One in every 33 children in the United States is born with a congenital anomaly or birth defect that affects the way they look, develop or function. Many of these congenital anomalies include severe oral and facial defects such as cleft lip or palate, skeletal and maxillofacial deformities, hypodontia (absence of teeth), and enamel hypoplasia. These anomalies can interfere with a child’s ability to breathe, speak, and/or eat in a normal manner. Specialized surgery is needed to correct these anomalies. These procedures are reconstructive in nature and are performed to correct abnormal structures of the body. Despite this, many insurance companies consider these services to be cosmetic, and while they may cover the preliminary surgeries, they will delay or deny follow-up or corrective procedures, including dental work related to the anomaly.
S. 560/H.R. 1379 would require all private group and individual health plans to cover medically necessary services resulting from a congenital anomaly or birth defect. This would include inpatient and outpatient care and reconstructive services and procedures, as well as adjunctive dental, orthodontic, or prosthodontic support. This legislation is crucial to ensure that children suffering from congenital anomalies and birth defects are able to receive the treatment they need.
The American Dental Association (ADA) is advocating that Congress pass S. 560/H.R. 1379, the Ensuring Lasting Smiles Act, to help patients with craniofacial anomalies and ensure they have the necessary coverage to restore their ability to function. Use the link provided below to reach out to your legislators now–write, call, or tweet your elected officials so they know where you stand on the issues.
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