Introduction:

The health plans provide funding towards dental care for 3 special types of patients: those with facial nerve development damage, those with cleidocranial dysplasia, and those with cleft lip and palate from birth
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The health plans provide funding towards dental care for 3 special types of patients: those with facial nerve development damage, those with congenital dental defects, and those with cleft lip and palate from birth.

  • Most dental and periodontal care for youth and adults is not included in the healthcare basket (the basket only covers dental care for children up to age 12), except for cases in which the treatment has been medically established to be necessary and life-saving.
  • In 2010, 3 cases of special patients who are entitled to dental and periodontal care were included in the healthcare basket:
    • Special dental treatments for patients with facial nerve development damage
    • Special dental treatments for those with cleidocranial dysplasia
    • Special dental treatments for those with cleft lip and palate from birth

Who is Eligible?

  • Those found to be eligible for treatment following diagnosis by a dental specialist.

How to Claim It?

  • After a diagnosis has been performed by a relevant specialist, the dental treatments described above are performed by dental specialists with experience treating these specifics types of patients.
  • The co-payment amounts vary depending on the type of treatment. Patients should contact their health plan for details.
  • In order to receive a reimbursement for treatment not performed by the health plan, health plan approval of the treatment must be obtained in advance by submitting a request to the primary care clinic (branch) to which the policyholder belongs.
  • After treatment, policyholders should provider their primary care clinic (branch) with original receipts and invoices. Reimbursements are given up to a pre-defined maximum ceiling. Policyholders should contact their health plan for the most up-to-date ceiling information.

Types of Cases and Treatments

Dental Care for Those with Facial Nerve Development Damage

  • Treatment may be provided following diagnosis from a surgical specialist, orthodontist or maxillofacial surgeon.
  • The basket includes:
    • Preservative dental treatment prior to orthodontic treatment
    • Orthodontic and surgical treatment

Dental Care for Those with Cleidocranial Dysplasia

  • Treatment may be provided following diagnosis from a doctor or dental specialist.
  • The basket includes:
    • Preservative dental treatment prior to orthodontic treatment
    • Orthodontic and surgical treatment

Dental Care for Those with Cleft Lip and Palate

  • Treatment may be provided to patients up to age 25 who were born with a cleft lip and palate, following diagnosis from a doctor or dental specialist.
  • The basket includes:
    • General preservative treatment
    • Preservative treatment in the area of the cleft
    • Pre-rehabilitation surgical treatment in the area of the cleft
    • Rehabilitation treatment in the area of the cleft

Please Note

Aid Organizations

  • For a comprehensive categorized listing of healthcare organizations offering assistance and support, click here.

Government Agencies

Laws and Regulations

Additional Publications

Sources