Amd §§3216, 3221 & 4303, Ins L; amd §365-a, Soc Serv L
Provides that dental insurance coverage shall include coverage for night guards; defines dental night guards; provides that dental night guards shall be covered under Medicaid.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6919
SPONSOR: Woerner TITLE OF BILL:
An act to amend the insurance law and the social services law, in
relation to insurance coverage for dental night guards
PURPOSE OR GENERAL IDEA OF BILL:
This bill will require dental insurance coverage for a dental night
guard when prescribed by a licensed dentist.
SUMMARY OF PROVISIONS:
Section 1: Amends subsection (i) of section 3216 of the insurance law by
adding a new paragraph. Section 2: Amends subsection (1) of section
3221 of the insurance law by adding a new paragraph. Section 3: Amends
section 4303 of the insurance law by adding a new subsection(ww).
Section 4: Amends subdivision 2 of section 365-a of the social service
law by adding a new paragraph.Section 5: Sets the effective date.
JUSTIFICATION:
Dentists recommend night guards for various reasons: bruxism (grinding
or clenched teeth), TMJ disorder, to protect teeth against further
damage. A professionally made device can cost anywhere between $400-$800
and prevents the need for restorative dental work in the future. The
device works by creating a synthetic barrier between the teeth so they
no longer touch one another and cannot grind or clench. A night guard
can (1) prevent further tooth damage, (2) prevent morning headaches, (3)
prevent enamel erosion, (4) ease symptoms of TMJ disorder, and (5)
reduce the risks of snoring. A medical device that can prevent costly
trips to the dentist is something that should be invested in.
PRIOR LEGISLATIVE HISTORY:
New bill.
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
TBD
EFFECTIVE DATE:
This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
6919
2025-2026 Regular Sessions
IN ASSEMBLY
March 18, 2025
___________
Introduced by M. of A. WOERNER -- read once and referred to the Commit-
tee on Insurance
AN ACT to amend the insurance law and the social services law, in
relation to insurance coverage for dental night guards
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subsection (i) of section 3216 of the insurance law is
2 amended by adding a new paragraph 40 to read as follows:
3 (40) (A) Every policy which provides coverage or reimbursement for
4 dental services shall provide coverage or reimbursement for night guards
5 when such night guard is prescribed by a licensed dentist.
6 (B) For purposes of this paragraph, "night guard" means a protective
7 device for the mouth that covers the teeth and gums to prevent and
8 reduce injury to the teeth, arches, lips and gums.
9 § 2. Subsection (l) of section 3221 of the insurance law is amended by
10 adding a new paragraph 23 to read as follows:
11 (23) (A) Every policy which provides coverage or reimbursement for
12 dental services shall provide coverage or reimbursement for night guards
13 when such night guard is prescribed by a licensed dentist.
14 (B) For purposes of this paragraph, "night guard" means a protective
15 device for the mouth that covers the teeth and gums to prevent and
16 reduce injury to the teeth, arches, lips and gums.
17 § 3. Section 4303 of the insurance law is amended by adding a new
18 subsection (ww) to read as follows:
19 (ww) (1) Every policy which provides coverage or reimbursement for
20 dental services shall provide coverage or reimbursement for night guards
21 when such night guard is prescribed by a licensed dentist.
22 (2) For purposes of this subsection, "night guard" means a protective
23 device for the mouth that covers the teeth and gums to prevent and
24 reduce injury to the teeth, arches, lips and gums.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07027-01-5
A. 6919 2
1 § 4. Subdivision 2 of section 365-a of the social services law is
2 amended by adding a new paragraph (f-1) to read as follows:
3 (f-1) dental night guards, as such term is defined in paragraph forty
4 of section thirty-two hundred sixteen of the insurance law, when such
5 night guard is prescribed by a licensed dentist;
6 § 5. This act shall take effect immediately and shall apply to poli-
7 cies and contracts issued, renewed, modified, altered or amended on or
8 after such effective date.
