TeamCare Level 2 Plan - Benefits

Applicable to new registrations or renewals on or after 1st November, 2015. This Schedule of Benefits must be read in conjunction with the DeCare Dental Terms and Conditions Booklet.

Section 1 - Investigative and Preventive Treatment – No Waiting Period Benefit Limit

Examinations

· Two times per calendar year 100%

Scaling and polishing

· Two times per calendar year 100%

Radiographs (x-rays):

Bitewings coverage:

· 1 series per 12 month period for insured persons up to the age of 18 years 100%

· 1 series per 24 month period for insured persons over 18 years 100%

Full Mouth (Complete Series) or Panoramic

· Covered once per 60-month period 100%

Periapical(s)

· 4 single x-rays are covered per 12-month period 100%

Occlusal

· 2 series per 24-month period 100%

Section 2 - Emergency Treatment – No Waiting Period Benefit Limit

· Once per 12 month period for the immediate, temporary relief of pain or infection 100%

Section 3 - Basic treatment – 3 month waiting period applies Benefit Limit

Restorations (fillings)

· Once per tooth surface per 24 month period 50%

Pre-fabricated or Stainless Steel Crowns

· Once per tooth per 60-month period for eligible dependant children up to the age of 19 50%

Sealants

· Once per tooth per lifetime for permanent first and second molars of eligible dependant children up to the age of 16 50%

Space Maintainers

· Once per tooth per lifetime on eligible dependant children up to the age of 17 for extracted primary posterior (back) teeth 50%

Periodontal Treatment

· Periodontal scaling and root planing - once per quadrant per 36 month period 50%

· Full mouth debridement - once per tooth per lifetime 50%

· Periodontal maintenance - once per 24 month period 50%

Tooth extractions

· Tooth extraction - once per tooth per lifetime 50%

Section 4 - Major treatment – 12 month waiting period applies Benefit Limit

Endodontic Therapy on Primary Teeth

· Pulpal therapy - once per tooth per lifetime 50%

· Therapeutic pulpotomy - once per tooth per lifetime 50%

Endodontic Therapy on Permanent Teeth

· Root canal therapy - once per tooth per lifetime 50%

Prosthetic Services - Dentures

· Removable prosthetic services (Dentures) - once per 5 year period 50%

· Reline and rebase - 1 per 24 month period 50%

· Repairs, replacement of broken artificial teeth, replacement of broken clasp(s) - 1 per 6 month period 50%

· Denture adjustments - 2 times per 12 month period 50%

Prosthetic Services - Bridge and Implant Supported Crowns

· Fixed prosthetic services (Bridge) - once per 5 year period 50%

· Bridge adjustments - 2 times per 12 month period 50%

· Implant supported crowns - once per tooth per 5-year period 50%

Crowns, Inlays and Onlays

· Permanent crowns, inlays and onlays - once per tooth per 5-year period 50%

· Crown repair - once per tooth per 12 month period 50%

Please Note:

A separate annual maximum of €500 per period of insurance applies to crowns, inlays and onlays. €500

Section 5 - Orthodontics - 18 Month Waiting Period Benefit Limit

Orthodontic treatment:

Orthodontic benefit is available for eligible dependent children aged 8 to 18 years. €750

Subject to a separate lifetime maximum of €750 per insured person

Section 6 – Annual Policy Maximum Benefit Limit

This applies to all sections of your plan (excluding crowns, inlays and onlays which has a separate maximum of €500). Maximum benefits may not be carried over to future years of cover.

· Annual policy maximum per member per year €1,750

This policy is underwritten by DeCare Dental Insurance Ireland DAC.

DeCare Dental Insurance Ireland DAC trading as DeCare Dental and DentalCover.ie is regulated by the Central Bank of Ireland.