Any health benefit plan as defined by § 58-18-42 shall cover anesthesia and hospital charges for dental care provided to a covered person who:

(1) Is a child under age five; or

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(2) Is severely disabled or otherwise suffers from a developmental disability as determined by a licensed physician which places such person at serious risk.

Such coverage applies regardless of whether the services are provided in a hospital or a dental office. A health carrier may require prior authorization of hospitalization for dental care procedures in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.

(Text of section effective the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospital or ambulatory surgery center charges for dental care to be covered for certain persons. Any health benefit plan as defined by § 58-18-42 shall cover anesthesia and hospital or ambulatory surgery center charges for dental care provided to a covered person who:

(1) Is a child under age five; or

(2) If determined by a licensed physician, is severely disabled, has a developmental disability, or otherwise has a medical condition that places the person at serious medical risk.

The coverage applies regardless of whether the services are provided in a hospital, ambulatory surgery center, or a dental office. A health carrier may require prior authorization in the same manner that prior authorization is required for other covered diseases or conditions.

Source: SL 1999, ch 248, § 3; SL 2018, ch 279, § 2, eff. Jan. 1, 2019.