Health Insurance: Mandatory Coverage for Congenital Anomalies
This act mandates health insurance plans to cover the diagnosis and treatment of congenital anomalies or birth defects. This means citizens with birth defects will have guaranteed access to necessary medical procedures, including dental and reconstructive services, that improve bodily function or appearance. The act aims to reduce financial burdens for families affected by such conditions.
Key points
Health insurers must cover the costs of treating congenital anomalies, including procedures that improve function and appearance.
Coverage includes inpatient and outpatient care, reconstructive services, and adjunctive dental and orthodontic support.
Cost-sharing requirements, such as coinsurance or deductibles, cannot be more restrictive than for other medical benefits.
The act does not cover cosmetic surgery performed solely to improve appearance or self-esteem without medical necessity.
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