Oroglee Joy Plan

Highlights
This plan includes a Dental Insurance cover of Rs 25,000 from Magma HDi General Insurance Company. This plan can be purchased post dental screening subject to meeting the eligibility criteria of the insurance company.
Validity of this plan is 1 year
Open for the age group 11 - 50 years
Zero payment/ Cashless for a variety of dental services and treatments across a large network of dental clinics
Only dental treatments and procedures that do not need general anaesthesia or can be done under local anaesthesia that are listed below will be covered
Coverage

Cavities are the early signs of tooth decay. Before the decay increases it is advisable to get the cavity filled to stop the decay from progressing.

As part of the plan you are eligible to get one cavity filled in any one tooth once in a year.

Sometimes the decay spreads to an extent that cavity filling may not be able to stop the decay. In such cases the dentist may advise a root canal treatment.

Based on the condition of the tooth the dentist shall decide if a normal root canal treatment will suffice. In certain cases the dentist may suggest a Root Canal Treatment with a Post and Core.

As part of the plan you are eligible to get one Root Canal Treatment on any one tooth once in a year. This root canal treatment may be with or without Post and Core.

RCT for third molars/ wisdom teeth is not covered.

After a RCT has been performed the dentist may advise an artifical cap/ crown to be placed to compensate for the loss of tooth structure.

For the front teeth (referred to as anterior teeth or teeth numbers 11,12,13,21,22,23,31,32,33,41,42,43 as per the FDI Numbering System) it is especially important that the crown color is similar to the color of your natural teeth. This is because the anterior teeth are part of your smile and are visible to others. Hence dentists recommend a Zirconia/ Pure ceramic crown so that the crown appears like a natural tooth

For the back teeth (referred to as posterior teeth or teeth numbers 14,15,16,17,24,25,26,27,34,35,36,37,44,45,46,47 as per the FDI Numbering System) you will be eligible for a DMLS/ PFM crown.

As part of the plan you are eligible to get one Crown (this could be a DMLS/ PFM crown or a Zirconia/ Pure ceramic crown) on any one tooth once in a year. Root canal treatment should have been performed on the tooth.

Crown placement for third molars/ wisdom teeth is not covered.

Due to any reason when a dentist believes that a natural tooth cannot be restored then he/ she may suggest removal of the tooth - this is called extraction.

This plan covers one tooth extraction in one year. The plan does not cover extraction of a third molar/ wisdom tooth.

It is recommended that an individual should visit a dentist for a check up at least once every year.

As part of the plan you are eligible to one consultation in one year alongwith any necessary IOPA X-Rays that the dentist may deem necessary.

As part of the plan you are eligible to get 15% discount on all treatments wherein you are making the payment to the dentist/ dental clinic.

You can utilize this discount as many times as necessary during the time your plan is active.

Max. discount Rs 10,000/treatment

It is necessary that the information about the accident is intimated to OroGlee within 48 hours of the accident for accident related dental cover eligibility.

You are eligible for upto Rs 25,000 in one year for accident related dental treatment.

The plan covers one abscess drainage in one year. The insurer will pay upto Rs 1,000 for an abscess drainage.

In case the abscess drainage is going to cost more than Rs 1,000 then the plan holder will have to pay the balance amount not paid by the insurer

The plan covers one cystectomy in one year. The insurer will pay upto Rs 1,500 for a cystectomy.

In case the cystectomy is going to cost more than Rs 1,500 then the plan holder will have to pay the balance amount not paid by the insurer

The plan covers excision of one periodontal outgrowth in one year. The insurer will pay upto Rs 1,000 for a periodontal growth excision.

In case the procedure is going to cost more than Rs 1,000 then the plan holder will have to pay the balance amount not paid by the insurer

Waiting period

Cavity filling

Root canal treatment

Crown placement

Extraction

Abscess drainage

Cystectomy

Excision

Accident related treatments

Consultation and IOPA X-rays

15% discount on all treatments

Pre-existing conditions

The services/ treatments covered by insurance do not cover any pre-existing condtions

The teeth that will not be covered by insurance will be mentioned in the insurance policy document from the insurance company

Exclusions

Orthodontic treatment/ Smile correction

Scaling/ cleaning of teeth

Cosmetic treatment

Teeth whitening

Dental jewellery

Extraction of third molar

Fluoride application

Periodontal flap surgery

Prosthodontic treatment/ cost of dentures

Diagnostics apart from IOPA X_rays as part of Consultation

Inpatient treatment

Primary dentition

Supernumary teeth

Pulpectomy/ pulpotomy procedures

Any procedure done/ needing general anaesthesia

Root canal treatment of the third molar

Crown for the the third molar

Special conditions

Accident clause will only be covered if intimation is done within 48 hours of the accident

Treatment and procedures should be done only in the network clinics

Implants will be covered only in accident injury cases

Extractions, root canal treatment and crown placement will not be covered for all third molars/ wisdom teeth

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