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.

All dentistry performed in hospital must be authorised

The Scheme provides unlimited benefits for certain major and trauma-related dental procedures.  These procedures are 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. 

Cover for dentists is dependent on your Benefit Option.

 In hospitalOut of hospital
LA Comprehensive












Specialised dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme.
All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid by the Scheme, subject to a joint overall limit per person for specialised dentistry. This limit applies in and out of hospital.

Basic dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme.
All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid from the MSA and the ATB, subject to a joint overall limit per person for basic dentistry. This limit applies in and out of hospital.

Please refer to your benefit brochure for the applicable limit amount and co-payment
Specialised dentistry
Benefits are paid from and limited to funds in MSA and the ATB. All specialised dentistry benefits allocate to, and are subject to, the overall limit for specialised dentistry, per beneficiary for the year.

Basic dentistry
Benefits are paid from and limited to funds in MSA and the ATB. All basic dentistry benefits allocate to, and are subject to, the overall limit for basic dentistry, per beneficiary for the year.

LA Core












Specialised dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme. All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid by the Scheme, subject to a limit per person for specialised dentistry.

Basic dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid from the MSA and the Extended Day-to-Day Benefit.

Please refer to your benefit brochure for limits and further information
Specialised dentistry
Benefits are paid from and limited to funds in MSA and the Extended Day-to-Day benefit. Basic dentistry Benefits are paid from and limited to funds in MSA and the Extended Day-to-Day benefit.







LA Active











Specialised dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme. All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid by the Scheme, subject to a limit per person for specialised dentistry.

Basic dentistry
The hospital account will be subject to a co-payment paid from the member’s own pocket. The remainder of hospital account is paid by the Scheme. All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid from the MSA and the Extended Day-to-Day Benefit.

Please refer to your benefit brochure for limits and further information
Specialised dentistry
Benefits are paid from and limited to funds in MSA and the Extended Day-to-Day benefit.

LA Focus










Specialised dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme. All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid by the Scheme, subject to a limit per person for specialised dentistry.

Basic dentistry
The hospital account will be subject to an upfront amount that is paid from the member’s own pocket. The remainder of the hospital account is paid by the Scheme. All related, non-hospital accounts (for example, for the surgeon and anaesthetist) are paid from the MSA.

Please refer to your benefit brochure for limits and further information
Specialised dentistry
Benefits are paid from and limited to funds in MSA Basic dentistry Benefits are paid from and limited to funds in MSA.








LA KeyPlusSubject to preauthorisationBasic dentistry full cover with no overall benefit limit, subject to a list of procedures performed by a dentist in the KeyCare network.