Bonsave & Bonfit select 2024 | Page 5

ROOT CANAL THERAPY AND EXTRACTIONS Paid from available savings Paid from available savings
Paid from available savings Pre-authorisation required Paid from available savings Pre-authorisation required
PLASTIC DENTURES AND ASSOCIATED LABORATORY COSTS
1 set of plastic dentures ( an upper and a lower ) per beneficiary , once every 4 years
Benefit for a mouth guard is available for both the clinical and the associated laboratory fee ( no pre-authorisation required )
1 set of plastic dentures ( an upper and a lower ) per beneficiary , once every 4 years
Benefit for a mouth guard is available for both the clinical and the associated laboratory fee ( no pre-authorisation required )
SPECIALISED DENTISTRY Paid from available savings Covered at the Bonitas Dental Tariff Paid from available savings Covered at the Bonitas Dental Tariff
PARTIAL CHROME COBALT FRAME DENTURES AND ASSOCIATED LABORATORY COSTS
CROWNS , BRIDGES AND ASSOCIATED LABORATORY COSTS
Paid from available savings Pre-authorisation required Paid from available savings Pre-authorisation required
2 partial frames ( an upper and a lower ) per beneficiary , once every 5 years 2 partial frames ( an upper and a lower ) per beneficiary , once every 5 years
Paid from available savings 3 crowns per family , per year Paid from available savings 3 crowns per family , per year
Benefit for crowns will be granted once per tooth , every 5 years
Pre-authorisation required
Benefit for crowns will be granted once per tooth , every 5 years
Pre-authorisation required
A treatment plan and X-rays may be requested
A treatment plan and X-rays may be requested Paid from available savings Pre-authorisation required Paid from available savings Pre-authorisation required
ORTHODONTICS AND ASSOCIATED LABORATORY COSTS
Pre-authorisation cases will be clinically assessed by using an orthodontic needs analysis
Benefit for orthodontic treatment will be granted where function is impaired ( not granted for cosmetic reasons )
Benefit allocation is subject to the outcome of the needs analysis and funding can be granted up to 100 % of the Bonitas Dental Tariff
Only 1 family member may begin orthodontic treatment in a calendar year
Pre-authorisation cases will be clinically assessed by using an orthodontic needs analysis
Benefit for orthodontic treatment will be granted where function is impaired ( not granted for cosmetic reasons )
Benefit allocation is subject to the outcome of the needs analysis and funding can be granted up to 100 % of the Bonitas Dental Tariff
Only 1 family member may begin orthodontic treatment in a calendar year
Benefit for fixed comprehensive treatment is limited to beneficiaries from age 9 and younger than 18 years
Orthodontic treatment is granted once per beneficiary , per lifetime
Benefit for fixed comprehensive treatment is limited to beneficiaries from age 9 and younger than 18 years
Orthodontic treatment is granted once per beneficiary , per lifetime
PERIODONTICS
Paid from available savings Pre-authorisation required Paid from available savings Pre-authorisation required
Benefit is limited to conservative , non-surgical therapy only and will only be applied to members who are registered on the Periodontal Programme
Benefit is limited to conservative , non-surgical therapy only and will only be applied to members who are registered on the Periodontal Programme
SURGERY IN THE DENTAL CHAIR
Paid from available savings
For the removal of impacted teeth only
Managed Care protocols apply
Paid from available savings
HOSPITALISATION ( GENERAL ANAESTHETIC )
A co-payment of R5 000 per admission applies for the removal of impacted teeth only OR A R2 500 upfront co-payment if the dental treatment is done in a day hospital
Avoid a 30 % co-payment by using a hospital on the applicable network
PMB only
Avoid a 30 % co-payment by using a hospital on the applicable network
Managed Care protocols apply Pre-authorisation required Managed Care protocols apply Pre-authorisation required
INHALATION SEDATION IN DENTAL ROOMS ( LAUGHING GAS )
Managed Care protocols apply
No benefit
MODERATE / DEEP SEDATION IN DENTAL ROOMS ( IV CONSCIOUS SEDATION )
Limited to extensive conservative dental treatment only
Pre-authorisation required
Managed Care protocols apply
PMB only
Pre-authorisation required
All benefits and limits are per calendar year , unless otherwise stated . Managed Care protocols apply . All benefits are approved by the Council for Medical Schemes . PMB = Prescribed Minimum Benefits
5 BONSAVE & BONFIT SELECT 2024 OUT-OF-HOSPITAL BENEFITS