The Dentistry Benefit Explained

Dentistry
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Flexible Unlimited Dentistry

6 Month Waiting Period
3 Benefit Levels
Nationwide Network

Cover your everyday basic dental needs with unlimited consultations with a network dentist. This includes procedures like fillings, crowns and root canal treatment.

The Day-to-Day collection of benefits has cover for all of this and more.

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Choose Your Level of Cover

Flexible levels of cover mean you get to choose your benefit limits to suit your needs and budget.

Level 1

  • Consultations
  • Pain control
  • Normal extractions
  • Teeth cleaning
  • Fillings

Level 2

  • All Level 1 benefits
  • 1 root canal per member every 12 months up to R2,000
  • 1 crown per member every 24 months up to R4,500

Level 3

  • All Level 2 benefits
  • 2 root canals per member every 12 months up to R2,000 each
  • 2 crowns per member every 24 months up to R4,500 each
  • Dentures up to R2,000 per policy per year

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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:

  • Consultation fee at a network dentist
  • Various procedures like extractions, fillings, cleaning & pain control
  • Crowns and root canal treatments according to the selected benefit level
  • Dentures up to R2,000 per policy per year on benefit level 3

The benefit is unlimited which means you may use it as often as is medically necessary. We believe primary care is the gateway to good health so we want you to see a dentist when you need to and avoid letting small concerns turning into serious problems.

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What is Not Covered?

The Dentistry benefit does not cover cosmetic procedures. If you want to get gold teeth then it is not covered on the plan.

Dental surgery is also not covered. The benefit is designed to cover the basic maintenance of your teeth.

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Will There be Co-Payments?

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

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.

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Is Medication Covered?

Medication prescribed by a network dentist is covered under the Medication Benefit of your Day-to-Day plan.

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A Network You Can Depend On

Access private healthcare when you need to see a doctor, visit a dentist, get medication or go to hospital.

Nationwide Network of Doctors & Dentists
Private hospitals across South Africa

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Simple & Efficient Claims

Find out how the claims process works for rapid and pain-free claims handling.

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No upfront payments
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Claims paid directly to providers
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Answers to Your Questions

What does "unlimited" benefit mean?

When a health insurance benefit is "unlimited" it means that the benefit can be used as many times as you need without any specific annual limits.

The only conditions are that the claim or consultation is medically necessary.

Unlimited benefits are usually managed. This means that pre-authorisation is needed after a certain number of times that the benefit is used to ensure that it is you utilising the benefit and that you are getting the proper care that you deserve. You can find more details on the Network page.

What is the Dentistry benefit waiting period?

The waiting period on the Dentistry Benefit is 6 months.

This means that after the first 6 months of your policy's inception, you can use the benefit and visit a network dentist.

Where I can find the network dentists?

The Network page has all the information needed to find a provider on the network. There is an online search tool available to look up providers in your region.

How are claims paid?

Claims are paid directly to the medical providers. You can find all the details on our claims page.

What are the age limits?

All new members joining a policy must be younger than 65 years on date of application.

Child dependants must be younger than 21 years before they will need to start their own policy.

However, if your child is still a registered full-time student and unmarried, then they may stay on the policy as a child dependant until they turn 26.

How many people can be on a policy?

Episodic health insurance policies can include:

  • you
  • your spouse/partner
  • up to 6 children