Health & Security Plan > SPD > Anesthesia – 90%

Summary Plan Description

Anesthesia—90%

Benefits are provided for the services of an anesthesiologist required for a covered surgery. Covered charges include the usual, customary, and reasonable charge (as determined by this plan) for the anesthesia. All anesthesia values are determined by adding a "basic value" which is related to the complexity of the service, plus "modifying units" (if any), plus "time units." Time units are the number of minutes which elapse between the administration of the anesthesia and the time the patient can safely be placed under post-operative care.

Benefits are not provided for:

  1. The patient's or physician's convenience or for fear anxiety states.
  2. General anesthesia or IV sedation for surgical procedures commonly and primarily performed in a clinic or physician's office.

Key Point

The plan does not cover general anesthesia or IV sedation for surgical procedures commonly and primarily performed in a clinic or physician's office. Please see page 78 for a list of applicable surgical procedures.