Pennsylvania Statutes Title 40 P.S. Insurance § 3510.2. Definitions

The following words and phrases when used in this act shall have the meanings given to them in this section unless the context clearly indicates otherwise:

“Associated medical costs.” Hospitalization and all related medical expenses normally incurred as a result of the administration of general anesthesia.

“Dental care.” The diagnosis, treatment planning and implementation of services directed at the prevention and treatment of diseases, conditions and dysfunctions relating to the oral cavity and its associated structures and their impact upon the human body or the implementation of professional dental care provided to dental patients by a legally qualified dentist or physician operating within the scope of the dentist's or physician's training and licensure.

“Eligible dental patient.” A patient who is seven years of age or younger or developmentally disabled for whom a successful result cannot be expected for treatment under local anesthesia and for whom a superior result can be expected for treatment under general anesthesia.

“General anesthesia.” A controlled state of unconsciousness, including deep sedation, that is produced by a pharmacologic method, a nonpharmacologic method or a combination of both and that is accompanied by a complete or partial loss of protective reflexes that include the patient's inability to maintain an airway independently and to respond purposefully to physical stimulation or verbal command.

“Health insurance policy.” An individual or group health, sickness or accident policy, subscriber contract or certificate offered, issued or renewed by an entity subject to any of the following:

The term does not include any of the following types of policies: accident only, fixed indemnity, limited benefit, credit, dental, vision, specified disease, Medicare supplemental, Civilian Heath  4 and Medical Program of the Uniform Services (CHAMPUS) supplement, long-term care, disability income, workers' compensation or automobile medical payment.