2026 benefit year · compiled from the scheme’s published documents
Sizwe Hosmed dental benefits, in plain language
Sizwe Hosmed's dental cover comes in two shapes. On the savings options — Value Platinum and Value Core — your conservative (everyday) dentistry is paid from your Medical Savings Account, subject to pre-authorisation and managed-care protocols; once the savings run out, further routine work is your own cost. Advanced dentistry, interestingly, works the other way around: it's funded from scheme risk, within limits.
On the traditional options, such as Gold Ascend, conservative dentistry is an insured day-to-day benefit per beneficiary, inside the option's limits — reach them, and the rest of the year is self-funded.
An honest caveat applies here: the scheme is currently under curatorship, and benefits are subject to approval. The structure of the 2026 cover is confirmed, but the rand limits aren't — so check your option guide, or ask the scheme, for current figures before committing to treatment. Claims are paid at the scheme's tariff rate, and hospital admissions run through network hospitals.
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Call nowHow it works at our practice
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.
Value Platinum / Value Core (savings options)
Check-up covered- Routine check-up
- Yes - from MSA
- What that includes
- Conservative dentistry paid from Medical Savings Account (pre-auth + managed care protocols)
- Paid from
- MSA; Advanced Dentistry from Scheme risk
- 2026 limits
- Per 2026 option guides (scheme under curatorship - benefits subject to approval)
- Network rule
- Scheme tariff rate; network hospitals
- Co-payments & gaps
- Savings empty = self-pay; above-tariff gap
Some figures for this option weren’t in the scheme’s primary 2026 document when we compiled this — we confirm them during your benefit check.
Gold Ascend / other traditional options
Check-up covered- Routine check-up
- Yes
- What that includes
- Conservative dentistry benefit per beneficiary within day-to-day limits
- Paid from
- Insured day-to-day
- 2026 limits
- Per 2026 option guide
- Network rule
- Network providers/hospitals
- Co-payments & gaps
- Beyond limits self-pay; note 19.15% contribution increase (Nov 2025) and curatorship
Some figures for this option weren’t in the scheme’s primary 2026 document when we compiled this — we confirm them during your benefit check.
Worth knowing before you book
- Even routine dentistry on the Value (savings) options needs pre-authorisation and follows managed-care protocols — check before you book.
- The scheme is under curatorship and benefits are subject to approval — confirm current 2026 limits before starting treatment.
- Once your savings (Value options) or day-to-day limits (traditional options) are used up, further dentistry is self-paid.
- Hospital admissions are subject to network-hospital rules — confirm before any in-hospital dental work.
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.