State		Statute #				Statute Explanation
AK						Arkansas: TMJ disorders must be treated the same as any other illness or injury and not considered dental work
CA
The Contract: General Provisions
		Insurance Code § 10123.21				conditions directly affecting the upper or lower jawbone, or associated bone joints, if each
						procedure is medically-necessary.
CA		Health & Safety Code § 1367.68				Any provision in a health care service plan or contract issued, renewed or delivered after July 1,
Health Care Service Plans: Standards						1995 that excludes coverage for any surgical procedure for any condition directly affecting the
						upper or lower jawbone, or associated bone joints, will have no force of effect as to any enrollee if
						that provision results in any failure to provide medically-necessary basic health care services to the
						enrollee pursuant to the plan's definition of medical necessity.
FL		37 FSA § 627.419(7)				States health insurance policies which provide coverage for any diagnostic or surgical procedure
The Insurance Contract:						involving bones or joints of the skeleton shall not discriminate against coverage for any similar
Construction of Policies						diagnostic or surgical procedure invovling bones or joints of the jaw and facial region if the
						procedure or surgery is medically necessary to treat conditions caused by congenital or
						developmental deformity, disease or injury.
FL		37 FSA § 627.6515(7)				Provides group, franchise, or blanket health insurance policies issued or delivered outside the state
Group, Blanket, & Franchise Health						from which a resident is provided coverage for any diagnostic or surgical procedure involving bones
insurance Policies: Out-of-State						or joints of the skeleton, shall not discriminate against coverage for any similar diagnostic or
						surgical procedure involving bones or joints of the jaw and facial region if such procedure or surgery
						is medically necessary to treat conditions caused by congenital or developmental deformity,
						disease or injury.
FL	37 FSA § 627.65735				Provides group, franchise, or blanket health insurance policies issued or delivered
Group, Blanket, & Franchise Health					from which a resident is provided coverage for any diagnostic or surgical procedure involving bones
insurance Policies: Nondiscrimination of					or joints of the skeleton, shall not discriminate against coverage for any similar diagnostic or
Coverage for Surgical Procedures					surgical procedure involving bones or joints of the jaw and facial region if such procedure or surgery
					is medically necessary to treat conditions caused by congenital or developmental deformity,
					disease or injury.
GA	33 GA ST 29-20				Requires individual accident and sickness insurance policies issued or delivered to
individual Accident & Sickness Insurance					provide medically necessary surgical or nonsurgical treatment for the correction of TMJ
					by physicians or dentists profressionally qualified by training and experience. Further
					requires policies to provide medically necessary surgery for the correction of functional
					deformities of the maxilla and mandible.
GA	33 GA ST 30-14				Requires group or blanket accident and sickness insurance policies issued or delivered
Group or Blanket Accident &					to provide medically necessary surgical or nonsurgical treatment for the correction of
Sickness Insurance					TMJ by physicians or dentists profressionally qualified by training and experience.
					Further requires policies to provide medically necessary surgery for the correction of
					functional deformities of the maxilla and mandible.
					Georgia: Claims for treatment by a physician or dentist for orofacial
					pain including, but not limited to, Tmj and myofascial pain problems must
					be honored under major medical policies of insurers and not-for- profit
					service corporations.
IL			215 ILCS 5/356Q				Requires insurers to offer, for an additional premium, optional coverage for the reasonable and
Accident & Health Insurance							necessary medical treatment of temporomandibular joint disorder and craniomandibular disorder.
							Maximum lifetime benefits for TMJ and craniomandibular treatment shall not be less than $2,500.
KY			25 KRS § 304.17-319				Requires health insurance policies which provide coverage on an expense-incurred basis for
Business and Financial Institutions:							surgical or nonsurgical treatment of skeletal disorders to provide coverage for medically necessary
Health Insurance Contracts							procedures relating to TMJ and craniomandibular jaw disorders. Applies to all policies issued,
							delivered or renewed after 1/1/91.
KY			25 KRS § 304.18-0365				Requires all group or blanket policies of health insurance which provides coverage on an expense-
Business and Financial Institutions:							incurred basis for surgical or nonsurgical treatment of skeletal disorders shall provide coverage for
Group & Blanket health Insurance							medically necessary procedures relating to TMJ and craniomandibualr jaw disorders.
							Applies to all policies issued, delivered or renewed after 1/1/91.
KY			25 KRS § 304.32-1585				Requires all policies of health insurance which provides coverage on an expense-
Business and Financial Institutions:							incurred basis for surgical or nonsurgical treatment of skeletal disroders shall provide coverage for
Nonprofit Hospital, Medical-Surgical,							medically necessary procedures relating to TMJ and craniomandibualr jaw disorders.
Dental & Health Service Corporations							Applies to all policies issued, delivered or renewed after 1/1/91.
							Kentucky: All policies and contracts that provide coverage for surgical
							or non-surgical treatment of skeletal disorders must provide coverage for
							medically necessary procedures relating to TMJ and craniomandibular
							disorders.
KY	25 KRS § 304.38-1937				Requires all contracts or agreements of health care services which provide coverage for surgical or
Business and Financial Institutions:					nonsurgical treatment of skeletal disorders to provide coverage for medically necessary procedures
Health Maintenance Organizations					relating to TMJ and craniomandibular jaw disorders. Applies to all policies issued, delivered or
					renewed after 1/1/91.
MD	ST			MSC § 15-821	States insurance policies that provide coverage on a group or individual basis for a diagnostic or
Insurance					surgical procedure involving a bone or joint of the skeletal structure may not exclude or deny coverage
					for the same diagnostic or surgical procedure involving a bone or joint of the face, neck, or head
					if the procedure is medically necessary to treat a condition caused by a congenital deformity,
					disease, or injury.
					Maryland: Group and individual insurers and non-profit health-service
					plans that provide coverage for diagnostic or surgical procedures
					involving a bone or a joint of the skeletal structure must provide
					coverage for the same procedure involving a bone or joint of the face,