Cal. Insurance Code § 10119.9
Cal. Insurance Code § 10119.9
California · California Insurance Code · Status: effective · Effective 1999-01-01
Cite this
- Citation
- Cal. Insurance Code § 10119.9, California, version 1 as recorded 2026-07-25, yourstate.us, https://yourstate.us/provision/879495
- Permanent ID
ys:prov:879495@1- SHA-256
c7af6d4df6a28c5a70973694b5884494072f62b4aae01c72365dccd4780dd217
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
(a) A disability insurance policy or certificate covering hospital, surgical, or medical expenses, that meets the definition of “health benefit plan” in subdivision (a) of Section 10198.6, that is issued, amended, renewed, or delivered on or after January 1, 2000, shall be deemed to cover general anesthesia and associated facility charges for dental procedures rendered in a hospital or surgery center setting, when the clinical status or underlying medical condition of the insured requires dental procedures that ordinarily would not require general anesthesia to be rendered in a hospital or surgery center setting. The disability insurance policy or certificate may require prior authorization of general anesthesia and associated charges required for dental care procedures in the same manner that prior authorization is required for other covered diseases or conditions.
(b) This section shall apply only to general anesthesia and associated facility charges for only the following insureds, and only if the insureds meet the criteria in subdivision (a):
(1) Insureds who are under seven years of age.
(2) Insureds who are developmentally disabled, regardless of age.
(3) Insureds whose health is compromised and for whom general anesthesia is medically necessary, regardless of age.
(c) Nothing in this section shall require insurers to cover any charges for the dental procedure itself, including the professional fee of the dentist. Coverage for anesthesia and associated facility charges pursuant to this section shall be subject to all other terms and conditions of the policy or certificate that apply generally to other benefits.
(d) Nothing in this section shall require insurers to cover anesthesia or related facility charges for dental procedures that ordinarily would require general anesthesia and that do not meet the requirements of subdivision (a), (b), or (c).
(e) A disability insurance policy may include coverage specified in subdivision (a) at any time prior to January 1, 2000.