If you have health insurance and you are covered for dental, the cost of your dental treatment will be paid for in 2 parts:
- The benefit amount that your health insurer will pay
- The out-of-pocket amount that you will need to pay
Every health insurer has their own method to determine the benefit amount they will pay towards your dental treatment.
Health insurers will normally pay on your behalf either a fix amount, or a fixed percentage of the treatment costs up until your annual limit. The level of benefit paid by your health insurer will also depend on the policy you have taken out (e.g. Bronze, Silver or Gold)
For treatments that are covered under our No Gaps Policy, as long as you have met the conditions under the policy, the cost of your dental treatment will be covered by your health insurance. That means that there is no out-of-pocket amount to be paid by you. For all other treatments, there will be an out-of-pocket amount that you will need to pay for.
When your dentist provides you with a treatment plan, you can contact your health insurer and request a quote to see how much benefit they will pay towards your treatment. This will give you an idea of how much out-of-pocket you will need to pay.