Common use of Anesthesia for Dental Services Clause in Contracts

Anesthesia for Dental Services. We cover general anesthesia and associated hospital or ambulatory facility Services for dental care provided to Members who are age: 1. 7 or younger or are developmentally disabled and for whom a: a. Superior result can be expected from dental care provided under general anesthesia; and b. Successful result cannot be expected from dental care provided under local anesthesia because of a physical, intellectual or other medically compromising condition. 2. 17 or younger who are extremely uncooperative, fearful or uncommunicative with dental needs of such magnitude that treatment should not be delayed or deferred, and for whom a lack of treatment can be expected to result in oral pain, infection, loss of teeth, or other increased oral or dental morbidity. 3. 17 and older when the Member’s medical condition requires that dental Service be performed in a hospital or ambulatory surgical center for the safety of the Member (e.g., heart disease and hemophilia). General anesthesia and associated hospital and ambulatory facility charges will be covered only for dental care that is provided by a fully accredited Specialist for whom hospital privileges have been granted. See the benefit-specific exclusions immediately below for additional information.

Anesthesia for Dental Services. We cover general anesthesia and associated hospital or ambulatory facility Services for dental care provided to Members who are agewho: 1. 7 Are seven (7) years of age or younger or are developmentally disabled and for whom a: a. Superior result can be expected from dental care provided under general anesthesia; and b. Successful result cannot be expected from dental care provided under local anesthesia because of a physical, intellectual or other medically compromising condition. 2. 17 Are seventeen (17) years of age or younger who are extremely uncooperative, fearful or uncommunicative with dental needs of such magnitude that treatment should not be delayed or deferred, and for whom a lack of treatment can be expected to result in oral pain, infection, loss of teeth, or other increased oral or dental morbidity. 3. 17 and older when the Member’s Have a medical condition that requires that dental Service Services be performed in a hospital or ambulatory surgical center for the safety of the Member (e.g., heart disease and hemophilia). General anesthesia and associated hospital and ambulatory facility charges will be covered only for dental care that is provided by a fully accredited Specialist for whom hospital privileges have been granted. See the benefit-specific exclusions exclusion(s) immediately below for additional information.