Member Benefits

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once every six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code Please contact us for a benefit check.
• Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Fluoride treatment: Members younger than 12 years, covered once every six months. Please contact us for a benefit check.
• Non-surgical extractions: More than 4 extractions per annum requires pre-authorisation.
• Emergency root canal treatment: Covered on permanent teeth. No cover for root canal treatment completion. DRC protocol rules apply.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once every six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code Please contact us for a benefit check.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Fluoride treatment: Members younger than 12 years, covered once every six months. Please contact us for a benefit check.
• Non-surgical extractions: More than 4 extractions per annum requires pre-authorisation.
• Emergency root canal treatment: Covered on permanent teeth. No cover for root canal treatment completion. DRC protocol rules apply.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once every six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code Please contact us for a benefit check.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Fluoride treatment: Members younger than 12 years, covered once every six months. Please contact us for a benefit check.
• Non-surgical extractions: More than 4 extractions per annum requires pre-authorisation.
• Emergency root canal treatment: Covered on permanent teeth. No cover for root canal treatment completion. DRC protocol rules apply.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once every six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code Please contact us for a benefit check.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Fluoride treatment: Members younger than 12 years, covered once every six months. Please contact us for a benefit check.
• Non-surgical extractions: More than 4 extractions per annum requires pre-authorisation.
• Emergency root canal treatment: Covered on permanent teeth. No cover for root canal treatment completion. DRC protocol rules apply.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once every six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code Please contact us for a benefit check.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Fluoride treatment: Members younger than 12 years, covered once every six months. Please contact us for a benefit check.
• Non-surgical extractions: More than 4 extractions per annum requires pre-authorisation.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.
In the event of Injury requiring emergency dental treatment, a limit R3 000.00 (Three Thousand Rand) per 24 (Twenty-Four) months will apply, subject to pre-authorisation of any treatment by the service provider.
Dental Limits : R1 500 per member per annum.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per annum. Scale and polish of adult teeth from 12 years and older, covered once per annum. Please contact us for a benefit check.
• Non-surgical extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.
In the event of Injury requiring emergency dental treatment, a limit R3 000.00 (Three Thousand Rand) per 24 (Twenty-Four) months will apply, subject to pre-authorisation of any treatment by the service provider.
Dental Limits : R1 750 per member per annum.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per annum. Scale and polish of adult teeth from 12 years and older, covered once per annum. Please contact us for a benefit check.
• Non-surgical extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.
In the event of Injury requiring emergency dental treatment, a limit R3 000.00 (Three Thousand Rand) per 24 (Twenty-Four) months will apply, subject to pre-authorisation of any treatment by the service provider.
Dental Limits : R2 000 per member per annum.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per annum. Scale and polish of adult teeth from 12 years and older, covered once per annum. Please contact us for a benefit check.
• Non-surgical extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.
In the event of Injury requiring emergency dental treatment, a limit R3 000.00 (Three Thousand Rand) per 24 (Twenty-Four) months will apply, subject to pre-authorisation of any treatment by the service provider.
Dental Limits : R1 750 per member per annum.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per annum. Scale and polish of adult teeth from 12 years and older, covered once per annum. Please contact us for a benefit check.
• Non-surgical extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively toclaims@dentalrisk.com.Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.
In the event of Injury requiring emergency dental treatment, a limit R3 000.00 (Three Thousand Rand) per 24 (Twenty-Four) months will apply, subject to pre-authorisation of any treatment by the service provider.
Dental Limits : R1 500 per member per annum.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum.
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per annum. Scale and polish of adult teeth from 12 years and older, covered once per annum. Please contact us for a benefit check.
• Non-surgical extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 3 restorations per annum. More than 3 restorations require pre-authorisation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.
Dental limits are as follows:

• Limited to R8000 per event.
• Limited to R2 400 per member per 18 months' period.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per covered period.
• Oral Radiographs: Maximum 2 x-rays per covered period. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per covered period. Scale and polish of adult teeth from 12 years and older, covered once per covered period. Please contact us for a benefit check.
• Non-surgical extractions: Limited to 3 extractions per member per covered period.
• Surgical removals: Surgical removal is only covered when authorised.
• Restorations: Limited to 3 restorations per covered period. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.
Dental limits are as follows:

• Limited to R800 per event.
• Limited to R2 400 per member per 18 months' period.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per covered period.
• Oral Radiographs: Maximum 2 x-rays per covered period. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: Scale and polish of adult teeth from 12 years and older, covered once per covered period.
• Non-surgical extractions: Limited to 3 extractions per member per covered period.
• Surgical removals: Surgical removal is only covered when authorised.
• Restorations: Limited to 3 restorations per covered period. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.
Dental limits are as follows:

• Limited to R800 per event.
• Limited to R2 400 per member per 18 months' period.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per covered period.
• Oral Radiographs: Maximum 2 x-rays per covered period. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: Scale and polish of adult teeth from 12 years and older, covered once per covered period.
• Non-surgical extractions: Limited to 3 extractions per member per covered period.
• Surgical removals: Surgical removal is only covered when authorised.
• Restorations: Limited to 3 restorations covered period. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com .Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.
Dental limits are as follows:

• Limited to R750 per event.
• Limited to R2 250 per member per 18 months' period.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per covered period.
• Oral Radiographs: Maximum 2 x-rays per covered period. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: Scale and polish of adult teeth from 12 years and older, covered once per covered period.
• Non-surgical extractions: Limited to 3 extractions per member per covered period.
• Surgical removals: Surgical removal is only covered when authorised.
• Restorations: Limited to 3 restorations covered period. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member.
• Emergency examination: Covered subject to covered service codes. Please contact us for a benefit check. (30 days waiting period is applicable).
• Oral Radiographs: Maximum 2 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 3 extractions per member per annum.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocols apply.
• Restorations: Limited to 3 restorations per annum. Please contact us for a benefit check.

Advanced dentistry: Please be advised that this benefit is limited to R900. As this is a generic Rand limited benefit any dental code claimed that is not in the above listings will be processed and paid at the billed rate to the maximum of the Rand limit. Please be advised that a 3 months waiting period is applicable on this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.
Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member.
• Emergency examination: Covered subject to covered service codes. Please contact us for a benefit check. (30 days waiting period is applicable).
• Oral Radiographs: Maximum 3 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 5 extractions per member per annum.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocols apply.
• Restorations: Limited to 4 restorations per annum. Please contact us for a benefit check. 
• Root canal treatment: Limited to 1 RCT per member per annum. DRC protocol rules apply.
• Impactions: Limited to 2 extractions per member per annum. Limited to wisdom teeth only. DRC protocol rules apply.
• Crown: Limited to 1 crown per member per annum. DRC protocol rules apply.

Advanced dentistry: Please be advised that this benefit is limited to R1 400 per policy per annum. As this is a generic Rand limited benefit any dental code claimed that is not in the above listings will be processed and paid at the billed rate to the maximum of the Rand limit. Please be advised that a 3 months waiting period is applicable on this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member.
• Emergency examination: Covered subject to covered service codes. Please contact us for a benefit check. (30 days waiting period is applicable)
• Oral Radiographs: Limited to 4 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 7 extractions per member per annum.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocols apply.
• Restorations: Limited to 5 restorations per annum.
• Root canal treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply.
• Impactions: Limited to 3 extractions per member per annum. Limited to wisdom teeth only. DRC protocol rules apply.
• Crown: Limited to 2 crowns per member per annum. DRC protocol rules apply.

Advanced dentistry: Please be advised that this benefit is limited to R2 100 per policy per annum. As this is a generic Rand limited benefit any dental code claimed that is not in the above listings will be processed and paid at the billed rate to the maximum of the Rand limit. Please be advised that a 3 months waiting period is applicable on this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member.
• Emergency examination: Covered subject to covered service codes. Please contact us for a benefit check. (30 days waiting period is applicable)
• Oral Radiographs: Maximum 4 x-rays annually. Please contact us for a benefit check.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 7 extractions per member per annum.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocols apply.
• Restorations: Limited to 5 restorations per annum.
• Root canal treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply.
• Impactions: Limited to 3 extractions per member per annum. Limited to wisdom teeth only. DRC protocol rules apply.
• Crown: Limited to 2 crowns per member per annum. DRC protocol rules apply.
• Plastic dentures: Limited to 1 set of plastic dentures per member every 48 months. DRC protocol rules apply.

Advanced dentistry: Please be advised that this benefit is limited to R2 800 per policy per annum. As this is a generic Rand limited benefit any dental code claimed that is not in the above listings will be processed and paid at the billed rate to the maximum of the Rand limit. Please be advised that a 3 months waiting period is applicable on this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 3 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 2 x-rays per member annually.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Non-surgical Extractions: Limited to 2 extractions per member per annum.
• Restorations: Limited to 2 restorations per member per annum.
• Trauma: Covered to the maximum stated benefits, once per annum at R16 770. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 3 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 2 x-rays per member annually.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Non-surgical Extractions: Limited to 2 extractions per member per annum.
• Restorations: Limited to 2 restorations per member per annum.
• Trauma: Covered to the maximum stated benefits, once per annum at R16 770. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 3 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 3 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Non-surgical Extractions: Limited to 2 extractions per member per annum.
• Restorations: Limited to 3 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Temporary crown: Limited to 1 per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefit. 6 Months waiting period applicable on all specialised dentistry.

• Plastic dentures: Limited to 1 full set of plastic dentures per member per 5 year period. Paid according to the stated benefit - DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 4 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 5 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: One per member per annum.
• Non-surgical Extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 4 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Root Canal Treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply, please note that a 6 months waiting period is applicable. Pre-authorisation and x-rays required.
• Temporary crown: Limited to 2 temporary crowns per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefits. 6 Months waiting period applicable on all specialised dentistry.

• Impaction in the Chair: Limited to 4 extractions per member per annum (Limited to wisdom teeth only) Paid according to the stated benefit – DRC protocol rules apply.
• Impaction in Hospital: Limited to 2 extractions per member per annum (Limited to wisdom teeth only). Paid according to the stated benefit – DRC protocol rules apply.
• Crown: Limited to 1 crown per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Plastic dentures: Limited to 1 full set of plastic dentures per member every 5 years. Paid according to the stated benefit – DRC protocol rules apply.
• Implants: Limited to 1 implant per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 4 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 5 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: One per member per annum.
• Non-surgical Extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 4 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Root Canal Treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply, please note that a 6 months waiting period is applicable. Pre-authorisation and x-rays required.
• Temporary crown: Limited to 2 temporary crowns per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefit. 6 Months waiting period applicable on all specialised dentistry.

• Impaction in the Chair: Limited to 4 extractions per member per annum (Limited to wisdom teeth only) Paid according to the stated benefit – DRC protocol rules apply.
• Impaction in Hospital: Limited to 2 extractions per member per annum (Limited to wisdom teeth only). Paid according to the stated benefit – DRC protocol rules apply.
• Crown: Limited to 1 crown per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Plastic dentures: Limited to 1 full set of plastic dentures per member every 5 years. Paid according to the stated benefit – DRC protocol rules apply.
• Implants: Limited to 1 implant per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 4 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 5 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: One per member per annum.
• Non-surgical Extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 4 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Root Canal Treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply, please note that a 6 months waiting period is applicable. Pre-authorisation and x-rays required.
• Temporary crown: Limited to 2 temporary crowns per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefit. 6 Months waiting period applicable on all specialised dentistry.

• Impaction in the Chair: Limited to 4 extractions per member per annum (Limited to wisdom teeth only) Paid according to the stated benefit – DRC protocol rules apply.
• Impaction in Hospital: Limited to 2 extractions per member per annum (Limited to wisdom teeth only). Paid according to the stated benefit – DRC protocol rules apply.
• Crown: Limited to 1 crown per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Plastic dentures: Limited to 1 full set of plastic dentures per member every 5 years. Paid according to the stated benefit – DRC protocol rules apply.
• Implants: Limited to 1 implant per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 4 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 5 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: One per member per annum.
• Non-surgical Extractions: Maximum of 3 extractions per member per annum.
• Restorations: Limited to 4 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Root Canal Treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply, please note that a 6 months waiting period is applicable. Pre-authorisation and x-rays required.
• Temporary crown: Limited to 2 temporary crowns per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefit. 6 Months waiting period applicable on all specialised dentistry.

• Impaction in the Chair: Limited to 4 extractions per member per annum (Limited to wisdom teeth only) Paid according to the stated benefit – DRC protocol rules apply.
• Impaction in Hospital: Limited to 2 extractions per member per annum (Limited to wisdom teeth only). Paid according to the stated benefit – DRC protocol rules apply.
• Crown: Limited to 1 crown per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Plastic dentures: Limited to 1 full set of plastic dentures per member every 5 years. Paid according to the stated benefit – DRC protocol rules apply.
• Implants: Limited to 1 implant per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 4 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 5 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: One per member per annum.
• Non-surgical Extractions: Limited to 3 extractions per member per annum.
• Restorations: Limited to 4 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Root Canal Treatment: Limited to 2 RCT per member per annum. DRC protocol rules apply, please note that a 6 months waiting period is applicable. Pre-authorisation and x-rays required.
• Temporary crown: Limited to 2 temporary crowns per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefit. 6 Months waiting period applicable on all specialised dentistry.

• Impaction in the Chair: Limited to 4 extractions per member per annum (Limited to wisdom teeth only) Paid according to the stated benefit – DRC protocol rules apply.
• Impaction in Hospital: Limited to 2 extractions per member per annum (Limited to wisdom teeth only). Paid according to the stated benefit – DRC protocol rules apply.
• Crown: Limited to 1 crown per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Plastic dentures: Limited to 1 full set of plastic dentures per member every 5 years. Paid according to the stated benefit – DRC protocol rules apply.
• Implants: Limited to 1 implant per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 5 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 6 x-rays per member annually.
• Pan scan: Once per lifetime.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: Once per 6 months per member per annum.
• Non-surgical Extractions: Limited to 4 extractions per member per annum.
• Restorations: Limited to 4 restorations per member per annum.
• Bite plate: Limited to 1 Bite plate per member per annum. DRC protocol rules apply.
• Mouth guard: Limited to 1 Mouth guard per member per annum. DRC protocol rules apply.
• Root Canal Treatment: Limited to 3 RCT per member per annum. DRC protocol rules apply, please note that a 6 months waiting period is applicable. Pre-authorisation and x-rays required.
• Temporary crown: Limited to 3 per member per annum. DRC protocol rules apply, please note that there is a 6 months waiting period applicable on this benefit. Pre-authorisation and x-rays required.

Specialised dentistry: All specialised dentistry must be pre-authorised and are paid according to the stated benefit. 6 Months waiting period applicable on all specialised dentistry.

• Impaction in the Chair: Limited to 4 extractions per member per annum (limited to wisdom teeth only) Paid according to the stated benefit – DRC protocol rules apply.
• Impaction in Hospital: Limited to 4 extractions per member per annum (limited to wisdom teeth only). Paid according to the stated benefit – DRC protocol rules apply.
• Crown: Limited to 2 crowns per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Plastic dentures: Limited to 1 full set of plastic dentures per member every 5 years. Paid according to the stated benefit – DRC protocol rules apply.
• Implants: Limited to 2 implants per member per annum. Paid according to the stated benefit – DRC protocol rules apply.
• Trauma: Covered to the maximum stated benefits, once per annum at R29 050. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 3 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: Limited to 3 consultations per member per annum. Full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 2 x-rays per member annually.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Non-surgical Extractions: Limited to 2 extractions per member per annum.
• Restorations: Limited to 2 restorations per member per annum.
• Trauma: Covered to the maximum stated benefits, once per annum at R16 770. Kindly note that there is a 1 month waiting period on this benefit. A police report/emergency room report is required to utilise this benefit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 60 days. Claims submitted after the 60 days will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six months. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions per annum require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six months. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions per annum require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six months. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions per annum require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six months. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions per annum require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code. Please contact us for a benefit check.
• Oral Radiographs: Limited to 7 x-rays annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: An injection is covered once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every six months.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code. Please contact us for a benefit check.
• Oral Radiographs: Limited to 7 x-rays annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: An injection is covered once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every six months.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code. Please contact us for a benefit check.
• Oral Radiographs: Limited to 7 x-rays annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check- Protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: An injection is covered once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every six months.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, a distinct/alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code. Please contact us for a benefit check.
• Oral Radiographs: Limited to 7 x-rays annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: An injection is covered once per visit where code 8201, 8202 or any restoration is claimed that is covered
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every six months.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code. Please contact us for a benefit check
• Oral Radiographs: Limited to 7 x-rays annually annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check- Protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: An injection is covered once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every six months.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation. Bankmed is administered by Discovery Administrators. All claims including the below Basic Option must be submitted to Discovery. All dental Pre-authorisations for Bankmed Basic Plan are performed via a quotation basis which means you will need to compile a quote of the work to be done that needs authorising by DRC. Once the pre-authorisation form is completed you can email it to auth@dentalrisk.com.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral Radiographs: Limited to 7 x-rays annually. Maximum two x-rays per visit per member per visit. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months. Please note that there are no benefits for oral hygiene instructions/evaluation.
• Fluoride treatment: Limited to members younger than 12 years, once per six months. Limited to members older than 12 years, once per six months. Please contact us for a benefit check.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Limited to 4 per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Dentures: One set of full/partial dentures (upper or lower jaw) per beneficiary per 24 months per membe rolder than 18 years. No benefits shall be granted for any metal dentures (full or partial), including the laboratory costs.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 365 days after the previous consultation. Emergency examination is covered subject to covered service code.
• Oral Radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months. Please note that there are no benefits for oral hygiene instructions/evaluation. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 1 per quadrant per 365 days. DRC protocol rules apply.
• Emergency root canal treatment is covered on permanent teeth. No cover for root canal treatment completion. Please contact us for a benefit check.
• Restorations: Limited to 3 restorations per annum. Pre-authorisation required for more than 3 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative/Basic Dentistry: Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. All members are to visit a contracted dentist. Claims submitted by non-network dentists will be rejected. The following procedures are covered:

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 365 days after the previous consultation. Emergency examination is covered subject to covered service code.
• Oral Radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months. Please note that there are no benefits for oral hygiene instructions/evaluation. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 1 per quadrant per 365 days. DRC protocol rules apply.
• Emergency root canal treatment is covered on permanent teeth. No cover for root canal treatment completion. Please contact us for a benefit check.
• Restorations: Limited to 3 restorations per annum. Pre-authorisation required for more than 3 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative/Basic Dentistry: Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. All members are to visit a contracted dentist. Claims submitted by non-network dentists will be rejected. The following procedures are covered:

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 365 days after the previous consultation. Emergency examination is covered subject to covered service code.
• Oral Radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months. Please note that there are no benefits for oral hygiene instructions/evaluation. Please contact us for a benefit check.
• Non-surgical Extractions: Limited to 1 per quadrant per 365 days.
• Emergency root canal treatment is covered on permanent teeth. No cover for root canal treatment completion. Please contact us for a benefit check.
• Restorations: Limited to 3 restorations per annum. Pre-authorisation required for more than 3 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code.
• Oral Radiographs: Limited to 2 x-rays per visit. Maximum of 7 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every 6 months. Members older than 12 months, covered once every 6 months.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: More than 4 restorations per annum must be pre-authorised. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code.
• Oral Radiographs: Limited to 2 x-rays per full mouth examination. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 9011, 8201 or 8202 is claimed.
• Fluoride treatment: Members younger than 12 years, covered once every 6 months. Members older than 12 months, covered once every 6 months.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: More than 5 restorations per annum require pre-authorisation. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Plastic dentures: One per jaw (set of dentures) every 4 years.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Emergency examination is covered subject to covered service code.
• Oral Radiographs: Limited to 4 x-rays per visit. Overall maximum of 7 per member per annum. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered. DRC protocol rules apply.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every 6 months. Members older than 12 months, covered once every 6 months,
• Sterilisation of instruments: Limited to 1 per visit. Will only be paid if code 9011, 9013, 8731, 8201 or 8202 is claimed.
• Non-surgical Extractions: More than 4 extractions per visit require pre-authorisation.
• Restorations: Pre-authorisation needed for more than 5 restorations per annum. No late pre-authorisation requests will be accepted.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Root Canal Treatment: Pre-authorisation required, please submit a quote with supporting documents to auth@dentalrisk.com.
• Plastic dentures: One per jaw (set of dentures) every 4 years.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims must be submitted to Discovery for capturing and processing. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation : A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per annum.
• Oral radiographs: Limited to 4 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months.
• Non-surgical extractions: Maximum of 1 x 8201 per quadrant per visit. Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: Maximum of 4 restoration per annum. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com .Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation : A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per annum.
• Oral radiographs: Limited to 4 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months.
• Non-surgical extractions: Maximum of 1 x 8201 per quadrant per visit. Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: Maximum of 4 restoration per annum. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com .Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation : A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per annum.
• Oral radiographs: Limited to 4 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months.
• Non-surgical extractions: Maximum of 1 x 8201 per quadrant per visit. Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: Maximum of 4 restoration per annum. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com .Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation : A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per annum.
• Oral radiographs: Limited to 4 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months.
• Non-surgical extractions: Maximum of 1 x 8201 per quadrant per visit. Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: Maximum of 4 restoration per annum. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com .Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions per annum require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 1 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 1 crown per member within a 24 month period. Paid according to the stated benefit, DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 1 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 1 crown per member within a 24 month period. Paid according to the stated benefit, DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 1 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 1 crown per member within a 24 month period. Paid according to the stated benefit. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 1 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 1 crown per member within a 24 month period. Paid according to the stated benefit. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 2 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 2 crowns per member within a 24 month period. Paid according to the stated benefit, DRC protocol rules apply.
• Plastic dentures: Limited to 1 set of plastic denture per policy per annum. Paid according to the stated benefit. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 2 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 2 crowns per member within a 24 month period. Paid according to the stated benefit, DRC protocol rules apply.
• Plastic dentures: Limited to 1 set of plastic denture per policy per annum. Paid according to the stated benefit. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum of 2 x-rays per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 2 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 2 crowns per member within a 24 month period. Paid according to the stated benefit, DRC protocol rules apply.
• Plastic dentures: Limited to 1 set of plastic denture per policy per annum. Paid according to the stated benefit. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols, kindly note there is 6 Months waiting period on all dental treatments. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Maximum 2 per member per consultation not more than 4 per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered once per six month. Code 8161 - Limited to members younger than 12 years. Code 8162 - Limited to members older than 12 years.
• Non-surgical Extractions: More than 4 extractions require authorisation.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.
• Root canal treatment: Limited to 2 RCT per member per annum. Paid according to the stated benefit. DRC protocol rules apply.
• Crown: Limited to 2 crowns per member within a 24 month period. Paid according to the stated benefit, DRC protocol rules apply.
• Plastic dentures: Limited to 1 plastic denture per policy per annum. Paid according to the stated benefit. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Subject to managed care protocols, providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Please note that there is a 3 months waiting period on all dental treatments.

The below rand values are overall limitation for dental benefits and the stated codes will be covered according to the rand limit. Maximum of R1 650 per family per annum (double the benefit on accidental injury).

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 2 x-rays per visit
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: Scale and polish of adult teeth from 12 years and older, covered once per annum.
• Fluoride treatment: Cover for children, once every six months. Limited to members younger than 12 years. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Limited to 1 per member per annum. DRC protocols apply.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Restorations: Pre-authorisation required for more than 4 restorations, please contact us for benefit confirmation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Subject to managed care protocols, providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Please note that there is a 3 months waiting period on all dental treatments.

The below rand values are overall limitation for dental benefits and the stated codes will be covered according to the rand limit. Maximum of R1 650 per family per annum (double the benefit on accidental injury).

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 2 per visit.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Maximum 1 per visit.
• Cleaning: Scale and polish of adult teeth from 12 years and older, covered once per annum.
• Fluoride treatment: Cover for children, once every six months. Limited to members younger than 12 years. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Limited to 1 per member per annum. DRC protocols apply.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Restorations: Pre-authorisation required for more than 4 restorations, please contact us for benefit confirmation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Subject to managed care protocols, providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Please note that there is a 3 months waiting period on all dental treatments.

The below rand values are overall limitation for dental benefits and the stated codes will be covered according to the rand limit. Maximum of R1 650 per family per annum (double the benefit on accidental injury).

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per annum per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 2 per visit.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: Scale and polish of adult teeth from 12 years and older, covered once per annum.
• Fluoride treatment: Cover for children, once every six months. Limited to members younger than 12 years. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Limited to 1 per member per annum. DRC protocols apply.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Restorations: Pre-authorisation required for more than 4 restorations, please contact us for benefit confirmation.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Subject to managed care protocols, providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 7 radiographs annually. DRC protocols apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.  Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Once every 6 months, limited to members younger than 12 years. Please contact us for benefit confirmation.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Limited to 1 per treatment date. DRC protocol applies.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per annum.
• Oral radiographs: Limited to 4 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months.
• Non-surgical extractions: Maximum of 1 x 8201 per quadrant per visit. Authorisation required for more than 4 non-surgical extractions.
• Emergency dental treatment: DRC protocol rules apply.
• Restorations: Maximum of 4 restoration per annum. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per annum.
• Oral radiographs: Limited to 4 x-rays per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months.
• Non-surgical extractions: Maximum of 1 x 8201 per quadrant per visit. Authorisation required for more than 4 non-surgical extractions.
• Emergency dental treatment: DRC protocol rules apply.
• Restorations: Maximum of 4 restoration per annum. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 3 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation (Includes cost of sterilisation of instruments): A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation.
• Oral radiographs: Limited to 2 x-rays per visit. Limited to 7 x-rays annually.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months. Members older than 12 years, covered once per 6 months.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: More than 4 restoration per annum requires pre-authorisation. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com .Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 6 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation (Includes cost of sterilisation of instruments): A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation.
• Oral radiographs: Limited to 2 x-rays per visit. Limited to 7 x-rays annually.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months. Members older than 12 years, covered once per 6 months.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: More than 4 restoration per annum requires pre-authorisation. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to DRC protocols. Kindly note that a 6 months waiting period is applicable on these benefits. Please contact our call centre for benefits confirmation.

• Consultation (Includes cost of sterilisation of instruments): A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation.
• Oral radiographs: Limited to 2 x-rays per visit. Limited to 7 x-rays annually
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Once per visit where code 8201, 8202 or any restoration is claimed that is covered.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months. Members older than 12 years, covered once per 6 months.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions.
• Emergency root canal treatment: Covered on permanent teeth. DRC protocol rules apply.
• Restorations: More than 4 restoration per annum requires pre-authorisation. DRC protocol rules apply.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Please note that there is no cover for conservative or specialised dental services on this option. Dental surgery in the dentist rooms is limited to removal of Impacted third molars. Sedation for extensive dental treatment for children younger than 12 years will not be covered.

• Conscious sedation in the dentist’s rooms: Limited to the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to the removal of impacted third molars. Only the stated codes are covered in-hospital unless related to a valid PMB event. A co-payment of R4 100 is applicable per admission.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Please note that there is no cover for conservative or specialised dental services on this option. Dental surgery in the dentist rooms is limited to removal of Impacted third molars. Sedation for extensive dental treatment for children younger than 12 years will not be covered.

• Conscious sedation in the dentist’s rooms: Limited to the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to the removal of impacted third molars. Only the stated codes are covered in-hospital unless related to a valid PMB event. A co-payment of R4 100 is applicable per admission

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services.

NB: Conservative services for members younger than 18 years, as indicated in the benefit guide, will be paid from the member's annual dental benefit. All claims for members older than 18 years will be paid from the savings account.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation.
• Pan scans: Limited to 1 per member in a 3-year period from date of service. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Cover for children, once every six months. Limited to members from 5 years and younger than 13 years of age. Please contact us for a benefit check.
• Restorations: Limited to 4 restorations per member per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older. DRC protocols apply.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period. DRC protocols apply.
• Bite plate: One per member every 365 days from date of service.

Specialised dentistry: Subject to available savings. managed care protocols and pre-authorisation. Authorisation requests may be submitted to auth@dentalrisk.com. Failure to pre-authorise the procedure(s) will result in a 20% co-payment on scheme tariff (of approved codes).

• Metal frame partial denture: 2 Partial metal frame dentures (an upper or/and a lower jaw) per member per 5-year period. Subject to available savings and pre-authorisation. DRC protocols apply.
• Crowns: Subject to available savings and pre-authorisation. DRC protocols apply.
• Orthodontic treatment: Limited to members younger than 18 years. Only one member per family may commence with orthodontic treatment in a calendar year. Subject to available savings and pre-authorisation. DRC protocols apply.
• Periodontic treatment: Periodontic treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels. Subject to available savings and pre-authorisation. DRC protocols apply.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures. Subject to available savings and pre-authorisation. DRC protocols apply.
• Implants: No theatre or hospital benefit for placement of implants. Subject to available savings and pre-authorisation. DRC protocols apply.
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in the dentist’s rooms: Limited to the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 7 years of age and the removal of impacted third molars. Only the stated codes will be covered in-hospital unless related to a valid PMB event. A co-payment of R4 100 is applicable per admission.
• Removal of impacted third molars: Dentist account payable from the member's savings account.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services.

NB: Conservative services for members younger than 18 years, as indicated in the benefit guide, will be paid from the member's annual dental benefit. All claims for members older than 18 years will be paid from the savings account.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation.
• Pan scans: Limited to 1 per member in a 3-year period from date of service. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Cover for children, once every six months. Limited to members from 5 years and younger than 13 years of age. Please contact us for a benefit check.
• Restorations: Limited to 4 restorations per member per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older. DRC protocols apply.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period. DRC protocols apply.
• Bite plate: One per member every 365 days from date of service.

Specialised dentistry: Subject to available savings, managed care protocols and pre-authorisation. Authorisation requests may be submitted to auth@dentalrisk.com. Failure to pre-authorise the procedure(s) will result in a 20% co-payment on scheme tariff (of approved codes).

• Metal frame partial denture: 2 Partial metal frame dentures (an upper or/and a lower jaw) per member per 5-year period. Subject to available savings and pre-authorisation. DRC protocols apply.
• Crowns: Subject to available savings and pre-authorisation. DRC protocols apply.
• Orthodontic treatment: Limited to members younger than 18 years. Only one member per family may commence with orthodontic treatment in a calendar year. Subject to available savings and pre-authorisation. DRC protocols apply.
• Periodontic treatment: Periodontic treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels. Subject to available savings and pre-authorisation. DRC protocols apply.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures. Subject to available savings and pre-authorisation. DRC protocols apply.
• Implants: No theatre or hospital benefit for placement of implants. Subject to available savings and pre-authorisation. DRC protocols apply.
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in the dentist’s rooms: Limited to the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 7 years of age and the removal of impacted third molars. Only the stated codes will be covered in-hospital unless related to a valid PMB event. A co-payment of R4 100 is applicable per admission.
• Removal of impacted third molars: Dentist account payable from the member's savings account.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation.
• Pan scan: Limited to 1 per member in a 3-year period from date of service. Please contact us for a benefit check, protocol rules apply. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Cover for children, once every six months. Limited to members from 5 years and younger than 13 years of age. Please contact us for a benefit check.
• Restorations: Limited to 4 per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply, please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older. DRC protocols apply.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period. DRC protocols apply.

Specialised dentistry: Subject to managed care protocols and pre-authorisation. Authorisation requests may be submitted to auth@dentalrisk.com. Failure to pre-authorise the procedure(s) will result in a 20% co-payment on scheme tariff (of approved codes).

• Metal frame partial denture: 1 Partial metal frame dentures (an upper or/and a lower jaw) per member per 5-year period. DRC protocols apply.
• Crowns: 1 Crown annually per family, limited to once per tooth per 5 year period from date of service. Subject to pre-authorisation. DRC protocols apply.
• Orthodontic treatment: Limited to beneficiaries younger than 18 years. Failure to pre-authorise orthodontic treatment shall result in benefits only being granted from the date of authorisation for the remaining month of treatment, provided that the treatment is approved as per managed care protocols. R11 160 per beneficiary per lifetime, limited to patients younger than 18 years. Only one beneficiary per family may commence with orthodontic treatment in a calendar year.
• Periodontic treatment: Periodontic treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels. Subject to available savings and pre-authorisation. DRC protocols apply.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures. Subject to DRC protocols and pre-authorisation.
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in the dentist’s rooms: Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 7 years of age and the removal of impacted third molars. Only the stated codes will be covered in-hospital unless related to a valid PMB event.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB. A co-payment of R1 850 is applicable per admission.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation.
• Pan scan: Limited to 1 per member in a 3-year period from date of service. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Cover for children, once every six months. Limited to members from 5 years and younger than 13 years of age. Please contact us for a benefit check.
• Restorations: Limited to 4 per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply, please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older. DRC protocols apply.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period. DRC protocols apply.

Specialised dentistry: Subject to managed care protocols and pre-authorisation. Authorisation requests may be submitted to auth@dentalrisk.com. Failure to pre-authorise the procedure(s) will result in a 20% co-payment on scheme tariff (of approved codes).

• Metal frame partial denture: 1 Partial metal frame dentures (an upper or/and a lower jaw) per member per 5-year period. DRC protocols apply.
• Crowns: 1 Crown annually per family, limited to once per tooth per 5 year period form date of service. Subject to pre-authorisation. DRC protocols apply.
• Orthodontic treatment: Limited to beneficiaries younger than 18 years. Failure to pre-authorise orthodontic treatment shall result in benefits only being granted from the date of authorisation for the remaining month of treatment, provided that the treatment is approved as per managed care protocols. R11 160 per beneficiary per lifetime, limited to patients younger than 18 years. Only one beneficiary per family may commence with orthodontic treatment in a calendar year.
• Periodontic treatment: Periodontic treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels. Subject to pre-authorisation. DRC protocols apply.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures. Subject to DRC protocols and pre-authorisation.
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in the dentist’s rooms: Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 7 years of age and the removal of impacted third molars. Only the stated codes will be covered in-hospital unless related to a valid PMB event.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB. A co-payment of R1 850 is applicable per admission.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation.
• Pan scan: Limited to 1 per member in a 3-year period from date of service. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Cover for children, once every six months. Limited to members from 5 to 13 years. Please contact us for a benefit check.
• Restorations: Limited to 4 per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply, please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older. DRC protocols apply.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period. DRC protocols apply.

Specialised dentistry (Subject to managed care protocols and pre-authorisation): Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review. Failure to obtain pre-authorisation for the following procedures will result in a 20% co-payment on scheme tariff/ approved service codes:

• Metal frame partial denture: 2 Partial metal frame dentures (an upper or/and a lover jaw) per member per 5 year period from date of service.
• Crowns: Limited to 2 crowns annually per family, limited to once per tooth per 5 year period from date of service.
• Orthodontic treatment: Limited to beneficiaries younger than 18 years. Failure to pre-authorise orthodontic treatment shall result in benefits only being granted from the date of authorisation for the remaining month of treatment, provided that the treatment is approved as per managed care protocols. R14 595 per beneficiary per lifetime, limited to patients younger than 18 years. Only one beneficiary per family may commence with orthodontic treatment in a calendar year.
• Periodontics treatment: Periodontics treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures.
• Implants - No benefits
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in dentist’s rooms: Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 7 years of age and the removal of impacted third molars. Only the stated codes will be covered in-hospital unless related to a valid PMB event. A co-payment of R1 120 is applicable per admission.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation.
• Pan scan: Limited to 1 per member in a 3-year period from date of service . DRC protocols apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Cover for children, once every six months. Limited to children older than 5 years and younger than 13 years of age. Please contact us for a benefit check.
• Restorations: Limited to 4 per annum. Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply, please contact us for a benefit check.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older DRC protocols apply.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period DRC protocols apply.

Specialised dentistry: Subject to DRC protocols and pre-authorisation. Authorisation requests may be submitted to auth@dentalrisk.com. Failure to pre-authorise the procedure(s) will result in a 20% co-payment on scheme tariff (of approved codes).

• Metal frame partial denture: 2 Partial metal frame dentures (an upper or/and a lover jaw) per member per 5 year period from date of service. Subject to DRC protocols and pre-authorisation.
• Crowns: Limited to 3 crowns annually per family, limited to once per tooth per 5 year period from date of service. Subject to DRC protocols and pre-authorisation.
• Orthodontic treatment: Limited to beneficiaries younger than 18 years. Failure to pre-authorise orthodontic treatment shall result in benefits only being granted from the date of authorisation for the remaining month of treatment, provided that the treatment is approved as per managed care protocols. R18 200 per beneficiary per lifetime, limited to patients younger than 18 years. Only one beneficiary per family may commence with orthodontic treatment in a calendar year.
• Implants: Limited to 2 implants per member per 5 year period. Benefits for the implant component are limited to R3 090 per implant. DRC protocols apply.
• Periodontic treatment: Periodontic treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels. Subject to pre-authorisation and DRC protocols.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures.
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in dentist’s rooms: Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 7 years of age and the removal of impacted third molars. Only the stated codes will be covered in-hospital unless related to a valid PMB event.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative dentistry: Benefits are subject to DRC protocols. Motivations may be required in case of extensive conservative dental services. Please note that this option is applicable for Network Providers and Network Hospitals.

• Consultation: A full mouth examination for clinical assessment which includes a treatment plan is covered once every 365 days per member from date of service. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 4 x-rays annually. Subject to DRC protocols.
• Pan scan: Limited to 1 per member in a 3-year period from date of service. Subject to DRC protocols.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Maximum 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per 365 days per member from date of service. Scale and polish of adult teeth from 12 years and older, covered once per 365 days per member from date of service.
• Fluoride treatment: One treatment annually, limited to members from 5 years and younger than 13 years. Please contact us for a benefit check.
• Restorations: Limited to 4 restorations per annum. Managed care protocol rules apply, please contact us for a benefit check.
• Incision and drainage of abscess: Limited to treatment in the consultation rooms.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. protocol rules apply.
• Root canal treatment: Limited to 2 RCT annually per member 12 years and older. DRC protocols apply.
• Plastic Dentures: Limited to 1 set of plastic dentures (an upper and a lower jaw) per family every 2-years for patients 21 years and older). DRC protocols apply. No benefits shall be granted for any metal frame dentures.

Specialised dentistry: Benefits are subject to managed care protocols and pre-authorisation. Benefits for the re-treatment of a tooth are subject to managed care protocols. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).

• Dental services/surgery rendered in dentist’s rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 35% co-payment on scheme tariff (of approved codes).
• Conscious sedation in dentist’s rooms: Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 35% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars only. Only the stated codes will be covered in-hospital unless related to a valid PMB event. A co-payment of R2 260 is applicable per admission.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to managed care and protocols. Motivations may be required in case of extensive conservative dental services. Benefits for the re-treatment of a tooth are subject to managed care protocols. All conservative services will be paid from member’s savings account.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check, payable from members' savings account
• Oral radiographs: Limited to 6 x-rays annually. More than 6 x-rays require pre-authorisation. Subject to DRC protocols
• Pan scan: 1 per member in a 3-year period from date of service. Subject to DRC protocols.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Once per 6 months, limited to members from 5 years and younger than 13 years. Please contact us for a benefit check.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check, protocol rules apply.
• Root canal treatment: RCT limited to members 12 years and older. DRC protocols apply.
• Plastic Dentures: One set of full/partial dentures (upper and/or lower jaw) per member per 4-year period. DRC protocols apply.

Specialised dentistry: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). All specialised dental services will be paid from member's savings account.

• Metal frame partial denture: 2 Partial metal frame dentures (an upper or/and a lover jaw) per member per 5 year period from date of service. Subject to available savings and pre-authorisation. DRC protocols apply.
• Crowns: Subject to available savings and pre-authorisation. DRC protocols apply.
• Orthodontic treatment: Limited to members younger than 18 years, subject to available savings, DRC protocols and pre-authorisation. Only 1 member of the family may commence with orthodontic treatment in a calendar year.
• Implants: Subject to available savings and pre-authorisation. DRC protocols apply. No theatre or hospital benefit for placement of implants.
• Periodontic treatment: Periodontic treatment is limited to conservative, non-surgical therapy only. This benefit will be applied to members who qualify for and are registered on the Periodontal Programme via standard pre-authorisation channels. Subject to available savings, pre-authorisation and DRC protocols.
• Maxillofacial surgery and oral pathology: Limited to certain maxillofacial procedures.
• Dental Services/surgery rendered in the dentist rooms: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes).
• Conscious sedation in dentist’s rooms: Limited to extensive dental treatment for children younger than 12 years of age and the removal of impacted third molars only. Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Procedure must be covered for sedation benefit to be payable.
• In-hospital treatment: Benefits are subject to managed care protocols and pre-authorisation. Failure to pre-authorise the procedure will result in a 20% co-payment on scheme tariff (of approved codes). Limited to the removal of impacted third molars only. Only the stated codes will be covered in-hospital unless related to a valid PMB event. A co-payment of R4 100 is applicable per admission.

Extensive dental treatment for children younger than 7 years is not covered by the Scheme and payable only from the members available saving. Please confirm available savings with the Scheme.

NB: Dental Procedures require a 35% co-payment per admission if voluntarily obtained in a hospital/facility other than a day procedure network facility, subject to PMB.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative services: Benefits are subject to managed care and protocols. Services must be obtained from a network provider and a R130.00 co-payment on the benefit amount is applicable per consultation.

• Consultation: One consultation per beneficiary per 365 days from day of service. Oral radiographs: Limited to 4 per valid consultation. Please contact us for a benefit check, protocol rules apply.
• Oral radiographs: Limited to 4 x-rays per valid consultation. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Sterilisation of instruments: Maximum 1 per visit.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – medihelp@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Basic and Specialised Dentistry Subject to Annual Savings Limit, please confirm rand value benefits with Momentum at (0861 000 300). All specialised dentistry requires pre-authorisation.

Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation.
• Oral radiographs: Limited to 7 x-rays annually. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months. Members older than 12 years, covered once per 6 months.
• Non-surgical extractions: More than 4 extractions per visit require pre-authorisation. DRC protocol rules apply.
• Restorations: Limited to 3 restorations per visit. Pre-authorisation and x-rays required for more than 3 restorations per visit. DRC protocol rules apply.
• Root Canal Treatment: DRC protocol rules apply.
• Plastic dentures: One set of plastic dentures, full or partial (an upper and a lower) per beneficiary in a 4 year period for members older than 21 years. DRC protocol rules apply.

Specialised dentistry such as Crowns, Dentures, Orthodontics, Impactions, Implants and non-surgical Periodontics are subject to pre-authorisation, DRC protocols rules and available savings. Pre-authorisation requests are to be submitted to auth@dentalrisk.com.

• Metal frame dentures: 1 Frame in 5 years per member older than 21 years. DRC protocol rules apply.
• Crown and bridges: Subject to DRC protocols, member must be older than 16 years.
• Orthodontic treatment: Paid from Annual Savings Limit per member per lifetime. Member must be 18 years and younger for ortho treatment.
• Bite plate: Paid from Annual Savings.
• Implants: Placement covered in dental chair only. DRC protocol rules apply.
• Conscious sedation: DRC protocol rules apply.
• Hospitalisation and anaesthetics: Admission protocols apply. Pre-authorisation required.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Basic and Specialised Dentistry Subject to Annual Savings Limit, please confirm rand value benefits with Momentum at (0861 000 300). All specialised dentistry requires pre-authorisation. In-hospital procedures for Classic Network is subject to Network Hospitals.
Conservative services: Benefits are subject to DRC protocols. Please contact our call centre for benefits confirmation.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation.
• Oral radiographs: Limited to 7 quantities annually. More than 7 x-rays require pre-authorisation. DRC protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Maximum 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Members younger than 12 years, covered once every 6 months. Members older than 12 years, covered once per 6 months.
• Non-surgical extractions: DRC protocol rules apply.
• Restorations: Limited to 3 restorations per visit.
• Root Canal Treatment: DRC protocol rules apply.
• Plastic dentures: DRC protocol rules apply.

Specialised dentistry such Crowns, Dentures, Orthodontics, Impactions, Implants and non-surgical Periodontics are subject to pre-authorisation, DRC protocols rules and available savings. Pre-authorisation requests are to be submitted to auth@dentalrisk.com .

• Metal frame dentures: DRC protocol rules apply.
• Crown and bridges: Subject to DRC protocols, member must be older than 16 years.
• Orthodontic treatment: Paid from Annual Savings Limit per member per lifetime. Member must be 18 years and younger for ortho treatment.
• Bite plate: Paid from Annual Savings.
• Implants: Placement covered in dental chair only. DRC protocol rules apply.
• Conscious sedation: DRC protocol rules apply.
• Hospitalisation and anaesthetics: Admission protocols apply. Pre-authorisation required.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative Dentistry is subject to the Dental sub-limit and the Day to Day limit of: Member = R2 985 and Family = R6 010. Please confirm benefits with Momentum at (086 1000 300).

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation.
• Oral radiographs: Limited to 7 x-rays annually.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Members younger than 12 years, covered once per 6 months. Members older than 12 years, covered once per 6 months.
• Non-surgical extractions: More than 4 extractions per visit requires pre-authorisation. DRC protocol rules apply.
• Restorations: Pre-authorisation and x-rays required for more than 3 restorations per visit. DRC protocol rules apply.

Specialised Dentistry Subject to Pre-Authorisation, Dental sub limit and the Day to Day limit of: Member = R15 800 or Family = R23 455. Please confirm available rand value limits with Momentum at 086 1000 300.

• Root Canal Treatment: DRC protocol rules apply, pre-authorisation required.
• Plastic dentures: One set of plastic dentures full or partial (an upper and a lower) per beneficiary in a 4-year period for members older than 21 years. DRC protocol rules apply, pre-authorisation required.
• Metal frame dentures: 1 Frame in 5 years per member older than 21 years. DRC protocol rules apply, pre-authorisation required.
• Crown and bridges: DRC protocol rules apply, pre-authorisation required. Member must be older than 16 years.
• Orthodontic treatment: Paid from Annual Savings once per member per lifetime. Member must be 18 years and younger for ortho treatment.
• Bite plate: Paid from Annual Savings.
• Implants: Placement covered in dental chair only. DRC protocol rules apply.
• Conscious sedation: DRC protocol rules apply.
• Hospitalisation and anaesthetics: Admission protocols apply. Pre-authorisation required.

Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative/Basic Dentistry (Subject to managed care protocols): All basic dentistry is subject to the annual day to day dental limits. Providers are to contact our call centre for benefits confirmation - 087 943 9611 before treatment.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check, protocol rules apply.
• Pan scan: Limited to 1 per member per annum.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Covered for children under 12 years (once every six months). Fluoride treatment for adults (once every six months).
• Occlusal guard/Bite plate: Covered once every 24 months, subject to pre-authorisation.
• Fissure sealant: Limited to members older than 5 years and younger than 18 years. Limited to permanent molars and pre-molars. Not within 2 years of previous treatment.
• Non-surgical extractions: Authorisation required for more than 5 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply, Please contact us for a benefit check.
• Root Canal Treatment: Benefit is subject to managed care protocol, only covered on permanent teeth. Please contact us for a benefit check.

Benefits are subject to managed care protocols and pre-authorisation. All specialised dentistry is subject to the annual day to day specialised dental limit. Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review.

• Plastic dentures: Limited to 1 set per beneficiary once every 4 years. Dentures limited to beneficiaries 16 years and older. Subject to pre-authorisation and DRC protocols.
• Crowns: Subject to pre-authorisation and DRC protocols.
• Implants: Placement covered in dental chair only. Subject to pre-authorisation and DRC protocols.
• Maxillofacial surgery: Covered in dental chair only. Subject to pre-authorisation and DRC protocols.
• Orthodontic treatment: Covered in dental chair only for members below the age of 21 years. Subject to pre-authorisation and DRC protocols.
• Conscious sedation in the dentist's room: Conscious sedation up to 16 years of age every 24 months
• In-hospital Treatment (General Anaesthesia): Pre-authorisation is compulsory - Limited to available overall annual hospital benefits Pre-Authorisation is required for hospitalisation related to dental trauma cases, removal of impacted teeth as well as children under 7 years of age.

Please consult your member guide for rand value limitations. Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

All basic dentistry is payable from risk subject to pre-authorisation and treatment protocol. Providers are to contact our call centre for benefits confirmation - 087 943 9611 before treatment.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. More than 7 x-rays require pre-authorisation. Please contact us for a benefit check, protocol rules apply.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once every six months. Scale and polish of adult teeth from 12 years and older, covered once every six months.
• Fluoride treatment: Covered for children under 12 years (once every six months). Fluoride treatment for adults (once every six months).
• Occlusal guard/Bite plate: Limited to 1 every 24 months, subject to pre-authorisation.
• Fissure sealant: Limited to children older than 5 years and younger than 18 years. Limited to permanent molars and pre-molars. Not within 2 years of previous treatment
• Non-surgical extractions: Authorisation required for more than 5 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply, please contact us for a benefit check.
• Root Canal Treatment: Benefit is subject to managed care protocol, only covered on permanent teeth. Please contact us for a benefit check.
• In-hospital Treatment (General Anaesthesia): Pre-authorisation is compulsory, limited to overall annual hospital benefit. Maxillo-facial surgery is limited to R20 780 per family, per annum subject to the overall hospital limit. Pre-Authorisation is required for hospitalisation related to dental trauma cases, removal of impacted teeth as well as children under 7 years of age.

Please consult your member guide for rand value limitations. Providers are to contact Dental Risk Company on 087 943 9611 for authorisation. Claims may be submitted electronically to Dental Risk Company or alternatively to claims@dentalrisk.com. Kindly be advised that the claim period for claim submissions is 4 months. Claims submitted after the 4 months will be rejected as stale.

Conservative dentistry payable from the Risk Pool. All clinically valid specialised dental treatment covered from MSA (Medical Savings account) including 1 set of plastic dentures per member every 4 years. Subject to Network contracted providers.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Please contact us for a benefit check. Protocol rules apply.
• Infection control: Gloves and mask are covered to the maximum of 2 per visit.
• Injection: An injection is covered once per visit subject to the following supporting treatments: extractions and fillings.
• Sterilisation of instruments: Will only be paid if code 8731, 9013, 9011, 8201 or 8202 is claimed.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment covered for members between the ages of 5 and 13 years once every six months. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Emergency root canal treatment is covered on permanent teeth.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Plastic dentures: Limited to one set of plastic dentures every 4 years. Kindly note that this is covered for members older than 16 years, pre-authorisation required .
• Extensive dental treatment covered under conscious sedation: Subject to pre-authorisation and DRC protocols and limited to children up to the age of 16 years.

Specialised dentistry: (e.g., Crowns & Bridgework, Dentures, Orthodontics (up to the age of 21 years), removal of impacted wisdom teeth and Non-Surgical Periodontics) are covered from the medical savings account - Subject to pre-authorisation and treatment protocol. No late authorisation requests will be accepted.

• Hospitalisation and Anaesthetics: Subject to pre-authorisation and DRC Protocols. Limited to PMB only

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative/Basic Dentistry (Subject to managed care protocols and available savings): Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Subject to managed care protocols.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check, protocol rules apply. One Pan scan is covered once per member per 3 years.
• Pan scan: Limited to 1 per member per 3 years.
• Gloves and mask as infection control are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered for members between the ages of 5 and 13 years, once per six months. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Root Canal Treatment: Benefit is subject to managed care protocol. Only covered on permanent teeth. Excluding wisdom teeth (3rd molars). Please contact us for a benefit check.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Plastic dentures: Limited to one set of plastic dentures every 4 years. Kindly note that this is covered for members older than 16 years, pre-authorisation required.

Specialised Dentistry e.g. Crowns & Bridgework, Metal frame Dentures, Orthodontics, Impactions and Non-Surgical Periodontics) - Subject to pre-authorisation and treatment protocol. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review.

• Partial Metal frame dentures: 2 Partial frames (an upper and lower) per beneficiary in a 5-year period, limited to 2 per family per annum. Subject to pre-authorisation and DRC protocols.
• Crown and bridgework: Limited to 3 crowns per family per annum. Subject to pre-authorisation and DRC protocols.
• Implants: Limited to 3 implants per beneficiary per annum over a period of 5 years limited to R18 058.95. Subject to pre-authorisation and DRC protocols.
• Orthodontic treatment: Subject to pre-authorisation and DRC protocols. Limited to members from the age of 9 to younger than 21 years of age.
• Conscious sedation in the dentist rooms: subject to pre-authorisation and DRC protocols.
• Extensive dental treatment covered under conscious sedation: Subject to pre-authorisation and DRC protocols and limited to children up to the age of 16 years.
• Impactions: Subject to pre-authorisation and DRC protocols
• Periodontics: Subject to pre-authorisation and registration on the Periodontal programme.
• Maxillo-facial and oral surgery in the dental chair (in the rooms): subject to pre-authorisation and DRC protocols.
• Dental hospitalisation: subject to pre-authorisation and DRC protocols.

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative/Basic Dentistry (Subject to managed care protocols and available savings): Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Subject to managed care protocols.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact DRC for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check, protocol rules apply.
• Pan scan: Limited to 1 scan per member every 2 years.
• Infection control: Gloves and mask as infection control are limited to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered for members between the ages of 5 and 13 years, once per six months. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Root Canal Treatment: Benefit is subject to managed care protocol. Only covered on permanent teeth. Excluding wisdom teeth (3rd molars). Please contact us for a benefit check.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Plastic dentures: Limited to one set of plastic dentures every 4 years. Kindly note that this is covered for members above 16 years, pre-authorisation required.

Specialised Dentistry e.g. Crowns & Bridgework, Metal frame Dentures, Orthodontics, Impactions and Non-Surgical Periodontics) - Subject to pre-authorisation and treatment protocol. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review.

• Partial Metal frame dentures: 2 Partial frames (an upper and lower) per beneficiary in a 5-year period, limited to 1 per family per annum. Subject to pre-authorisation and DRC protocols.
• Crown and bridgework: Limited to 1 crown per family per annum. Subject to pre-authorisation and DRC protocols.
• Implants: Limited to 1 implant per beneficiary per annum over a period of 5 years limited to R17 199. Subject to pre-authorisation and DRC protocols.
• Orthodontic treatment: Subject to pre-authorisation and DRC protocols. Limited to members from the age of 9 to younger than 21 years of age.
• Conscious sedation in the dentist rooms: Subject to pre-authorisation and DRC protocols.
• Extensive dental treatment covered under conscious sedation: Subject to pre-authorisation and DRC protocols. Limited to children up to the age of 16 years.
• Impactions: Subject to pre-authorisation and DRC protocols.
• Periodontics: Subject to pre-authorisation and registration on the Periodontal programme.
• Maxillo-facial and oral surgery in the dental chair (in the rooms): subject to pre-authorisation and DRC protocols.
• Dental hospitalisation: Subject to pre-authorisation and DRC protocols.

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative/Basic Dentistry (Subject to managed care protocols and available savings): Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Subject to managed care protocols. Please note that voluntary use of a non-DSP dental provider will result in a co-payment of 30% on the professional fee, unless treated as a PMB.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact DRC for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check, protocol rules apply.
• Pan scan: Limited to 1 scan per member every 2 years.
• Infection control: Gloves and mask as infection control are limited to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit. Sterilisation of instruments is covered once per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered for members between the ages of 5 and 13 years, once per six months. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Root Canal Treatment: Benefit is subject to managed care protocol. Only covered on permanent teeth. Excluding wisdom teeth (3rd molars). Please contact us for a benefit check.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Plastic dentures: Limited to one set of plastic dentures every 4 years. Kindly note that this is covered for members above 16 years, pre-authorisation required.

Specialised Dentistry e.g. Crowns & Bridgework, Metal frame Dentures, Orthodontics, Impactions and Non-Surgical Periodontics) - Subject to pre-authorisation and treatment protocol. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review.

• Partial Metal frame dentures: 2 Partial frames (an upper and lower) per beneficiary in a 5-year period, limited to 1 per family per annum. Subject to pre-authorisation and DRC protocols.
• Crown and bridgework: Limited to 1 crown per family per annum. Subject to pre-authorisation and DRC protocols.
• Implants: Limited to 1 implant per beneficiary per annum over a period of 5 years limited to R17 199. Subject to pre-authorisation and DRC protocols
• Orthodontic treatment: Subject to pre-authorisation and DRC protocols. Limited to members from the age 9 to younger than 21 years of age.
• Conscious sedation in the dentist rooms: Subject to pre-authorisation and DRC protocols.
• Extensive dental treatment covered under conscious sedation: Subject to pre-authorisation and DRC protocols. Limited to children up to the age of 16 years.
• Impactions: Subject to pre-authorisation and DRC protocols.
• Periodontics: Subject to pre-authorisation and registration on the Periodontal programme.
• Maxillo-facial and oral surgery in the dental chair (in the rooms): subject to pre-authorisation and DRC protocols.
• Dental hospitalisation: Subject to pre-authorisation and DRC protocols.

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative/Basic Dentistry (Subject to managed care protocols): Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Subject to managed care protocols.

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check, protocol rules apply.
• Pan Scan: Limited to 1 per member every 2 years.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Fluoride treatment: Covered for members between the ages of 5 and 13 years, once per six months. Please contact us for a benefit check.
• Injection: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Root Canal Treatment: Benefit is subject to managed care protocol. Only covered on permanent teeth. Excluding wisdom teeth (3rd molars). Please contact us for a benefit check.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Plastic dentures: Limited to one set of plastic dentures per beneficiary in a 4 year period. Kindly note that this is covered for members above 16 years, pre-authorisation required.

Specialised Dentistry - Subject to pre-authorisation and treatment protocol. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review.

• Conscious sedation in the dentist rooms: Subject to pre-authorisation and DRC protocols.
• Extensive dental treatment covered under conscious sedation: Subject to pre-authorisation and DRC protocols. Limited to children up to the age of 16 years
• Impactions: Subject to pre-authorisation and DRC protocols.
• Periodontics: Subject to pre-authorisation and registration on the Periodontal programme.
• Maxillo-facial and oral surgery in the dental chair (in the rooms): Subject to pre-authorisation and DRC protocols.
• Dental hospitalisation: Subject to pre-authorisation and DRC protocols.

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Conservative/Basic Dentistry (Subject to managed care protocols): Providers are to contact our call centre for benefits confirmation on 087 943 9611 prior to treatment. Subject to managed care protocols. Please note that voluntary use of a non-DSP dental provider will result in a co-payment of 30% on the professional fee, unless treated as a PMB

• Consultation: A full mouth examination for clinical assessment which include a treatment plan is covered once per six months per member. When the full mouth examination is not available, an alternative consultation which excludes a treatment plan may be charged once per 4 weeks after the previous consultation. Please contact us for a benefit check.
• Oral radiographs: Limited to 7 x-rays annually. Please contact us for a benefit check, protocol rules apply.
• Pan Scan: Limited to 1 per member every 2 years.
• Infection control: Gloves and masks are covered to the maximum of 2 per visit.
• Injection: Limited to 1 per visit.
• Sterilisation of instruments: Limited to 1 per visit.
• Cleaning: This includes polishing of children teeth aged younger than 12 years, covered once per six months. Scale and polish of adult teeth from 12 years and older, covered once per six months.
• Fluoride treatment: Covered for members between the ages of 5 and 13 years, once per six months. Please contact us for a benefit check.
• Non-surgical extractions: Authorisation required for more than 4 non-surgical extractions. Please contact us for a benefit check. Protocol rules apply.
• Root Canal Treatment: Benefit is subject to managed care protocol. Only covered on permanent teeth. Excluding wisdom teeth (3rd molars). Please contact us for a benefit check.
• Restorations: Pre-authorisation required for more than 4 restorations per annum. No late pre-authorisation requests will be accepted. Managed care protocol rules apply. Please contact us for a benefit check.
• Plastic dentures: Limited to one set of plastic dentures per beneficiary in a 4 year period. Kindly note that this is covered for members above 16 years, pre-authorisation required.

Specialised Dentistry Subject to pre-authorisation and treatment protocol. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Pre-authorisation requests are to be submitted to auth@dentalrisk.com for clinical review.

• Conscious sedation in the dentist rooms: Subject to pre-authorisation and DRC protocols.
• Extensive dental treatment covered under conscious sedation: Subject to pre-authorisation and DRC protocols. Limited to children up to the age of 16 years.
• Impactions: Subject to pre-authorisation and DRC protocols.
• Periodontics: Subject to pre-authorisation and registration on the Periodontal programme.
• Maxillo-facial and oral surgery in the dental chair (in the rooms): Subject to pre-authorisation and DRC protocols.
• Dental hospitalisation: Subject to pre-authorisation and DRC protocols.

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com.

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

Subject to pre-authorisation and treatment protocol. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Hospital benefits are only available at the Designated Service Providers and limited to PMB only. Voluntary use of non-DSP* hospital will result in a 30% co-payment.

• Subject to pre-authorisation and treatment protocol and limited to PMB only.
• Extensive dental treatment: Subject to pre-authorisation and DRC protocols.
• Impactions: Subject to pre-authorisation and DRC protocols.

Dentists or members are advised to contact our DRC client service team on 087 943 9611 for further information. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com

All day to day and specialised dentistry for this option are administered by 3Sixty Health. Please contact them directly for any queries, authorisation or remittances. DRC will be responsible for the pre-authorisation of the following in-hospital services. Please forward all quotations and supporting documents to auth@dentalrisk.com. Failure to pre-authorise or to notify the scheme of an admission will result in non-payment of claims. Hospital benefits are only available at the Designated Service Providers. Voluntary use of non-DSP* hospital will result in a 30% co-payment. Subject to pre-authorisation and treatment protocol and limited to PMB only.

• Limited to conservative dental treatment for children younger than 7 years of age and the removal of symptomatic impacted wisdom teeth (pre-authorisation required and limited to PMB only).

Dentists or members are advised to contact 3Sixty Health on 0860 100 871 for further information on this option. Kindly note that the claim period for Sizwe Hosmed Medical scheme is 4 months. Claims submitted after 4 months will be rejected as stale. Please submit claims electronically to DRC or alternatively to claims@dentalrisk.com

Contact Our Team:
Enquiries – enquiries@dentalrisk.com
Authorisation requests – auth@dentalrisk.com
Claim submissions – claims@dentalrisk.com