THE ESSENTIALS
Before you start
- Dental cover alone does not confirm payment for implants.
- Read the specific exclusion and any applicable contrary agreement.
- Request an answer identifying the estimate’s procedures and your own cost.
Read the specific exclusion
In Médis individual terms dated August 2025, clause 13(3) excludes implants and related procedures unless otherwise agreed in the particular conditions. The Dentistry special condition lists prostheses and other procedures subject to the contracted terms. Do not read that list separately from the exclusion.
This is a documentary example, not a product recommendation or a conclusion about Sofia’s policy. Ask whether an applicable provision addresses the proposed implant and its associated procedures. Finding the word prosthesis in a general table is not enough.
Itemise the plan before comparing its total
As preparation, ask the provider for an estimate identifying stages and procedures instead of a single line called treatment. Distinguish what is proposed, what has already been done and payments already made. Do not turn a commercial description into a clinical classification yourself.
Sofia creates one column for each procedure and another for the insurance answer. Clara asks for any exclusion, limit, charge or condition invoked to be connected to the correct line. An explanation about a consultation does not necessarily address the implant and the plan’s other procedures.
An appointment is not payment confirmation
Before committing to a planned expense in reliance on insurance funding, request confirmation for the relevant procedure, provider and contractual version. If information is missing, identify what is needed and the appropriate submission channel. A submitted request is not an approval.
Keep administrative assessment separate from the need for treatment. Do not delay necessary care or change a clinical plan because of this guide. Clinical information, images and identity documents should only go through the indicated private channel, outside public comments and messages.
Compare future protection against the actual need
Sofia can now ask a concrete comparison question: what kind of benefit exists, which procedures are considered and what cost remains hers? Dentist included does not summarise those answers. Keep the explanation with the estimate it concerns to avoid comparing different versions.
For an existing policy, use Policy support. To compare future protection, select Health under Request a quote on the RMACHADO site and describe the need without sending clinical details through a general form. A new proposal does not guarantee payment for treatment already begun or planned.
KEEP THESE QUESTIONS
Your checklist for the next conversation
- Collect the policy version and itemised estimate.
- Read the implant-specific rule and any contrary provisions.
- Obtain an answer for the actual procedures, provider and charges.
- Separate financial comparison from the clinical decision.
FROM THE ARTICLE TO YOUR SITUATION
Let us discuss your situation
Tell us what you want to protect. We review your request and help compare relevant terms. Requesting a quotation does not activate insurance.
Sources and transparency
Content updated on .
Consultation dates are stated in individual references when available.
Numerical examples are fictional and explain concepts. Editorial interpretations are identified in the text.
Information from RMACHADO GROUP. This is not an insurance offer or individual advice. Covers, acceptance, exclusions, sums insured and costs depend on the policy. The intermediary does not underwrite the risks.