Comprehensive
(High Cover)
Subject to Savings first, then Basic Dentistry limit
Subject to Savings and ATB. Implants (limited to 2 pb every 5 years, R3,387 per implant), 2partial frames (upper and lower) per beneficiary (every 5 yrs). 3 crowns per family. Orthodonic treatment is granted once per beneficiary per lifetime (100% of Dental Tariff). In-hospital dentistry. Subject to *DENIS protocols
Subject to available Savings and Threshold.
DEB limit for Dental devices, appliances and orthodontic treatment of R34,500 per beneficiary before and after threshold
Subject to Savings and Threshold. Limited to R8,270 pbpa and R24,700 pfpa before and after Threshold
Plastic/Metal frame dentures, Crowns & Bridges: 3 pfpa, Orthodontic treatment:
R17,340 pb per lifetime (Refer to member guide for full details)
Subject to available Savings & Threshold (Extender Cover limit of R16,400 pb and R42,600 pf. Both in & out of hospital dental specialist accounts accumulate to Threshold)
Subject to Basic Dentistry limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Comprehensive
(High Cover)
Subject to Savings first, then Basic Dentistry limit
Limit of R6,997 pfpa, 2 Partial frames (upper and lower) per beneficiary (every 5 yrs). 1
crown per family. Orthodonic treatment is granted once pbp lifetime (100% of Dental Tariff). In-hospital dentistry and maxillo facial surgery in dental chair. R3,500 co-pay (children under 5yrs) and R5,000 co-pay all other admissions. Subject to *DENIS protocols
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Plastic/Metal frame dentures, Crowns & Bridges: 2 pfpa, Orthodontic treatment:
R13,900 pb per lifetime (Refer to member guide for full details)
Subject to available Savings & Threshold (Extender Cover limit of R16,400 pb and R42,600 pf. Both in & out of hospital dental specialist accounts accumulate to Threshold)
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Comprehensive
(Medium to High Cover)
Subject to Savings first, then Basic Dentistry limit
Partial frame (upper or lower) per beneficiary (every 5 yrs). 1 crown per family. Orthodonic treatment is granted once per
beneficiary per lifetime (up to 65% of Dental Tariff). In-hospital dentistry and maxillo facial surgery in dental chair. R3,500 co-pay (children under 5yrs) and R5,000 co-pay all
other admissions. Subject to *DENIS protocols
Subject to available Savings and Threshold.
DEB limit limit for Dental devices, appliances and orthodontic treatment of R20,300 per beneficiary before and after threshold
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Plastic/Metal frame dentures, Crowns & Bridges: 1 pfpa, Orthodontic treatment:
R10,630 pb per lifetime (Refer to member guide for full details)
Subject to Savings, if available
Subject to Basic Dentistry limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Comprehensive
(Medium to High Cover)
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1 Partial frame (upper or lower) per beneficiary (every 5 yrs). 1 crown per family. Orthodonic treatment is granted once per
beneficiary per lifetime (up to 80% of Dental Tariff). In-hospital dentistry and maxillo facial surgery in dental chair. R3,500 co-pay (children under 5yrs) and R5,000 co-pay all
other admissions. Subject to *DENIS protocols
Subject to available Savings and Threshold.
DEB limit limit for Dental devices, appliances and orthodontic treatment of R20,300 per beneficiary before and after threshold
Subject to Savings or self-funded and Threshold. Limited to R8,270 pbpa and R24,700 pfpa before and after Threshold
Plastic/Metal frame dentures, Crowns & Bridges: 1 pfpa, Orthodontic treatment:
R10,630 pb per lifetime (Refer to member guide for full details)
Subject to Savings, if available
Subject to Basic Dentistry limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Comprehensive
(Medium to High Cover)
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1 Partial frame (upper or lower) per beneficiary (every 5 yrs). 1 crown per family. Orthodonic treatment is granted once per
beneficiary per lifetime (up to 80% of Dental Tariff). In-hospital dentistry and maxillo facial surgery in dental chair. R3,500 co-pay (children under 5yrs) and R5,000 co-pay all
other admissions. Subject to *DENIS protocols
Subject to available Savings and Threshold.
DEB limit limit for Dental devices, appliances and orthodontic treatment of R20,300 per beneficiary before and after threshold
Subject to Savings or self-funded and Threshold. Limited to R8,270 pbpa and R24,700 pfpa before and after Threshold
Plastic/Metal frame dentures, Crowns & Bridges: 1 pfpa, Orthodontic treatment:
R10,630 pb per lifetime (Refer to member guide for full details)
Subject to Savings, if available
Subject to Basic Dentistry limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Hospital & Savings
(Low to Medium Cover)
Subject to Savings
In-hospital subject to PMB and *DENIS protocols
Removal of impacted teeth only, with R5,000 co-payment
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
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Hospital & Savings
(Low to Medium Cover)
Subject to Savings
In-hospital dentistry and maxillo facial surgery in dental chair. R3,500 co-pay (children under 5yrs) and R5,000 co-pay all other admissions. Subject to *DENIS protocols
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
Subject to day-to-day limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Hospital & Savings
(Low to Medium Cover)
Subject to Savings
In-hospital dentistry and maxillo facial surgery in dental chair. R3,500 co-pay (children under 5yrs) and R5,000 co-pay all other admissions. Subject to *DENIS protocols
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
Subject to day-to-day limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Hospital & Savings
(Low to Medium Cover)
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In-hospital subject to PMB and *DENIS protocols
Subject to available Savings
Subject to Savings/ Wallet or self-funded
Subject to Savings
Subject to Savings, if available
Subject to day-to-day limit and dental tariff.
Orthodontic treatment: up to 18yrs. Subject to pre-auth
Capitation
(Low Cover)
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No Benefit
No Benefit – See Dental
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Subject to Health Saver, if available
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Capitation
(Low Cover)
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No Benefit
No Benefit – See Dental
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No Benefit
Subject to Health Saver, if available
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Hospital Plan
(Hospitalization Cover)
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No Benefit
No Benefit – see Dental
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Hospital Plan
(Hospitalization Cover)
No Benefit
No Benefit
No Benefit – see Dental
Subject to Savings/ Wallet or self-funded
Removal of impacted teeth in the dentists chair
Subject to Health Saver, if available
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Hospital Plan
(Hospitalization Cover)
No Benefit
No Benefit
No Benefit – See Dental
Subject to Savings/ Wallet or self-funded
No Benefit
Subject to Health Saver, if available
Subject to Basic Dentistry limit and PPS Wallet, if available
Primary Care
(Network & Income Based)
No Benefit
No Benefit
No Benefit
Subject to Savings or self-funded
No Benefit
No Benefit
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