Insurance that supplements your Medical aid for maximum cover
Dental insurance includes cover for dentist consultations, root canals, fillings, crowns, wisdom teeth extractions, x-rays, and dentures. Plans may also offer preventative care such as cleaning, polishing, and infection control.
What does a Dental plan cover?
In addition to routine dental care which includes consultations, x-rays, extractions, and root canals, dental benefits may also cover the removal of wisdom teeth, dentures, implants, crowns, and bridges.
What will be covered as well as the cover limits and required co-payments will depend on the insurer as well as which tier of dental plan you opt for.
Dental coverage will generally not cover any cosmetic procedures such as teeth whitening, braces, and veneers.
Who needs this type of cover?
Anyone that doesn’t have a medical aid or who has a low-tier medical aid that does not offer sufficient dental care could benefit from taking out a dental plan.
While most top-tier plans do offer significant dental insurance, most low-tier plans will only cover in-hospital emergencies and very basic routine check-ups and care. For those who are on hospital plans only, there will not be any dental benefits. In these cases, it will be a good idea to consider obtaining separate dental cover.
Most medical aids will offer additional add-on benefits to boost your current policy. It will be a good idea to get in touch with your medical aid provider and enquire about extra benefits. In most cases, you will be able to add your additional cover at a discounted price because you are bundling your cover with the same provider.
Types of plans
Just as with regular medical aid plans, dental plans also offer lower and higher-tier plans with lower plans offering less cover at a more affordable premium, and the higher plans offering the highest level of cover at an increased rate.
If you are a young individual you could consider a lower-tier plan that includes emergencies and preventative care such as cleaning. However, if you have a family it will be better to consider a more comprehensive plan to cover all emergencies as well as the different problems that your children may face.
What alternatives are there to Dental coverage?
Many top-tier medical aids offer dental insurance that will be sufficient for all basic dental care and in-hospital emergency treatment.
You can also set up a dental savings account for yourself and your family and work to save up enough to take care of most routine and occasional dental needs.
What do you need to apply for cover
You will need to provide your insurer with your ID and a completed application form containing personal contact information and general details. This will include whether or not you are part of medical aid and whether you have any pre-existing dental issues.
Dental costs from your Medical aid savings
Some medical aid plans come with a savings account that you can use to cover dental procedures that your plan does not cover outright. The problem is that if you’ve depleted your savings and need dental work you’re going to have to pay for the procedures yourself. You may also need your medical aid savings during the year for medicines, for example, but you would have exhausted these funds on dental care.
Who provides Dental plans in South Africa?
From Affinity Dental to DENIS, South Africa has an ever-increasing number of dental insurers ready to provide you and your family with the cover you need. There are also companies that offer exclusive dental plans for you to choose from just like you would a medical aid.
Do Dental plans have limits?
Just like medical aid plans, dental benefits also have limits that apply to different types of care and may also require you to make a co-payment.
When you look at the different providers it is important to not only take your monthly premiums into account but also what procedures and benefits the different plans offer and whether you would need to see a network dentist or if you can choose your own dentist.
What waiting periods apply?
Dental insurers may specify a 3-month waiting period for basic dental services and a 6-month waiting period for specialised services. There may also be exclusions for pre-existing conditions.
Do you need pre-authorisation?
You may not need to obtain pre-authorisation for basic dental consultations and work but for more complex procedures and diagnoses you will have to contact your insurer and obtain pre-authorisation.
If you will be needing extensive dental work then you should speak to the accounts department of your dental provider as they deal with medical aids all the time and they will be able to advise you on whether you need to obtain pre-authorisation.
Is a Dental plan worth it?
If you’re on a hospital plan and have no dental benefits or a lower-tier medical aid that offer very limited benefits, a dental insurance plan will be worth it for you. Dental cover is also ideal for families with children or elderly members as they require the most dental care and will benefit the most.
How to choose a plan
Choosing a dental benefits plan must start with you reviewing your medical aid benefits and determining what gaps there are in the cover and how you’re going to fill these. If you have a savings account with enough to cover both routine and a couple of more specialised dental procedures you may not need cover at all.
On the other hand, if your medical aid only offers annual check-ups and basic fillings, you may want to take out dental cover that offers you cover for things such as bridges and crowns.
The goal is to always carefully evaluate your specific needs and review all available dental plans to see which offers you the most affordable cover for your needs.
Get quotes online
You can make use of the services of a medical aid broker to help you find packages or gap cover that will suit all of your dental needs, even as your needs and those of your family change over time.
Dental insurance plan premiums vary depending on the benefits that the specific plan offer but can start from as little as R200 a month for the main member.