If dental benefits form part of your cover, under most of our plans you can simply pay for your treatment and then claim back any eligible expenses via our MyHealth Digital Services.
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 must 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 and the exclusions 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 your applicable definitions and exclusions.
You can access your Benefit Guide and Table of Benefits via MyHealth Digital Services. Simply login via browser or use the Allianz MyHealth app, click on “My Policy” and select the “Documents” tab.
01. Dental treatment
Dental treatment includes an annual check-up, simple fillings related to cavities or decay, root canal treatment and dental prescription drugs.
02. 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. They do not include mouthwashes, fluoride products, antiseptic gels and toothpastes.
03. Dental surgery
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 that 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 surgical treatment that relates to dental implants.
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.
In summary, the “Orthodontics” benefit covers:
- Orthodontist's fees
- Other related treatment such as x-rays or photographs of jaws
Orthodontic treatments take place on an Out-Patient basis. They are usually carried out over the course of several years: however, you do not need to wait until the end of your treatment to be reimbursed. You might submit invoices throughout the duration of your treatment (e.g. quarterly), but only once the part of the treatment relating to the invoice you submit has all taken place. For example, you could submit an invoice at the end of every quarter for the treatment that has taken place in that quarter.
06. Dental prostheses
Dental prostheses include crowns, inlays, onlays, adhesive reconstructions/restorations, bridges, dentures and implants as well as all necessary and ancillary treatment required.
07. Emergency Out-Patient Dental treatment
Emergency out-patient dental treatment is treatment received in a dental surgery/hospital emergency room for the immediate relief of dental pain caused by an accident or an injury to a sound natural tooth. Treatment may include pulpotomy or pulpectomy and the subsequent temporary fillings, limited to three fillings per Insurance Year. Treatment must take place within 24 hours of the emergency event. It does not include any form of dental prostheses, permanent restorations or the continuation of root canal treatment. However, if your policy also includes a Dental Plan, it will cover dental treatment in excess of the (Core Plan) limit on emergency out-patient dental treatment benefit. In that case, the Dental plan terms will apply.
Dental veneers and related procedures are not covered, unless medically necessary.