Bill > H953

This bill mandates that various types of insurance policies, including individual and group accident and sickness insurance, hospital service plans, medical service agreements, health maintenance contracts, and preferred provider contracts, must cover the costs associated with treating specific medically diagnosed congenital craniofacial defects such as ectodermal dysplasia, dentinogenesis imperfecta, amelogenesis imperfecta, congenital oligodontia, and cleft lip and palate for children under 18. This coverage is intended to be comprehensive, including medical, dental, oral and facial surgery, orthodontic treatment, preventative and restorative dentistry, speech therapy, audiology, and nutrition services, provided these are prescribed by a physician or surgeon and deemed medically necessary as a consequence of the craniofacial condition. The bill clarifies that coverage for dental or orthodontic treatment not directly related to managing these craniofacial defects will not be included. This legislation aims to ensure that individuals, particularly children, receive necessary medical and therapeutic care for these conditions through their insurance plans, applying to policies renewed on or after January 1, 2016.