The Dentistry Benefit Explained

Get covered for dentists consultations and procedures

Cover for Network Dentists

Get the benefit that lets you and your family see a network dentist. You get unlimited managed cover for consultations as well as basic procedures like fillings, extractions, cleaning and x-rays.

You can upgrade your benefit level to include crowns, root canals and dentures.

The benefit is available as a standard part of the Day-to-Day Plan but you get a choice in which benefit level suits you best.

6 Month Waiting Period

3 Benefit Levels

Included in Day-to-Day Plan

Choose Your Level of Cover

Flexible levels of cover mean you get to build your plan to suit your needs and budget.

Level 1

Unlimited consultations per member per year

Covers basic procedures like:

Pain control
Normal extractions
Teeth cleaning
Amalgam Fillings
Dental X-rays

Level 2

Includes all Level 1 benefits with the following upgrades:

Resin fillings
1 root canal per member up to R2,200 every 12 months
1 crown per member up to R4,950 every 24 months

Level 3

Includes all Level 2 benefits with the following upgrades:

2 root canals per member up to R2,200 each every 12 months
2 crowns per member up to R4,950 each every 24 months
Dentures up to R2,000 per policy per year

How Does It Work?

Find answers to the most common questions about this benefit. Browse our Help pages and Blog posts for more information.

What is covered?

The Dentistry benefit is all about getting you access to a private network dentist for regular checkups and maintenance on your teeth. It covers:

Unlimited consultations per member per year at a network dentist
Various procedures like extractions, fillings, cleaning & pain control are limited to 2 per member per year, unless you get pre-authorisation.
Crowns and root canal treatments according to the selected benefit level
Dentures up to R2,000 per policy per year on benefit level 3

Protocols and formularies do apply to the procedures. The full list of protocols is not published by the product administrator because it is extensive and is constantly updated as medical procedures change. Your network dentist can advise you though.

What is the waiting period?

There is a 6 month waiting period before any new member on a policy can claim under this benefit.

Is medication covered?

Medication prescribed by a network dentist may be covered under the Acute Medication benefit of your Day-to-Day Plan.

Will there be co-payments?

The benefit is not uncapped. The limits are stated and the various protocols will apply. Most of the basic procedures listed are fully covered but if the dentist needs to perform a procedure that is not fully covered then you may have to pay in.

For example: amalgam fillings are covered under Level 1 but some dentists only do resin fillings, so there might be a shortfall that the benefit does not cover.

If you are unsure about what is covered then it is best to consult your network dentist about it or speak to us and we can assist.