Dentistry
Visiting a dentist
The Scheme has contracted the Dental Risk Company (DRC) to provide a range of basic dental services at an agreed network rate. Members visiting a network provider will not have to pay upfront or experience co-payments when receiving these services.
Search for "Dentists" in the provider search after logging in. Click on the name of the dentist to read the detail about network cover. A list of DRC network providers is available by calling the Call Centre on 0860 222 633.
If you choose to use a dentist outside the network, you will have to pay a co-payment (the difference between 80% of the Scheme Reimbursement Rate and the claimed amount). Services are limited to the basic dental services listed below and subject to DRC protocols.
Members on the Standard Care Plan can make use of the following dental services:
Every 180 days: 1 consultation, 1 scaling, polishing and fluoride treatment; 2 intra-oral radiographs per visit; 1 local anaesthetic per visit; 4 extractions, 5 restorations (amalgam or resin) per year; one panoramic radiograph every 36 months, one pair of plastic dentures every 4 years including 1 annual relining and repair per year.
Authorisation is required for more than 4 extractions or more than 5 resin restorations.
Subject to DRC protocols.
If the range of basic dental services is insufficient, a limited extended dental benefit can be used for additional basic or specialised dentistry.
Additional basic and specialised Dentistry Family Limit
R1 800 per adult and R450 per child per year This limit applies to both network and non-network providers. Use the available limit for one or more family member.