Dental consultations
Extractions
Fillings
Dental X-rays & Prescription

Special Conditions

* All Premiums must be paid in full before commencement of cover
* All In Patient Bills will be paid nett of National Hospital Insurance Fund
* Doctor’s Fee is paid at 100% if APA panel is used, if you use your own doctor we settle 85% of the total bill or subject to APA panel rates
* All scheduled admissions must be reported to APA Insurance with at least 48 hours notice. Member must await APA preauthorisation before proceeding
* For emergency admissions the hospitals will contact APA within 48 hours of admission
* All waiting periods are subject to continuous renewal with no break in cover. Where there is a break in cover the waiting periods will apply afresh
* Fibroids, Hernias, Adenoidectomy and Haemorrhoids shall have a waiting period of 12 months
* Members must produce their medical cards to enable them access treatment at the accredited panel of providers
* Premiums are calculated based on the members age at next birthday
* Waiting Period 30 days for illness & 90 days for surgical procedures, waived for accident cases
* Age Limits: 1 month – 75 years (Maximum joining age 75 years). All renewals are subject to claims experience and underwriting guidelines.
* Benefits may not be payable if there is no full disclosure of any material facts that could influence our assessment and acceptance of this application.