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AAP supports insurance coverage for reconstructive surgery

Hanna Gremp, a lively, blond-haired, blue-eyed 7-year-old, was born without ears. Michael Hatfield, a 20-year-old college student, was born without cheekbones, eye sockets or a bone in his nose. Both of their insurance companies refused to pay for surgery to correct their conditions, claiming it was only cosmetic.

Approximately 7 percent of American children are born with pediatric deformities and congenital defects such as birth-marks, cleft lip, cleft palate, absent external ears and other facial deformities. A recent survey of the American Society of Plastic and Reconstructive Surgeons (ASPRS) indicated more than half of the plastic surgeons surveyed have had a pediatric patient in the last two years who has been denied, or experienced significant difficulty in obtaining insurance coverage for their surgical procedures. Insurance companies often claim these procedures are not medically necessary.