Odonto-stomatological treatment (dental treatment) and laboratory charges for dentures, prosthetic dental fees and radiology/radiography fees are all reimbursed at 80% subject to a maximum annual ceiling of CHF 2,500 per annum. Orthodontic treatment, including the cost of the apparatus, is included within the ceiling.
Attention: for temporary staff with contracts of less than 3 months, dental treatment is not covered except for emergency treatments approved by the Medical Advisor at 80% up to a maximum of CHF 500.
VERY IMPORTANT Please note:
- Teeth Whitening is EXCLUDED
- Any form of dental implant or bone grafts, related to such implant, fall within the annual Dental Limit
- The annual ceiling of CHF 2,500 can be accumulated over a maximum period of two calendar years (i.e. the maximum ceiling can be CHF 5,000 in the second calendar year assuming no dental expenses were submitted for reimbursement during the first year)
- The Supplementary Plan is NOT applicable in the case of Dental care.
- In the case of new membership the annual ceiling is accrued on a prorata monthly basis. For example, a member who joined the society three months ago will not have the full annual ceiling, they will accrue 1/12 of the CHF 2,500 ceiling every month. After 3 months the insured member would thus accrue 3/12 of the annual credit, which equates to CHF 625.
- For staff joining UNSMIS who have been covered under a similiar plan of the United Nations family of Organization for more than two years, the Dental credit will be calculated on the basis of the number of months remaining untill the end of the year. i.e for staff joining on 1 April of any given year and who have two or more years of participation in a similiar medical plan of one of the United Nation Organizations, the dental credit will be CHF 1,875 for the year (CHF 2,500 divided by 12 months and then multiplied by 9 months remaining to the end of the year)
The dental ceiling may be waived to the discretion of the Medical Officer if treatment is necessary following a serious accident (tooth breakage while eating is not considered a serious accident for example) or as a consequence of an illness. Remember to always request
Prior Authorization for any such waiver so as to avoid unpleasant surprises.
Your Dental Credits Balance is indicated on your latest Benefits Advice. This information CANNOT BE PROVIDED OVER THE PHONE.
The Dental Credit Balance changes at the start of each year because you can accumulate credits only for the last two years (today, for example, your balance for 2020 + your balance for 2021). The dental credit of each member, as explained above, is CHF 2,500 per year cumulative over 2 years, except for new members during the first year of affiliation for whom the calculation is prorated on the number of months of affiliation. It is important to note that due to the 24 month accumulation limit, dental expenses will always erode the dental credits of the current year and subsequently any carry over from the previous year. Hence if you have in 2021 a balance of CHF 2,500 for the current year and CHF 1,000 carried over from 2020, you have a total of CHF 3,500 for 2021. If you are reimbursed CHF 3,000 in 2021 for dental expenses, you will have no credit carried over to 2022 as firstly the 2021 credit is eroded, then the remainder is reimbursed with the 2020 credit brought forward to 2021 ( which cannot be brought forward to 2022).
It is not necessary to get our Medical Advisor’s prior authorization for dental and/or orthodontic treatment.