2026 benefit guide · confirm your current option with the scheme
KeyHealth dental benefits, in plain language
KeyHealth provides different code-based dental benefits across its options. Essence covers five listed out-of-hospital codes including an annual examination and limited intraoral X-rays; it does not provide ordinary cleaning or filling benefits. Origin instead uses a pooled day-to-day family allowance for routine care.
Equilibrium and Silver provide one routine check-up yearly, while Gold and Platinum provide two six months apart. These benefits use the KeyHealth Dental Tariff and still have treatment-specific restrictions. Gold adds crowns and partial frames with co-payments; Platinum includes defined implant benefits.
Planned dental admissions use the KeyHealth Hospital Network. The source distinguishes authorised day-clinic care and emergency/PMB admissions from voluntary non-network hospital treatment; those exceptions matter when assessing a co-payment.
AIM Dental is at AIM Healthcare Centre in Malanshof, Randburg. Reception can help with a treatment quote; your scheme confirms cover for your option.
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Call nowHow it works at our practice
We claim directly from medical aids. Bring your card and option name, ask for a written treatment quote, and confirm current benefits, authorisation requirements and any expected co-payment with your scheme. A benefit check does not guarantee final claim payment; you remain responsible for amounts your scheme does not pay. We quote before we treat. If a network rule applies, ask your scheme to confirm this practice’s eligibility for your option and treatment.
Option by option
Reference first compiled on 2026-07-29 for the 2026 benefit year. Reference reconciled 2026-11-03. Source review: 2026-11-03. Details and available benefits depend on your exact option. Confirm your personal cover before treatment.
Essence
Benefit listed — rules apply- Routine check-up
- Yes — one per year under the five-code benefit
- What that includes
- One consultation at least six months after the prior year’s consultation; limited gloves/masks, one sterile tray and four intraoral X-rays per beneficiary per year. No extraoral X-ray benefit.
- Paid from
- The five listed out-of-hospital codes are paid by DENIS at the KeyHealth Dental Tariff (KDT).
- 2026 limits
- Five-code benefit only; other out-of-hospital treatment is excluded except authorised PMB events.
- Network rule
- Confirm this benefit and its current limits with your scheme.
- Co-payments & gaps
- R2,060 per authorised hospital admission; authorised day-clinic dental cases are exempt. Voluntary non-network hospital use can attract 30%; the table waives the non-network co-payment for emergency/PMB admission. Charges above the applicable dental tariff may leave a gap.
Origin
Benefit listed — rules apply- Routine check-up
- Yes — one routine and three emergency consultations per year
- What that includes
- One check-up, three specific emergency consultations and four intraoral X-rays per beneficiary yearly; a scale/polish, eligible fillings and extractions are subject to protocols and available funds.
- Paid from
- Shared day-to-day family benefit, except pre-authorised impacted-tooth removal which uses risk.
- 2026 limits
- Family allowance built from R3,425 principal member + R1,990 per adult dependant + R1,050 per child per year; other day-to-day claims use the same pool.
- Network rule
- Confirm this benefit and its current limits with your scheme.
- Co-payments & gaps
- R2,060 per authorised hospital admission; authorised day-clinic dental cases are exempt. Voluntary non-network hospital use can attract 30%; the table waives the non-network co-payment for emergency/PMB admission. Charges above the applicable dental tariff may leave a gap. Depletion of the family pool can leave routine costs unpaid.
Equilibrium
Benefit listed — rules apply- Routine check-up
- Yes — 1 per year
- What that includes
- 1 check-up per beneficiary yearly; one scale-and-polish treatment. Listed fillings, root canals, extractions and plastic dentures have code/frequency rules. Three specific emergency consultations and four intraoral X-rays yearly.
- Paid from
- Dental benefits at KDT, subject to option-specific code, clinical and authorisation rules.
- 2026 limits
- Code and frequency limits at KDT; plastic dentures normally one upper/lower set per beneficiary in four years.
- Network rule
- Confirm this benefit and its current limits with your scheme.
- Co-payments & gaps
- R2,060 per authorised hospital admission; authorised day-clinic dental cases are exempt. Voluntary non-network hospital use can attract 30%; the table waives the non-network co-payment for emergency/PMB admission. Charges above the applicable dental tariff may leave a gap.
Silver
Benefit listed — rules apply- Routine check-up
- Yes — 1 per year
- What that includes
- 1 check-up per beneficiary yearly; one scale-and-polish treatment. Listed fillings, root canals, extractions and plastic dentures have code/frequency rules.
- Paid from
- Dental benefits at KDT, subject to option-specific code, clinical and authorisation rules.
- 2026 limits
- Code and frequency limits at KDT; plastic dentures normally one upper/lower set per beneficiary in four years.
- Network rule
- Confirm this benefit and its current limits with your scheme.
- Co-payments & gaps
- R2,060 per authorised hospital admission; authorised day-clinic dental cases are exempt. Voluntary non-network hospital use can attract 30%; the table waives the non-network co-payment for emergency/PMB admission. Charges above the applicable dental tariff may leave a gap.
Gold
Benefit listed — rules apply- Routine check-up
- Yes — 2 per year, six months apart
- What that includes
- 2 check-ups per beneficiary yearly; two six-monthly scale-and-polish treatments. Listed fillings, root canals, extractions and plastic dentures have code/frequency rules.
- Paid from
- Dental benefits at KDT, subject to option-specific code, clinical and authorisation rules.
- 2026 limits
- Two-crown yearly limit; one partial frame per beneficiary in five years. Ordinary conservative care at 100% KDT.
- Network rule
- Confirm this benefit and its current limits with your scheme.
- Co-payments & gaps
- R2,060 per authorised hospital admission; authorised day-clinic dental cases are exempt. Voluntary non-network hospital use can attract 30%; the table waives the non-network co-payment for emergency/PMB admission. Charges above the applicable dental tariff may leave a gap.
Platinum
Benefit listed — rules apply- Routine check-up
- Yes — 2 per year, six months apart
- What that includes
- 2 check-ups per beneficiary yearly; two six-monthly scale-and-polish treatments. Listed fillings, root canals, extractions and plastic dentures have code/frequency rules.
- Paid from
- Dental benefits at KDT, subject to option-specific code, clinical and authorisation rules.
- 2026 limits
- Implant components R5,700 per beneficiary per year. Two partial frames per beneficiary in five years; ordinary conservative care at 100% KDT.
- Network rule
- Confirm this benefit and its current limits with your scheme.
- Co-payments & gaps
- R2,060 per authorised hospital admission; authorised day-clinic dental cases are exempt. Voluntary non-network hospital use can attract 30%; the table waives the non-network co-payment for emergency/PMB admission. Charges above the applicable dental tariff may leave a gap.
Read the official sources
Worth knowing before you book
- Origin’s allowance is R3,425 principal + R1,990 adult + R1,050 child, shared with other day-to-day claims.
- Essence’s exclusions have authorised PMB exceptions; do not turn a routine exclusion into a claim that emergency care can never qualify.
- The R2,060 hospital admission co-payment does not apply to authorised day-clinic dental cases; the non-network co-payment is waived for emergency/PMB admissions in this table.
- Gold’s two crowns pay at 80% and 70% KDT; Platinum implant components are limited to R5,700 per beneficiary yearly.
Have your scheme and option name ready when you contact reception.
This guide helps you discuss dental cover; it isn’t financial advice or confirmation of personal cover. Confirm current benefits with your scheme and get a written treatment quote. Final payment depends on the claim assessment.