Dentists

Dentistry is the evaluation, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body.TFG Medical Aid Scheme provides cover for major trauma-related dental procedures, specialised dentistry and basic dental procedures.

Trauma–related dental procedures are for the treatment of certain severe infections, jaw-joint replacements, cancer-related and certain trauma-related surgery, cleft-lip and palate repairs and are normally performed in-hospital. These procedures require preauthorisation and are covered in full if performed by a network specialist. Cover for procedures performed by non-network specialists is at 100% of Scheme Rate, so you may incur a co-payment if your specialist is not on the network.

There is limited cover for specialised dentistry on TFG Health Plus which includes:

  • metal base and soft base dentures
  • metal, porcelain and resin inlays
  • root canal treatment
  • periodontal treatment
  • restorative phase of implants, inclusive of implant components
  • crown and bridge work
  • bleaching of root canal treated teeth and;
  • orthodontic treatment.

These procedures are covered at 100% of Scheme Rate if you see a specialist on our network and at 80% of Scheme Rate if you use a non-network specialist.

On TFG Health you receive cover in hospital for Severe dental and oral surgery.

The basic dentistry benefit is also limited and covers examinations, preventative dentistry; x-rays; fillings; acrylic and partial dentures and the addition of teeth to dentures and repair to dentures. These procedures are funded at 80% of Scheme Rate on TFG Health Plus and up to 100% of the Scheme Rate at a dentist in the Primary care network on TFG Health. Basic dentistry in hospital on TFG Health is not a covered benefit.