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Cleft Lip and Palate Repair

Correcting Abnormal Development

Cleft lip repair and cleft palate repair are types of surgery used to correct this abnormal development and are meant to restore function to the lips and mouth along with producing a more normal appearance.

What is the cost of cleft lip and palate repair?

Costs for cleft repair surgery vary depending on the type and severity of the defect.

Is cleft repair surgery covered by health insurance?

Your health insurance plan will likely cover cleft surgery because it is a reconstructive procedure. Be certain to check with your insurance carrier. Coverage varies among insurers including pre-certification requirements, inpatient stay allowances and coverage for secondary procedures and allied health care services such as speech therapy.

While insurance is likely to cover the procedure, it's important to know the surgical costs before filing a claim. A surgeon's cost may vary based on his or her experience, the type of procedure used, as well as geographic location.

Cleft repair costs may include:

  • Surgeon's fee
  • Hospital or surgical facility costs
  • Anesthesia fees
  • Prescriptions for medication
  • Medical tests
  • Post-surgery feeding supplies

In many cases, orthodontic treatment is required to improve tooth positioning, treat an abnormal bite and prepare patients for gumline surgery. These services often are not covered by standard medical insurance.

The American Society of Plastic Surgeons, in conjunction with the American Academy of Pediatrics, have co-authored a position statement regarding health care coverage for the reconstruction of abnormal appearance in children, including cleft repair. Ask your plastic surgeon for a copy of this document to file with your insurance claims.

Your satisfaction involves more than a fee

When choosing a plastic surgeon for your child's cleft surgery, remember that the surgeon's experience and your comfort with him or her are just as important as the final cost of the surgery.

Multidisciplinary team care is considered essential for this condition and should be figured into your decision-making process. Complete care is more than just a surgical procedure and should continue through childhood as your child grows and develops.


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