2026 benefit year · compiled from the scheme’s published documents
KeyHealth dental benefits, in plain language
None of KeyHealth's six options makes you fund check-ups from a medical savings account. Essence, Equilibrium and Silver pay for one check-up a year from scheme risk, and Gold and Platinum pay for two; Origin covers a yearly check-up too, but pays it — along with fillings and extractions — from a pooled family day-to-day limit that your other everyday claims also draw on. For routine dentistry you can use any dentist on every option.
The bigger fork is what's covered beyond the check-up. Essence stops at five listed codes — the check-up, infection control, a sterile tray and four intraoral X-rays — so fillings, cleans and extractions are entirely your own cost. Origin adds fillings, a scale and polish and extractions, but excludes root canals and dentures. From Equilibrium and Silver upward, conservative dentistry — fillings, root canals, extractions and plastic dentures — is insured at 100% of the KeyHealth Dental Tariff, the scheme's own rate; charges above that rate aren't covered.
Specialised work climbs the range: Gold adds crowns, partial metal frames and gum (periodontal) treatment with 20–30% co-payments, and implants are covered only on Platinum.
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We claim directly from medical aids. Before treatment we do a benefit check with your scheme — bring your card and your option name — so you know what your plan pays before you sit in the chair. You pay only co-payments and anything your plan doesn’t cover or has already used up. And as always: we quote before we treat.
Option by option
As published for the 2026 benefit year (checked 2026-07-29). Benefits are re-registered every year and can change — the benefit check is what makes it certain for you.
Essence
Check-up covered- Routine check-up
- Yes - 1 check-up/yr
- What that includes
- ONLY 5 codes: 1 check-up pp/yr + infection control (2 sets) + 1 sterile tray + 4 intraoral X-rays
- Paid from
- Insured (risk) - DENIS pays
- 2026 limits
- The 5 listed codes only
- Network rule
- Any dentist for the 5 codes; KeyHealth Hospital Network for impacted-teeth GA
- Co-payments & gaps
- ALL other dentistry (fillings, cleans, extractions) = your cost; R2,060 hospital admission co-pay (day clinics exempt); 30% non-network hospital
Origin
Check-up covered- Routine check-up
- Yes - 1 check-up/yr
- What that includes
- 1 check-up + 3 emergency consults pp/yr; 4 intraoral X-rays; 1 scale & polish; fillings; extractions
- Paid from
- Day-to-day Family Limit: R3,425 principal + R1,990 adult + R1,050 child per yr (pooled family amount)
- 2026 limits
- All routine dental competes with other day-to-day claims inside that family pool
- Network rule
- Any dentist; KeyHealth Hospital Network for impacted-teeth GA
- Co-payments & gaps
- Pool exhausted = self-pay; NO root canal, NO dentures; R2,060 admission co-pay; 30% non-network
Equilibrium
Check-up covered- Routine check-up
- Yes - 1 check-up/yr
- What that includes
- 1 check-up + 3 emergency consults pp/yr; 4 X-rays; 1 scale & polish; fillings; RCT; extractions; plastic dentures (1 set / 4 yrs)
- Paid from
- Insured (risk) at 100% KDT
- 2026 limits
- Code-based; no published overall rand cap
- Network rule
- Any dentist; KeyHealth Hospital Network
- Co-payments & gaps
- R2,060 hospital admission co-pay; 30% non-network; above-KDT gap
Silver
Check-up covered- Routine check-up
- Yes - 1 check-up/yr
- What that includes
- 1 check-up pp/yr; 1 scale & polish; X-rays; fillings; RCT; extractions; plastic dentures (1 set / 4 yrs)
- Paid from
- Insured (risk) at 100% KDT
- 2026 limits
- Code-based
- Network rule
- Any dentist; KeyHealth Hospital Network
- Co-payments & gaps
- R2,060 admission co-pay; 30% non-network; above-KDT gap
Gold
Check-up covered- Routine check-up
- Yes - 2 check-ups/yr
- What that includes
- 2 check-ups pp/yr (6-monthly); 2 scale & polish; X-rays; fillings; RCT; extractions; dentures
- Paid from
- Insured (risk) at 100% KDT (conservative)
- 2026 limits
- Code-based; crowns capped at 2 pp/yr
- Network rule
- Any dentist; KeyHealth Hospital Network
- Co-payments & gaps
- Crown 1 paid at 80% KDT (20% co-pay), crown 2 at 70% (30% co-pay); frames & perio at 80%; R2,060 admission co-pay; 30% non-network
Platinum
Check-up covered- Routine check-up
- Yes - 2 check-ups/yr
- What that includes
- 2 check-ups pp/yr; 2 scale & polish; X-rays; fillings; RCT; extractions; dentures
- Paid from
- Insured (risk) at 100% KDT (conservative)
- 2026 limits
- Implant components capped R5,700 pp/yr
- Network rule
- Any dentist; KeyHealth Hospital Network
- Co-payments & gaps
- Specialised paid at 80% KDT (20% co-pay); R2,060 admission co-pay; 30% non-network
Worth knowing before you book
- Essence covers only five listed codes a year — every filling, clean or extraction is your own cost.
- Origin's dental competes with your other day-to-day claims inside one family pool, and root canals and dentures aren't covered at all.
- Dental work in hospital carries a R2,060 admission co-payment (authorised day-clinic cases exempt), and a non-network hospital adds a 30% co-payment.
- Crowns start only at Gold — capped at two per person a year, with 20–30% co-payments — and implants are covered on Platinum alone.
Tell us your option — we’ll check your benefits before you visit.
This page describes the scheme’s published benefits — it isn’t financial advice, and every treatment plan here starts with a benefit check and a quote.