I do not know whether Title 19 will cover the surgery, but I recall that my son's surgeon, who did his residency at the Shriner's Hospital (yeah, the guys in the parades with the scooters), said it was something that could be done at the Shriner's Hospital since they are a charitable organization for children born with birth defects and my doctor said polydactyly would qualify as a birth defect. I know there are Shriner's hospitals all over the country so you might was to look into that.