insurance policies, including those from health maintenance organizations and preferred provider organizations.

Health and Social Services

Joint Committee on Financial Services (Joint)

https://malegislature.gov/Bills/194/H5041