Can I use my medical savings account for a check-up or a filling?

If your plan has a medical savings account, usually yes. A routine check-up, a scale and polish, X-rays and a simple filling are generally classed as basic or conservative dentistry, and are typically paid from your medical savings account first, at your scheme’s own tariff, until the available amount for the year is used up. This tariff is the scheme’s own published figure, not a practice’s fee, and many dentists charge more than it, so the patient pays that difference themselves, as a co-payment.

In short

• A medical savings account is the part of your monthly contribution that is set aside for your own day-to-day claims, including basic dental treatment.
• Basic or conservative dentistry, such as check-ups, cleaning, X-rays, fillings and simple extractions, is the category usually paid from this account.
• Once the account is used up for the year, some plans move to a further threshold benefit, and others leave you to pay for further treatment yourself.
• Specialised dentistry, such as crowns, implants and orthodontics, is usually paid differently, often with its own separate limit and its own pre-authorisation.
• Your available balance is shown on your scheme’s app, member website or statement, and you can also ask the practice whether they can check this for you.

How does a medical savings account work?

A medical savings account is the part of your contribution that a scheme sets aside for you to spend on your own day-to-day healthcare, rather than pooling it with other members’ contributions. The full annual amount is typically available to you from the start of the benefit year, even though you pay your contribution monthly, and the benefit year generally runs from 1 January to 31 December.

Which dental treatments are usually paid from the account?

Basic or conservative dentistry is the category generally paid from a medical savings account. This commonly includes a consultation or check-up, a scale and polish, intraoral X-rays, a simple filling and a simple extraction, paid from available day-to-day benefits, meaning the medical savings account first. On some plans, once the savings account is used up, dental benefits continue from the plan’s own threshold limit instead.

What happens when the account runs out?

This depends on your specific plan. Some plans move on to a further threshold benefit once the medical savings account is used up for the year, which continues to pay claims, sometimes at a different rate. Other plans have no further day-to-day benefit, and further treatment becomes a self-payment until the next benefit year. What dental work does medical aid usually not cover? covers some of the limits that apply even before the account runs out.

Does a savings account also pay for specialised dentistry?

Generally not on its own. Specialised dentistry, such as crowns, implants, orthodontics and periodontal treatment, usually draws on a separate part of the benefit, often with its own limit and its own pre-authorisation requirement, rather than simply being paid from the savings account. Cover for a dental emergency can also fall outside the savings account. See the dental emergency guidance on this site if you are in pain now, and Does medical aid cover emergency dental treatment in South Africa? for how cover is generally handled.

How do I check my own available balance?

Your scheme’s member app, website or call centre will show your current medical savings account balance and what has already been claimed against it. It is worth checking before a planned appointment, particularly if you know you need more than a simple check-up. You can also ask the practice whether they can check your cover, or ask about a written quotation, if you are not sure what your plan will pay.

How do I reach Dr Davies?

For a figure for your own treatment, call the practice’s reception, where fees are discussed, and ask for a written quotation after an examination. BRS Dental is not registered with medical aids, so it does not claim from them directly, but reception can help you submit your claim to your medical aid. For anything clinical, contact Dr Davies. Check your own plan before your appointment too.