Scale of benefits

Benefit A - Emergency Treatment - when away from your own dentist

Emergency symptom e.g. - toothache, lost filling, crown fallen out, bleeding or swelling.

Cover
If you are away from your own dental practice, and require emergency dental treatment, Denplan will pay up to the specified limits for temporary dental treatment to resolve your dental emergency.

Limits of cover:
£370.00 per incident
£740.00 per year

  • Patients are covered for temporary emergency treatment to alleviate any pain or discomfort.
  • All routine and permanent work should be provided by their registered dentist under their Denplan contract.

Exclusions

  • Treatment by your own dentist, a dentist acting on behalf of your dental practice, or a dental practice in the locality of your registered dentist.
  • Reimbursement for any telephone/travelling expenses in seeking advice or a dental appointment.
  • Any treatment care or repair to, or in connection with "tooth jewellery".
  • Permanent treatment.

Benefit B - Treatment following Dental Injury/Trauma
Dental injury means injury to an insured patientís dentition and/or supporting structures (including damage to dentures whilst being worn) caused by a direct extra oral impact (blow to outside of the mouth).

  • Prior authorisation from Denplan should be sought if permanent treatment exceeds £200.00.
  • Permanent treatment is normally carried out by the registered dentist, however if the treatment is not provided by the patient's own dentist, approval must be sought from Denplan.
  • Should Implants be clinically required and you have additional Implant Upgrade Insurance the insurers will pay up to £2000.00 per Implant up to £10.000 per calendar year. If you do not have the Implant Insurance, the insurers will pay the equivalent bridgework up to specified limits.

Limits of cover:
Up to £10,000 in connection with one injury/incident, subject to policy limits

In all cases the insurer retains the right to recover any incurred costs as a result of any third party involvement.

Benefit C - Out of Hours Consultation for Dental Emergency or Injury
In the event of a dental emergency/accident patients are covered for emergency treatment outside of normal surgery hours. Please refer to your policy document for fees payable when the appointment occurs within the specified times. The Insurer will pay the maximum of two domiciliary fees (in cases of emergency only) per patient per calendar year, after which such visits are excluded.

  • Please call your surgery in the first instance, if you are not away from home, for on-call instructions.
  • If you are away from home, or unable to contact the on-call dentist for your own surgery, please call the Denplan Emergency Helpline who will endeavour to assist you.
  • If you require dental advice, you can receive a telephone consultation from either your registered dentist or a Dental Advisor by contacting the 24hour Helpline.
  • Patients are liable for the first £15.00 should a dentist treat them outside normal surgery hours.

Benefit D - Hospital Cash
Patients can claim up to £60 for each night spent in hospital under the care of an Oral Consultant/Maxillo-facial surgeon.

This benefit is payable 365 days per year.

Exclusions

  • Treatment or hospital costs.
  • No benefit shall be payable in respect of any condition where treatment was diagnosed prior to, or at the time of the patients registration.
  • If not wholly or partly under the care of a consultant specialising in dental or oral/maxillo facial surgery.
  • Day patient care.
  • Overnight stay for the purpose of cosmetic dentistry.

Benefit E - Overseas Emergency Dental Treatment

This policy is run as indemnity insurance which means that costs will be reimbursed to the value of the treatment.

  • Patients can source a dentist themselves whilst overseas, or call the Denplan Emergency Helpline for assistance.
  • Treatment should be paid for at the time, then submit a claim form and receipts to Denplan for assessment.
  • Patients are covered for temporary emergency treatment to alleviate any pain or discomfort.

Limits of cover:
£370.00 per calendar year
£740.00 per calendar year

Exclusions
Reimbursement for any travelling expenses in relation to seeking advice or dental appointment.

Mouth Cancer Cover
Mouth Cancer means a malignant (invasive) tumour inside the mouth.

Limit of cover:
Treatment received within 12 months of diagnosis up to £12,000

  • Patients registered with Denplan are covered for costs for treatment, for 12 months, following a positive diagnosis of Mouth Cancer.
  • Patients registered with Denplan can claim Benefit D - Hospital cash, should the patient need an overnight stay whilst having treatment ( subject to policy limits).

Exclusions

  • Mouth cancer diagnosed before registering with Denplan.
  • Mouth cancer diagnosed within 90 days after the date you registered with Denplan or for which tests or consultations began within those 90 days, even if within those 90 days, even if the diagnosis is not made until later (please note: this does not apply if you registered on Denplan before 1st November 1998).
  • Mouth cancer, which is related in any way to HIV infection or AIDS.
  • Any charges for consultations or tests for non-invasive tumours.
  • Mouth cancer resulting from the chewing of tobacco products (including betel nut juice), or prolonged alcohol abuse.

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