In South Africa, medical schemes cover the cost of dentistry either partially or in full. The level of cover is determined by the value of your monthly contribution.
Medical schemes usually pay for procedures conducted in hospital up to a specified limit, while dental cover generally covers only a portion of the cost of procedures.
Very few patients understand the limitations of dental cover through their medical aid schemes. In general, medical aid schemes are likely to pay for the majority of your medical procedures, but may not cover certain invasive, preventive and cosmetic procedures.
Elective dental surgery is related to improving your lifestyle rather than actually “staying alive”, so it might not be covered by your medical aid scheme.
Good dental habits require that you go for at least two dental check-ups per year. The costs of dental maintenance can add up, so it’s important to have dental insurance.
A basic clean can cost about R500, while an implant can cost as much as R13 000. Removal of wisdom teeth may cost up to R20 000 if done in hospital.
It’s costs like these that make it even more necessary to make sure that you find out the details about cover exclusions. There are specific dental procedures which might not be covered by medical aid schemes, such as root canals or crowns.
If you were to pay for some common dental procedures using cash upfront, here’s what you can expect to pay:
Root canal R900 to R2500
Crown R2500 to R4500
Implant R8000 to R13 000
What are your options for paying for dental procedures not covered by medical cover?
Get a medical loan or get dental health insurance. You can do this by first comparing the total cost of dental treatments to the total costs of the insurance plan. Check participating dentists. The type of procedures covered by your preferred or chosen dental insurance plan is also important.