Complimed Dental Gap Cover

Benefit Offering: Prime
Basic Denistry  
Dental Procedure Description Waiting Period Usage pa Annual Cover pp
Consultations 3 Months 2 @ R 295 per visit R 590.00
Fillings 3 Months 2 @ R 300 per filling R 600.00
X‑rays 3 Months 2 x-rays @ R 75 each R 150.00
Extractions 3 Months 2 extractions @ R 180 each R 360.00
Emergency Root Canal 3 Months 2 events @ R 190 each R 380.00
Infection control, Local anaesthetic & Sterilisation 3 Months R 200.00
Specialised Dentistry
(All Specialised Denistry Benefits listed below needs to be pre-authorised)
 
OVERALL ANNUAL LIMIT per person on the policy R 1 160
Lab (Crowns, Dentures, Implants) - use in conjuction with: 6 Months n/a
1.   Dentures (Professional Fees) 6 Months 0 -
2.   Crowns and Bridge Work (Professional Fees) 6 Months 0 R 0
3.   Implants (Professional Fees) 6 Months 0 -
Orthodontics 6 Months 0 -
Wisdom Teeth (chairs) 6 Months 2 teeth @ R 580 each R 1 160.00
Wisdom Teeth (hospital) 6 Months 0 -
Root Canal 6 Months 0 -
Protector Benefit  
Trauma ××× 1 Month 1 per year R 16 000.00
Benefit Offering: Bronze
Basic Dentistry  
Dental Procedure Description Waiting Period Usage pa Annual Cover pp
Consultations 3 Months 3 @ R 295 per visit R 590.00
Fillings 3 Months 3 @ R 300 per filling R 900.00
X‑rays 3 Months 3 x-rays @ R 75 each R 225.00
Extractions 3 Months 2 extractions @ R 180 each R 360.00
Emergency Root Canal 3 Months 3 events @ R 200 each R 600.00
Infection control, Local anaesthetic & Sterilisation 3 Months R 300.00
Specialised Denistry
(All Specialised Denistry Benefits listed below needs to be pre-authorised)
 
OVERALL ANNUAL LIMIT per person on the policy R 3000
Lab (Crowns, Dentures, Implants) - use in conjuction with: 6 Months n/a
1.   Dentures (Professional Fees) 6 Months One full set every 5 years R3000 -
2.   Crowns and Bridge Work (Professional Fees) 6 Months One treatment R3000 -
3.   Implants (Professional Fees) 6 Months 0 -
Orthodontics 6 Months 0 -
Wisdom Teeth (chairs) 6 Months 0 -
Wisdom Teeth (hospital) 6 Months 0 -
Root Canal 6 Months 0 -
Protector Benefit  
Trauma ××× 1 Month 1 per year R 25 000.00
Benefit Offering: Silver
Basic Denistry  
Dental Procedure Description Waiting Period Usage pa Annual Cover pp
Consultations 3 Months 4 @ R 295 per visit R 1180.00
Fillings 3 Months 4 @ R 400 per filling R 1600.00
X‑rays 3 Months 5 x-rays @ R 85 each R 425.00
Extractions 3 Months 3 extractions @ R 200 each R 600.00
Emergency Root Canal 3 Months 4 events @ R 270 each R 810.00
Infection control, Local anaesthetic & Sterilisation 3 Months R 400.00
Specialised Denistry
(All Specialised Denistry Benefits listed below needs to be pre-authorised)
 
OVERALL ANNUAL LIMIT per person on the policy R 20 000
Lab (Crowns, Dentures, Implants) - use in conjuction with: 6 Months  n/a
1.   Dentures (Professional Fees) 6 Months 1 full set per 5 years R 3 000.00
2.   Crowns and Bridge Work (Professional Fees) 6 Months 2 crowns @ R 4 000 each R 8 000.00
3.   Implants (Professional Fees) 6 Months 2 implants @ R 7 000 each R 14 000.00
Orthodontics 6 Months 1 treatment plan per lifetime R 17 000.00
Wisdom Teeth (chairs) 6 Months 4 teeth @ R 1 000 each R 4 000.00
Wisdom Teeth (hospital) 6 Months 2 teeth @ R 3 500 each R 7 000.00
Root Canal 6 Months 2 events @ R 1 300 each R 2 600.00
Protector Benefit  
Trauma ××× 1 Month 1 per year R 25 000.00
Benefit Offering: Gold
Basic Dentistry  
Dental Procedure Description Waiting Period Usage pa Annual Cover pp
Consultations 3 Months 5 @ R 295 per visit R1 475.00
Fillings 3 Months 4 @ R 400 per filling R 1 600.00
X‑rays 3 Months 6 x-rays @ R 90 each R 540.00
Extractions 3 Months 4 extractions @ R 215 each R 860.00
Emergency Root Canal 3 Months 3 events @ R 290 each R 870.00
Infection control, Local anaesthetic & Sterilisation 3 Months R 500.00
Specialised Dentistry
(All Specialised Dentistry Benefits listed below needs to be pre-authorised)
 
OVERALL ANNUAL LIMIT per person on the policy R 30 000
Lab (Crowns, Dentures, Implants) - use in conjuction with: 6 Months n/a
1.   Dentures (Professional Fees) 6 Months 1 full set per 5 years R 3 500.00
2.   Crowns and Bridge Work (Professional Fees) 6 Months 3 crowns @ R 2 500 each R 7 500.00
3.   Implants (Professional Fees) 6 Months 3 implants @ R 7 000 each R 21 000.00
Orthodontics 6 Months 1 treatment per lifetime R 25 000.00
Wisdom Teeth (chairs) 6 Months 4 teeth @ R 1 250 each R 5 000.00
Wisdom Teeth (hospital) 6 Months 4 teeth @ R 3 500 each R 14 000.00
Root Canal 6 Months 3 events @ R 1 500 each R 4 500.00
Protector Benefit  
Trauma ××× 1 Month 1 per year R 25 000.00
 

All benefits are paid subject to the DRUM annual tariff rate. PLEASE NOTE: only existing teeth are covered after expiring of the waiting periods, up to the maximum value stated.

×××  TRAUMA - in case of Trauma, authorisation must be given within 48 hours of the event occurring.

The benefit descriptions in this brochure do not supersede the Benefit Policy.E&OE. NOTE: BENEFITS AVAILABLE PER ANNUM TO APPLICANTS IF AGREEMENT IS ENTERED INTO BEFORE THE AGE OF 65.Claims have a 30 day turn around time.

Please note: The Orthodontic benefit will be removed as of September 1st 2017.

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