Severe Dental and Oral Surgery benefit
Discovery covers a defined list of maxillo-facial procedures on the Severe Dental and Oral Surgery Benefit, available on all plans. There is no co-payment for these procedures.
The procedures that are included in the Severe Dental and Oral Surgery Benefit and which are paid from the Hospital Benefit are:
- Internal temporomandibular joint (TMJ) surgery
- Cleft lip and palate repairs
- Surgery for severe life-threatening infections
- Cancer-related surgery
There is no limit for these procedures, but accounts for dental appliances and their placement are paid from day-to-day benefits.
Discovery Basic Dental Trauma Benefit
This covers the sudden and unanticipated injury to the teeth and mouth that requires urgent dental treatment after an accident or trauma injury.
The benefit is paid from your Hospital Benefit, but there is a co-payment if done in-hospital or in a day clinic (see your individual plan for details).
There is a limit of R58,000 for dental appliances, prosthesis and the placement thereof, and this does not affect your day-to-day benefits.
This benefit is available on all plans except the Essential Smart plan and all the Keycare plans.
The benefit is applied on a case-by-case basis, and includes the following criteria:
- Either partial or complete loss of one or more teeth
- Where partial loss has occurred, there isn’t enough remaining dental hard tissue to support conservative restoration
- The initial treatment needs to start within 30-days of the injury
- The relevant ICD-10 codes and external cause codes indicate trauma
