Any dental benefits available to you are shown on your Table of Benefits along with any deductibles, co-payments, benefit limits, waiting periods or age restrictions which apply. Your Table of Benefits should be read in conjunction with your Benefit Guide for full details of your dental benefits, including definitions and/or exclusions.
For your convenience, below we list the definitions related to dental benefits that apply to our standard international healthcare plans – these may vary slightly depending on the plans you have, so please consult your Benefit Guide and Table of Benefits to confirm the definitions available to you:
- Dental treatment includes an annual check-up, simple fillings related to cavities or decay, root canal treatment and dental prescription drugs.
- Dental prescription drugs are those prescribed by a dentist for the treatment of a dental inflammation or infection. The prescription drugs must be proven to be effective for the condition and recognised by the pharmaceutical regulator in a given country. This does not include mouthwashes, fluoride products, antiseptic gels and toothpastes.
- Dental surgery includes the surgical extraction of teeth, as well as other tooth related surgical procedures such as apicoectomy and dental prescription drugs. All investigative procedures necessary to establish the need for dental surgery such as laboratory tests, X-rays, CT scans and MRI(s) are included under this benefit. Dental surgery does not cover any surgical treatment that is related to dental implants.
- Dental prostheses includes crowns, inlays, onlays, adhesive reconstructions/restorations, bridges and dentures as well as all necessary and ancillary treatment required. Dental implants are not covered under the ‘Dental prostheses’ benefit, but may be included in your cover under a separate ‘Dental implants’ benefit
- Periodontics refers to dental treatment related to gum disease.
- Orthodontics is the use of devices to correct malocclusion (misalignment of your teeth and bite). We only cover orthodontic treatment that meets the medical necessity criteria described below. As the criteria is very technical, please contact us before starting treatment so we can verify if your treatment meets the criteria.
Medical Necessity Criteria:
a) Increased overjet > 6mm but <= 9 mm
b) Reverse overjet > 3.5 mm with no masticatory or speech difficulties
c) Anterior or posterior crossbites with > 2 mm discrepancy between the retruded contact position and intercuspal position
d) Severe displacements of teeth > 4
e) Extreme lateral or anterior open bites > 4 mm
f) Increased and complete overbite with gingival or palatal trauma
g) Less extensive hypodontia requiring pre-restorative orthodontics or orthodontic space closure to obviate the need for a prosthesis
h) Posterior lingual crossbite with no functional occlusal contact in one or more buccal segments
i) Reverse overjet > 1 mm but < 3.5 mm with recorded masticatory and speech difficulties
j) Partially erupted teeth, tipped and impacted against adjacent teeth
k) Existing supernumerary teeth
You will need to send us some supporting information to show that your treatment is medically necessary and therefore covered by your plan. The information we ask for may include, but is not limited to:
- A medical report issued by the specialist, stating the diagnosis (type of malocclusion) and a description of your symptoms caused by the orthodontic problem.
- A treatment plan showing the estimated duration and cost of the treatment and the type/material of the appliance used.
- The payment arrangement agreed with the medical provider.
- Proof of payment for orthodontic treatment.
- Photographs of both jaws clearly showing dentition before the treatment.
- Clinical photographs of the jaws in central occlusion from frontal and lateral views.
- Orthopantomogram (panoramic x-ray).
- Profile x-ray (cephalometric x-ray).
- Any other document we may need to assess the claim.
We will only cover the cost of standard metallic braces and/or standard removable appliances. However, we’ll cover cosmetic appliances such as lingual braces and invisible aligners up to the cost of metallic braces, subject to the “Orthodontic treatment” benefit limit.