or older. Such sealants are covered for in-
dividuals less than 10 years of age for pro-
tection of the 1st permanent molars. Such 
sealants are covered for individuals 10 
years of age or older for protection of the 
2d permanent molars. 
(B) TREATMENT OF DENTAL DISEASE.— 
Prior to January 1, 2016, the items and serv-
ices described in paragraph (1)(C) are covered 
only for individuals less than 18 years of age 
and special needs patients. On or after such 
date, such items and services are covered for all 
individuals enrolled for benefits under this Act, 
except that endodontic services are not covered 
for individuals 18 years of age or older. 
(C) SPACE MAINTENANCE.—The items and 
services described in paragraph (1)(D) are cov-
ered only for individuals at least 3 years of age, 
but less than 13 years of age and— 
(i) are limited to posterior teeth; 
(ii) involve maintenance of a space or 
spaces for permanent posterior teeth that 
would otherwise be prevented from normal 
eruption if the space were not maintained; 
and 
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(iii) do not include a space maintainer 
that is placed within 6 months of the ex-
pected eruption of the permanent posterior 
tooth concerned. 
(D) ORTHODONTIC TREATMENT.—Prior to 
January 1, 2016, the items and services de-
scribed in paragraph (1)(E) are covered only 
for individuals at least 6 years of age, but less 
than 12 years of age, who have severe 
dentofacial abnormalities. On or after such 
date, such items and services are covered only 
for individuals at least 6 years of age, but less 
than 12 years of age. 
(E) DENTURES.—Prior to January 1, 
2016, the dentures described in paragraph 
(1)(F) are not covered, except for special needs 
patients. On or after such date, dentures are 
covered for an individual consistent with a peri-
odicity schedule established by the Board, ex-
cept that the limitation of periodicity provided 
in such schedule shall not apply to a special 
needs patient. 
(3) DEFINITIONS.—For purposes of this title: 
(A) MEDICALLY NECESSARY ORAL HEALTH 
CARE.—The term ‘‘medically necessary oral 
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health care’’ means oral health care that is re-
quired as a direct result of, or would have a di-
rect impact on, an underlying medical condi-
tion. Such term includes oral health care di-
rected toward control or elimination of pain, in-
fection, or reestablishment of oral function. 
(B) SPECIAL NEEDS PATIENT.—The term 
‘‘special needs patient’’ includes an individual 
with a genetic or birth defect, a developmental 
disability, or an acquired medical disability. 
(i) NURSING FACILITY; NURSING FACILITY SERV-
ICES.—Except as may be provided by the Board, the 
terms ‘‘nursing facility’’ and ‘‘nursing facility services’’ 
have the meanings given such terms in sections 1919(a) 
and 1905(f), respectively, of the Social Security Act. 
(j) SERVICES IN INTERMEDIATE CARE FACILITIES 
FOR INDIVIDUALS WITH MENTAL RETARDATION.—Ex-
cept as may be provided by the Board— 
(1) the term ‘‘intermediate care facility for indi-
viduals with mental retardation’’ has the meaning 
specified in section 1905(d) of the Social Security 
Act (as in effect before the enactment of this Act); 
and 
(2) the term ‘‘services in intermediate care fa-
cilities for individuals with mental retardation’’ 
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