Dental practitioners
For basic dentistry; Oral Hygienist and Dental Therapists
80% of the lower of cost or Scheme Rate.
M + 0 = R4 503
M + 1 = R7 431
M + 2 = R8 741
M + 3+ = R10 028
Upfront payment for In-Hospital/ Day Clinic
12 years and younger in-hospital R3 068/R1 389 Day Clinic
13 years or older R7 872 In-Hospital/R5 036 Day Clinic
M
Advanced dentistry + Implants
No Benefit
-
Orthodontic treatment
No Benefit
-
Oral Surgery, Maxillo-Facial Surgery: For consultations, visits, surgical procedures by maxillo facial specialists and dental practitioners
100% of the lower recommended tariff. Subject to Overall Annual limit and Hospital Management Programme benefit.
-
Dental Practitioners For Basic Dentistry; Oral Hygienist and Dental Therapists
80% of the lower of cost or Scheme Rate.
M + 0 = R4 503
M + 1 = R7 431
M + 2 = R8 741
M + 3+ = R10 028
Upfront payment for In-Hospital/ Day Clinic
12 years and younger in-hospital R3 068/R1 389 Day Clinic
13 years or older R7 872 In-Hospital/R5 036 Day Clinic
Advanced Dentistry + Implants
No Benefit.
Orthodontic Treatment
No Benefit.
Oral Surgery, Maxillo-Facial Surgery
100% of the lower recommended tariff. Subject to Overall Annual limit & Hospital Management Programme benefit.
Dental practitioners for basic dentistry; Oral Hygienist and Dental Therapists
80% of lower cost or recommended tariffs.
Subject to Day-to-Day limit upfront payment for Basic Dentistry performed In-Hospital / Day clinic:
12 years and younger: R3 068 In-Hospital / R1 389 Day clinic
13 years and older: R7 872 In-Hospital / R5 036 Day clinic
Advanced dentistry
80% of lower cost or Scheme Rate.
M + 0 = R14 041
M + 1+ = R18 369
Orthodontic treatment — limited to members younger than 21 years.
Treatment will not be granted after member turns 21.
80% of lower cost or Scheme Rate.
Subject to Advanced Dentistry limit and prior scheme approval.
Osseo-integrated implants and orthognathic surgery (including the cost of hospitalisation, dental practitioners, anaesthetist fees and implants)
Subject to and included in Advanced Dentistry Limit and Dentistry Benefit Management Programme.
Oral Surgery and Maxillo-Facial Surgery
Unlimited. Subject to Hospital Benefit Management Programme. 100% of the lower of cost or recommended tariff.