What to know before buying dental insurance: Dental insurance reduces the financial burden of more expensive procedures such as crowns, bridges, and fillings while also assisting in the payment of preventive care. It takes some time to locate a dental insurance provider with policies that offer the level of protection you need without low annual caps or exclusions that could prevent you from receiving any benefits.
The best dental insurance plans give you access to a sizable dentist network, reasonable benefit caps each year, and perhaps reasonable prices. While looking for the best dental insurance provider, make sure you carefully compare and research the dental policies you are considering so you know exactly what is and is not covered.
5 Things To Know Before Buying For Dental Insurance
Dental Costs can be Extremely Expensive
Today, even routine dental procedures like root canals can cost up to $4,000. Parents may be appalled by the costs of routine dental care for their children in addition to their own dental expenses. Orthodontics, such as braces, can easily cost anywhere between $50,000 and $100,000.
Thankfully, the majority of South African medical aid plans do include dental coverage. The expenses of less expensive plans are covered by member savings, and the costs of more expensive plans may be covered by risk.
Schemes may provide benefits for both specialized and general dentistry, depending on the amount of coverage you have chosen to purchase.
What differentiate basic Dental Coverage From Specialized Dental Coverage?
Usually, less expensive medical aid plans only pay for routine dental care at a network dentist or other certified service provider (DSP).
Regular dental procedures like fillings, extractions, x-rays, scaling and polishing, root canal therapy, and conventional plastic dentures are covered by benefits.
You can be eligible for coverage for specialized dental operations including crowns, implants, bridges, orthodontics, periodontics, and metal frame dentures if you choose a more expensive medical assistance policy.
Pre-authorization is necessary, and benefits are constrained. Schemes may either place a limit on the cost of a certain surgery or treatment or mandate that members follow a managed care plan.
Cosmetic Procedures are Covered?
Dentistry-related cosmetic treatments and operations are unlikely to be reimbursed by South African medical aids, in line with standard exclusions that bar coverage for vanity-related cosmetic surgeries.
Therefore, it is possible that you may have to pay for porcelain veneers, teeth whitening, or tooth-coloured fillings to treat cavities.
Bonita’s dental tariff is used to calculate dental benefits. Pre-authorization is necessary for certain specialized operations and hospitalization.
Orthodontic procedures are subject to co-payments under the Standard and Standard Select policies. Members are expected to use dentists who are a part of the network of certified service providers for crown and bridge work.
Co-payments, Managed Care Policies, and Cxclusions, Bonita’s
Dental coverage under primary plans is subject to the DSP network of the plan. Scheme exclusions apply, and managed care protocols regulate all dental benefits.
On the Bon Com option, specialized dental benefits are paid out of available savings or the Above Threshold limit.
Pre-authorization is necessary for hospital admissions and some operations, including implants, crowns, and orthodontics, and benefits are subject to managed care guidelines.
Denis is a component of the EOH Health brand and specializes in offering medical aid program participants dental managed care services.
Its managed care standards combine technology and clinical expertise, and benefits are based on best practices. Heatshield, Key Health Medical Scheme, Bonita’s Medical Scheme, and Sizwe Medical Fund are members.
Dental insurance is offered by a number of insurers in South Africa; some of them have a network of dentists, while others let you choose any dentist.
Please enter your information in the form on this page if you are interested in dental coverage or simply want more information about it. A helpful adviser will contact you again to go over your alternatives.