Genesis Medical Scheme offers excellent financial cover for dentistry on all their benefit options.
We all know that the benefits of good oral health reach far beyond a fresh breath and a celeb smile. Healthy teeth can also help lower the risk of cardiovascular disease, contribute to an overall healthy pregnancy and reduce the risk of oral cancer.
Unfortunately, dental treatment in South Africa can be quite expensive. Patients often have to dig deep into their pockets to cover the cost of dental treatment.
Dental cover for Genesis members
Genesis has designed their benefit offering across all their benefit options, including their hospital plans, to include good financial cover for basic dentistry. Some enhanced dentistry benefits are also available.
All qualifying dental benefits are paid from members’ risk benefits. Members therefore don’t have to fund their available dental benefits from their Self Managed Fund benefits or their own pockets.
Dental benefits explained
- Three (3) dental oral examinations
- Six (6) fillings
- Unlimited tooth extractions
- Plain X-rays and / or wide angle / Panorex imaging limited to the lower of cost or Scheme Tariff further limited to R750
- Two (2) root canal treatments, excluding root canal treatment on wisdom teeth
- Crowns, bridges or dentures are paid at the lower of cost or Scheme Tariff, further limited to R5,500
- In-hospital extractions and fillings (once only, lifetime limit) for child beneficiaries under the age of nine (9) years, further limited to R10,000 per case
- Surgical removal of bony impacted wisdom teeth, where pathology and pain are directly associated with the wisdom teeth. When this procedure is performed in-hospital, the benefit is limited to R15,000 per case including all cost(s). One (1) hospital admission per beneficiary per annum
- One (1) scale and polish
- One (1) dental implant, limited to R10,000 per three-year financial year cycle of membership
Will your qualifying accounts always be settled in full?
YES, if your Dental Practitioner charges the according to the Genesis Scheme Tariff. In the event where he/she charges more than this rate, you may have a co-payment.
When are dental procedures covered in hospital?
Members have in-hospital dental benefits for the removal of bony, impacted wisdom teeth, where pain and pathology are directly associated with the wisdom teeth. Members are entitled to one such dental hospital admission per annum.
Genesis will cover the cost of in-hospital removal of wisdom teeth at cost up to 100% of Scheme Tariff, further limited to R15, 000 per case (inclusive of all costs).
In addition, children under the age of nine (9) years have a once in a lifetime in-hospital benefit for fillings and extractions.
The in-hospital benefit for extractions and fillings is limited to R10, 000 per case (inclusive of all costs).
Infographic
The Infographic below shows the annual dental benefits that are available to all members when obtained from a registered Dental Practitioner:
Important information
Benefits reflected in this schedule are for the full benefit year and will be pro-rated for those members joining us during the benefit year.
The information provided herein is for information purposes only. It is not intended to flout or in any other way compromise the conditions prescribed in the Financial Advisory and Intermediary Services Act’s General Code of Conduct insofar as comparing different financial products with each other is concerned. Nothing herein contained is intended to be advice and any uncertainty regarding anything said should be referred to an accredited financial advisor.
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